neck Flashcards
what are the anatomical contents in the neck?
Arteries Veins Nerves Lymph nodes Lymphatic channels Thyroid gland Parathyroid glands Muscles Trachea
what is the superior boundry of the neck?
mandible
what is the inferior boundry of the neck?
clavicle
what is the anterior boundry of the neck?
anterior midline
what is the posterior boundry of the neck?
trapezius
what is anterior to the anterior triangle of the neck?
midline of the neck
what is posterior to the anterior triangle of the neck?
anterior border of sternocleidomastoid
what is anterior to the posterior triangle of the neck?
posterior border of sternocleidomastoid
what is posterior to the posterior triangle of the neck?
anterior border of trapezius
what are the contents of the anterior triangle?
Common carotid artery Internal carotid artery External carotid artery Internal jugular vein Facial artery Facial vein Hypoglossal nerves Accessory nerves Vagus nerves Laryngeal nerves Glossopharyngeal nerves Submandibular nodes Submental nodes
what are the posterior triangle contents of the neck?
Accessory nerve Cervical nerve plexus Occipital artery External jugular vein Lymph nodes
indications for central lines
Central venous pressure Fluid resuscitation
Drug administration Haemodialysis
Cardiac pacing Intravenous nutrition
Blood sampling
complications of central lines
Pneumothorax Air embolism Thrombosis Haematoma Chylothorax Sepsis Cardiac tamponade False passage Line blockage
how many lymph nodes are there in the head and neck
600
where do lymphh nodes in head anad neck drain to?
cisterna chyli then drain to thoracic duct
where does the parotid node drain from?
scalp, face and parotid gland
where does the occipital node drain from?
scalp
where does the superficial cervical node drain from?
final drainage pathway to thoracic duct
where does the submandibular node drain from?
tongue, nose, paranasal sinuses, submandibular gland and oral cavity
where does the submental nodes drain from?
lips and floor of mouth
where do the supraclaviculas node drain from?
breast, oesophagus and solid viscera
what is Lymphadenopathy
disease of the lymph nodes, in which they are abnormal in size or consistency
what type of gland is the thyroid gland?
endocrine gland
how many lobes does the thyroid gland have?
2
what are the lobes joined by in the thyroid gland?
isthmus
what does the thyroid gland produce?
thyroid hormone and calcitonin
what is the function of calcitonin?
acts to lower calcium and raise phosphate
what is a thyroglossal cyst?
dilation of thyroglossal duct remnant
who is more likely to get a solitary thyroid nodule?
female of 30-40 years old
how do you investigate a solitary thyroid nodule?
fine-needle aspiration cytology and ulrasound scanning
can a fine needle aspiration cytology distinguish between a follicular adenoma and a follicular carcinoma
no
what is papillary thyroid cancer?
lymphatic metastasis
what is follicular thyroid cancer
haematogenous metastesis
what is medullary thyroid cancer?
familial association 10% arise from parafollicular C cells
what is anaplastic thyroid cancer?
aggressive, local spread, very old, poor prognosis
how does Colloid goitre form
due to gland hyperplasia iodine deficiency puberty, pregnancy, lactation
what is graves disease?
autoimmune disorder that causes hyperthyroidism, or overactive thyroid. With this disease, your immune system attacks the thyroid and causes it to make more thyroid hormone than your body needs
treatment for graves disease
anti-thyroids
beta blockers
radio-iodine
surgery
indications for thyroidectomy
Airway obstruction Malignancy or suspected malignancy Thyrotoxicosis Cosmesis Retrosternal extension
complications of thyroidectomy
Bleeding-primary or secondary Voice hoarseness Thyroid storm Infection Hypoparathyroidism Hypothyroidism Scar (keloid/ hypertrophic)
why would someone get multi-nodular goitre?
due to graves disease or toxic goitre
whos more likely to get multi- nodular goitre?
women, middle aged with hyperthyroidism
how many parathyroid glands are there?
4 usually
function of the parathyroid glands?
Regulate calcium & phosphate levels
where are the parathyroid glands locarted?
posterior to poles of thyroid
what can parathyroid disease cause?
PAINFUL STONES ACHING BONES PSYCHIC MOANS ABDOMINAL GROANS Renal calculi, polyuria, renal failure Pathological fractures, osteoporosis, bone pain
Abdominal pain, constipation, peptic ulceration, pancreatitis, weight loss
Anxiety & depression, confusion, paranoia
how to investigate parathyroid disease
Urea & electrolytes, creatinine, calcium, phosphate Parathyroid hormone, bicarbonate Vitamin D Ultrasound scan CT/MRI: identify ectopic glands Isotope scanning: detect diseased glands
treatment of parathyroid disease
surgery
fascia of the neck
4 Fascial layers Pre-tracheal Pre-vertebral Deep cervical Carotid sheath
indications for tracheostomy
Airway obstruction
Airway protection
Poor ventilation to reduce dead space
treatment for stridor
O2, Nebulised Adrenaline, IV Dexamethasone, (Heliox), (Definitive) airway management
how does a branchial cysts occur?
Remnant of fusion failure of branchial arches OR lymph node cystic degeneration
what is a pharyngeal pouch?
Herniation of pharyngeal mucosa between
thyropharyngeus and cricopharyngeus muscles of the
inferior constrictor of the pharynx
symptoms of pharyngeal pouch
Voice hoarseness Regurgitation
Dysphagia Weight loss
Aspiration pneumonia Neoplasia 1%
investigation of pharyngeal pouch
Barium swallow; excision (endoscopic or open); dilate
