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Head and neck AM > Neck anatomy and physiology > Flashcards

Neck anatomy and physiology Flashcards

1
Q

What are the anatomical contents of the neck?

A 
Arteries
Veins
Nerves
Lymph nodes
Lymphatic channels
Thyroid gland
Parathyroid gland
Muscles
Trachea
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2
Q

What are the boundaries of the neck?

A

Superior- mandible
Inferior- clavicle
Anterior- anterior midline
Posterior- trapezius

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3
Q

What are the 2 triangles of the neck?

A

Anterior and posterior triangles

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4
Q

What are the borders of the anterior triangle of the neck?

A

Anterior- midline
Posterior- anterior border of sternocleidomastoid
Superior- mandible

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5
Q

What are the borders of the posterior triangle of the neck?

A

Anterior- posterior boxer of sternocleidomastoid
Posterior- anterior border of trapezius
Inferior- clavicle

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6
Q

What structures are in the anterior triangle of the neck?

A 
Common carotid artery
External and internal carotid artery
Facial artery
Internal jugu;ar vein
Facial vein
Hypoglossal nerves
Vagus nerves
Glossopharyngeal nerves
Accessory nerves
Laryngeal nerves
Submandibular and submittal nodes
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7
Q

What are the contents of the posterior triangle of the neck?

A 
Accessory nerve
Cervical nerve plexus
Occipital artery
External jugular vein
Lymph nodes
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8
Q

At what level does the common carotid divide?

A

C4

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9
Q

What are the branches of the external carotid?

A 
Superior thyroid
Ascending pharygeal
Lingual
Occipital
Facial
Posterior auricular
Maxillary
Superficial temporal
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10
Q

What are the main veins of the head and neck?

A 
External jugular
Anterior jugular
Communicating
Maxillary
Facial
Suprotrochlear
Supraorbital
Posterior external jugular
Oblique jugular
Retromandibular
Posterior auricular
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11
Q

What are the lymph node levels?

A 
I= submandibular;ar and submental
II-IV= Upper, middle and lower jugular
V= posterior triangle 
VI= Midline nodes
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12
Q

What do the parotid nodes drain?

A

Scalp, face and parotid gland

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13
Q

What do the occipital nodes drain?

A

Scalp

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14
Q

What do the superficial and cervical nodes drain?

A

Breast and solid viscera

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15
Q

What do the deep cervical nodes drain?

A

Final drainage pathway to the thoracic duct

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16
Q

What do the submandibular nodes drain?

A

Tongue, nose, paranasal sinuses, submandibular gland, oral cavity

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17
Q

What do the submental nodes drain?

A

Lips, floor of mouth

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18
Q

What dot he supraclavicular nodes drain?

A

Breast, oesophagus, solid viscera

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19
Q

What are the causes of lymphadenopathy?

A

Infective
Inflammatory
Malignant

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20
Q

What is the structure of the thyroid gland?

A

2 lobes connected by isthmus

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21
Q

What does the thyroid gland produce?

A

Thyroid hormones and calcitonin

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22
Q

What does calcitonin do?

A

Acts to lower calcium and raise phosphate

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23
Q

What is a thyroglossal cyst?

A

Dilation of the thyroglossal duct remnant

24
Q

What are the causes of a solitary thyroid nodule?

A

Cyst
Adenoma
Carcinoma
Lymphoma

25
Q

What causes a thyroid cyst?

A

Localised haemorrhage

26
Q

How is a solitary thyroid mass investigated?

A

Fine needle aspiration cytology and ultrasound scanning

27
Q

What causes diffuse thyroid enlargement?

A

Colloid gotre
Grave’s disease
Thyroiditis

28
Q

What is Colloid goitre and what is the cause?

A

Iodine deficiency due to gland hyperplasia

Can be caused by puberty, pregnancy, lactation

29
Q

What is Grave’s disease?

A

Autoimmune disease resulting in hyperthyroidism

30
Q

What does Grave’s disease cause?

A

Thyroid eye disease
Acrophachy/clubbing
Pre tibial myxoedema

31
Q

What is the treatment of Grave’s disease?

A

anti-thyroids
Beta blockade
Radio-iodine
Surgery

32
Q

What causes multi nodular goitre?

A

Grave’s disease or toxic goitre

33
Q

What investigations are carried out for multi-nodular goitre?

A

TFTs
Fine needle aspration cytology
CXR

34
Q

What are the forms of thyroid cancer?

A

Papillary
FollicularMedullary
Anaplastic

35
Q

What are the indications for a thyroidectomy?

A 
Airway obstruction
Malignancy/suspected malignancy
Thyrotoxicosis
Cosmesis
Retrosternal extension
36
Q

What are the possible complications of a thyroidectomy?

A 
Bleeding
Voice hoarseness
Thyroid storm
Infection
Hypoparathyroidism
Hypothyroidism
Scar
37
Q

How many parathyroid glands are there?

A

4 usually

38
Q

What is the function of the parathyroid glands?

A

Regulate calcium and phosphate levels

39
Q

Where are the parathyroid glands located?

A

Posterior to the poles of the thyroid

40
Q

What are the signs and symptoms of parathyroid disease?

A

Renal canaliculi, polyuria, renal failure
Pathological fractures, osteropososis, bone pain
Abdo pain, constipation, peptic ulceration, pancreatitis, weight loss
Anxiety and depression, confusion, paranoia

41
Q

What investigations are carried out for parathyroid disease?

A 
U+E, creatinine, Ca, phosphate
Parathyroid hormone, bicarb
Vit D
Ultrasound
CT/MRI
Isotope scanning
42
Q

What is the treatment for hyperparathyroidism?

A

Surgery

Medical treatment

43
Q

What is the treatment for parathyroid disease, excluding hyperparathyroidism?

A

Medical treatment

44
Q

What surgical treatments can be done for hyperparathyroidism?

A

Removal of single or multiple adenomas or hyper plastic glands
Removal of carcinomas with thyroid glands and lymph nodes

45
Q

What ar he 4 fascial layers of the neck?

A

Pre-tracheal
Pre-vertebral
Deep cervical
Carotid sheath

46
Q

What are the indications for tracheostomy?

A

Airway obstruction
Airway protection
Poor ventilation to reduce dead space

47
Q

What are the causes of inspiratory stridor?

A

Laryngeal

48
Q

What are the causes of expiratory stridor?

A

Tracheobronchial

49
Q

What are the causes of biphasic stridor?

A

Glottic/subglottic

50
Q

How is stridor terated

A

O2
adrenaline (neb)
IV dexamethasone
Definitive airway management

51
Q

What is a brachial cyst?

A

Remnant of fusion failure of brachial arches or lymph node cystic degeneration

52
Q

Where do brachial cysts arise?

A

Anterior to sternocleidomastoid at junction between upper and middle thirds of trachea

53
Q

What is the treatment for a brachial cyst?

A

Excision

54
Q

What is a pharyngeal pouch?

A

Herniation of pharyngeal mucosa through thyropharyngeus and cricopharynxgeus muscles of the inferior constrictor of the pharynx

55
Q

What are the signs and symptoms of a pharyngeal pouch?

A 
Voice hoarseness
Regurgitation
Dysphagia
Weight loss
Aspiration pneumonia
Neoplasia
56
Q

What investigations are done for a pharyngeal pouch?

A

Barium swallow

57
Q

How is a pharyngeal pouch treated?

A

Excision

Dilation

Head and neck AM (13 decks)

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