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Head and Neck - Year 2 > Neck > Flashcards

Neck Flashcards

1
Q

What is the superior border of the neck?

A

Mandible

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2
Q

What is the inferior border of the neck?

A

Clavicle

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3
Q

What is the anterior border of the neck?

A

Anterior midline

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4
Q

What is the posterior border of the neck?

A

Trapezius

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5
Q

What is the anterior and posterior borders of the anterior triangle?

A 
Anterior = midline of neck
Posterior = anterior border of sternocleidomastoid
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6
Q

What is the anterior and posterior borders of the posterior triangle?

A 
Anterior = posterior border of sternocleidomastoid
Posterior = anterior border of trapezius
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7
Q

Which arteries are in the anterior triangle?

A

Common carotid
External carotid
Internal carotid
Facial

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8
Q

Which veins are in the anterior triangle?

A

Internal jugular

Facial

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9
Q

Which nerves are in the anterior triangle?

A 
Hypoglossal
Vagus
Glossopharyngeal
Accessory
Laryngeal
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10
Q

Which lymph nodes are in the anterior triangle?

A

Submandibular

Submental

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11
Q

Which nerves are in the posterior triangle?

A

Accessory

Cervical nerve plexus

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12
Q

Which blood vessels are in the posterior triangle?

A

Occipital artery

External jugular vein

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13
Q

Which level does the common carotid artery divide?

A

C4

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14
Q

What are the branches of the external carotid artery?

A 
Superior thyroid
Ascending pharyngeal
Lingual
Occipital
Facial
Posterior auricular
Maxillary
Superficial temporal
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15
Q

What are central lines used for?

A 
Central venous pressure
Drug administration
Cardiac pacing
Blood sampling
Fluid resuscitation
Haemodialysis
IV nutrition
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16
Q

What are the complications of central lines?

A 
Pneumothorax
Haematoma
Cardiac tamponade
Air embolism
Chylothorax
False passage
Thrombosis
Sepsis
Line blockage
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17
Q

Where do the lymph nodes in the neck drain to?

A

Cisterna chyli then to thoracic duct (left)

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18
Q

What do the parotid nodes drain?

A

Scalp
Face
Parotid gland

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19
Q

What do the occipital nodes drain?

A

Scalp

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20
Q

What do the superficial cervical nodes drain?

A

Breast

Solid viscera

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21
Q

What do deep cervical nodes drain?

A

Final drainage pathway to thoracic duct

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22
Q

What do submandibular nodes drain?

A 
Tongue
Nose
Paranasal sinuses
Submandibular gland
Oral cavity
23
Q

What do submental nodes drain?

A

Lips

Floor of mouth

24
Q

What do supraclaviculas nodes drain?

A

Breast
Oesophagus
Solid viscera

25
Q

What type of gland is the thyroid?

A

Endocrine

26
Q

What is the structure of the thyroid gland?

A 
2 lobes (left and right)
Joined by isthmus
27
Q

What does the thyroid gland produce?

A

Thyroid hormone

Calcitonin

28
Q

What is the role of calcitonin?

A

Acts to lower calcium and raise phosphate

29
Q

What is a thyroglossal cyst?

A

Dilatation of thyroglossal duct remnant

30
Q

What are the causes of a solitary thyroid nodule?

A

Cyst (localised haemorrhage)
Adenoma (benign follicular tissue)
Carcinoma
Lymphoma

31
Q

How is investigation of a solitary thyroid nodule done?

A

Fine-needle aspiration cytology AND USS

32
Q

What are the different types of thyroid cancer?

A 
Papillary = lymphatic metastasis
Follicular = haematogenous metastasis
Medullary = familial association
Anaplastic = aggressive, local spread
33
Q

What are the causes of diffuse thyroid enlargement?

A

Colloid goitre (gland hyperplasia, iodine deficiency, puberty, pregnancy, lactation)
Grave’s disease
Thyroiditis

34
Q

What is Grave’s disease?

A

When auto-antibodies against thyroid-stimulating hormone receptor stimulates receptor = hyperthyroidism

35
Q

What is the treatment for Grave’s disease?

A

Anti-thyroids
Beta-blockage
Radio-iodine
Surgery

36
Q

What are the indications for a thyroidectomy?

A 
Airway obstruction
Malignancy or suspected malignancy
Thyrotoxicosis
Cosmesis
Retrosternal extension
37
Q

What are the complications of a thyroidectomy?

A 
Bleeding (primary or secondary)
Voice hoarseness
Thyroid storm
Infection
Hypoparathyroidism
Hypothyroidism
Scar
38
Q

What is a multi-nodular goitre?

A

Due to Grave’s disease or toxic goitre

39
Q

What investigations are done for multi-nodular goitre?

A

Thyroid function tests
FNAC
CXR

40
Q

What is the role of parathyroid glands?

A

Regulate calcium and phosphate levels

41
Q

What are the signs of parathyroid disease?

A

Renal calculi, polyuria, renal failure
Pathological fractures, osteoporosis, bone pain
Abdominal pain, constipation, peptic ulceration, pancreatitis, weight loss
Anxiety, depression, confusion, paranoia

42
Q

What are the investigations for parathyroid disease?

A

U+Es, creatinine, calcium, phosphate
Parathyroid hormone, bicarbonate, vitamin D, USS, CT/MRI (identify ectopic glands), isotope scanning (detect diseased glands)
Surgery (ONLY for hyperparathyroidism)

43
Q

What are the causes for hyperparathyroidism?

A

Adenoma
Hyperplasia (12%)
Malignancy (rare)

44
Q

How is parathyroid disease managed?

A

Medical treatment
Surgery
Remove single/multiple adenomas
Remove 3 or 3.5 hyperplastic glands through neck exploration
Carcinomas removed with thyroid gland and lymph nodes

45
Q

What are the 4 fascial layers of the neck?

A

Pre-tracheal
Pre-vertebral
Deep cervical
Carotid sheath

46
Q

What are the indications for a tracheostomy?

A

Airway obstruction
Airway protection
Poor ventilation to reduce dead space

47
Q

What is the sign of laryngeal obstruction?

A

Inspiratory stridor

48
Q

What is the sign of tracheobronchial obstruction?

A

Expiratory stridor

49
Q

What is the sign of glottic/subglottic obstruction?

A

Biphasic stridor

50
Q

How is stridor treated?

A

O2
Nebulised adrenaline
IV dexamethasone

51
Q

What is a branchial cyst?

A

Remnant of fusion failure of branchial arches OR lymph node cystic degeneration

52
Q

What is a pharyngeal pouch?

A

Herniation of pharyngeal mucosa between thryopharyngeus and cricopharyngeus muscles of the inferior constrictor of the pharynx

53
Q

What are the signs of a pharyneal pouch?

A 
Voice hoarseness
Dysphagia
Aspiration pneumonia
Regurgitation
Weight loss
Neoplasia (1%)

Head and Neck - Year 2 (14 decks)

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