Neck Anatomy and physiology Flashcards
what is a thyroglossal cyst?
Dilatation of thyroglossal duct remnant (birth defect)
describe the signs of a thyroglossal cyst
midline neck lump
Moves on tongue protrusion
usually painless, smooth and cystic
if infected, pain can occur
give three causes of a thyroid mass
Solitary nodule
Diffuse enlargement
Multi-nodular goitre
what are the causes of Solitary thyroid nodule?
Cyst: due to localised haemorrhage Adenoma: benign follicular tissue Carcinoma Lymphoma Prominent nodule in multi-nodular goitre
how would you investigate a Solitary thyroid nodule
Investigate by fine-needle aspiration cytology (FNAC) ultrasound scanning
what investigation can distinguish between a follicular adenoma and a follicular carcinoma?
FNAC CANNOT
tissue required for histological diagnosis=THYROID LOBECTOMY
What is simple diffuse goiter?
the enlargement of the entire thyroid gland
often displayed by adolescents (at puberty)
What is Graves’ disease?
Auto-antibodies against thyroid-stimulating hormone receptor stimulate receptor
Hyperthyroidism results
who is more susceptible to thyroid disorders?
women
what are Indications for Thyroidectomy?
Airway obstruction Malignancy or suspected malignancy Thyrotoxicosis Cosmesis Retrosternal extension
what causes Multi-nodular goitre?
Grave’s disease OR toxic goitre
what are indications of toxic goitre?
Older, no eye signs, atrial fibrillation
give the Symptoms of Parathyroid Disease (Hyperparathyroidism)?
Renal calculi, polyuria, renal failure
Pathological fractures, osteoporosis, bone pain
Abdominal pain, constipation, peptic ulceration, pancreatitis, weight loss
Anxiety & depression, confusion, paranoia
what causes Hyperparathyroidism?
too much parathyroid hormone (PTH) which can lead to:
high blood calcium and/or high blood phosphate
what can lead to Hyperparathyroidism?
Adenoma 80%
Hyperplasia 12%
Malignancy (rare)
what is the treatment for Parathyroid disease?
Surgery easiest if patient fit
what is stridor?
a harsh or grating sound
Clinical sign of airway obstruction
where is the obstruction if the stridor occurs on:
- Inspiratory
- Expiratory(wheeze)
- Biphasic
Inspiratory - laryngeal
Expiratory - tracheobronchial
Biphasic – glottic/subglottic
how would you treat stridor?
O2, Nebulised Adrenaline, IV Dexamethasone, (Heliox), (Definitive) airway management
what is a Branchial cyst?
Remnant of fusion failure of branchial arches OR lymph node cystic degeneration
arises on the lateral part of the neck
what is a Pharyngeal pouch?
Herniation of pharyngeal mucosa between
thyropharyngeus and cricopharyngeus muscles of the
inferior constrictor of the pharynx
what are symptoms of a Pharyngeal pouch?
Voice hoarseness Regurgitation Dysphagia Weight loss Aspiration pneumonia
