neck-endo pulm gastro

Question 1

which cervical triangle hold the thyroid and parathyroid gland

Answer 1

muscular triangle (inferior anterior triangle)

Question 2

where can aberrant thyroid gland tissue be seen ? what is this important?

Answer 2

along the embryonic thryoglossbal duct
(from tongue to thyroid)
-cysts can form along duct and and cause problems with the hyoid bone and swallowing
-may need to be removed

Question 3

what is accessory thryoid gland

Answer 3

thyroid glandular tissue found along the thyroglossal duct

-can run into problems if trying to do tracheotomy

Question 4

what is the pyramidal lobe of the of the thyroid gland

Answer 4

• tissue found climbing up middle of isthmus anteriorly
• present in 50% of people
• can extend all the way up to the hyoid bone
• can be there without isthmus as well

Question 5

what is a thyroid Ima A.

Answer 5

10% of people have this accessory artery to the thyroid mainly coming from brachiocephalic trunk (or aorta or common carotid) the travels anteriorly up the middle of the trachea and continues to the thyroid isthmus
*must be considered before a tracheotomy bc it can be a source of bleeding

Question 6

what structures must be careful saved during a thyroidectomy

Answer 6

there is a rich blood supply to the thyroid (inferior thyroid a. ) , and laryngeal nerves (especially recurrent laryngeal) and parathyroid glands are near and should be left in place

can be done transorally to avoid a scar

Question 7

in the nasopharnyx and oropharynx what is the structure that passes from the nasal cavity to the nasopharynx and oral cavity to oropharpnyx

Answer 7

choanae to nasal cavity

fauces to oral cavity

Question 8

the soft palate ends at the

Answer 8

uvula

Question 9

the pharyngotympanic tube connects? and important because?

Answer 9

middle ear to nasopharynx to equalize pressure

located in the ring of torus tubarius

Question 10

what is the function of the salpingopharyngeal M. covered by salphingophayrngeal fold coming from the torus tubarius at the top

Answer 10

• elevates the pharnyx

- equilzes pressure by pulling on the torus tubularis

Question 11

what is the “false” vocal cords? “true” vocal cords? and space above and between?

Answer 11

space above- laryngeal vestibule 
false -  the  vestibular folds 
space b/t - laryngeal ventricle 
true-vocal fold 
-infraglottic cavity lies below vocal fold before the trachea

Question 12

what is the glottis

Answer 12

the vocal fold plus the rimma glottidis
(the space plus the ligaments muscle and mucosa around)
*hence why the infra glottis cavity is below the glottis

Question 13

what are the contents of the vocal fold

Answer 13

the vocal fold is a mucosal covering around:

1. conus elasticus (the vocal L. plus the lateral cricothyroid L.)
2. vocalis M.

Question 14

describe the process of aspiration of a foreign body

Answer 14

foreign body entering the the airway and gets stuck in the vestibular folds. this causes spasm of the muscles and prevents air to get to the lungs.
-compression of the stomach (hemlock maneuver) can force air out and dislodge the obstruction

Question 15

what is a cricothyrotomy

Answer 15

• when intubation is not possible
• emergent procedure
• needle passage into the larynx through the Cricothyroid membrane to create a space where a catheter can be inserted to make an airway

Cricothyroid membrane is the space between the thryoid and cricoid cartilages

Question 16

what is a tracheostomy

Answer 16

• less emergent procedure
• incision through skin, retraction of the infra hyoid muscles, separation and retraction of the thyroid gland isthmus, insertion of tube inside the trachea to make an airway
• typically at the 2 or 3rd rings of the trachea

Question 17

where is the thyroid cartilage located? thryoid gland?

Answer 17

cartilage- in the larynx

gland- on top the trachea

Question 18

describe the changes to the larynx as you age

Answer 18

• the larynx grows steadily till age 3 when it stops in both males and females
• at puberty, testosterone in males causes the laryngeal cartilages to grow (increasing the size of the vocal cord and voice box) which causes the voice to become deeper and a prominent adams apple
• after age 65 ossification of the laryngeal cartilages occurs and causes the voice to sound weak

Question 19

how do you treat cancer of the larynx if there is malignancy or damage to vocal cords

Answer 19

• common in those who smoke
  1. tracheostomy
  2. laryngoectomy
• electrolayrnx (electronic voice box), tracheoesophageal prothesis, or esophageal speech (burping words)

Question 20

how far does the pharynx extend

Answer 20

from the base of the skull to the inferior border of the cricoid cartilage

Question 21

what does the larynx connect

Answer 21

the oropharynx to the trachea

Question 22

what passes in the laryngopharynx

Answer 22

food and air

-from epiglottis to esophagus

Question 23

palatoglossal arch vs the palatopharyngeal arch

Answer 23

1. anterior arch in the faces covering the palatoglossus M.

2. posterior arch in fauces covering the palatopharngyeal M.

Question 24

what is the epiglottic valleculae

Answer 24

space between anterior surface of the epiglottis and root of tongue

Question 25

what is a brachial fistula

Answer 25

persistence of the 2nd pharyngeal pouch and 2nd pharyngeal groove that creates a canal between the tonsillar celft and side of the neck
(patent opening between the palatine tonsils and neck causing a leaking of liquid mucous outside of the neck)

Question 26

what is a brachial sinus

Answer 26

patent remnant of the embryonic cervical sinus that failed to disappear. the opening for this sinus may exist anywhere along anterior border of the SCM.
(opening on the outside, but not inside therefore communicates externally but not internally)

Question 27

what is a brachial cyst

Answer 27

similar to the brachial sinus, it is a remnant of the embryonic cervical sinus, however it does not open externally or communicate externally

• can cause issues with the hypoglassal N., glossopharyngeal N, or spinal accessory N.
• may need to be removed

Question 28

what is a tracheoesophageal fistula

Answer 28

congenital anomaly of the esophagus and trachea

• most commonly the esophagus ends in blind pouch and the trachea connects to the stomach
• can also be blind ended trachea and esophagus, or communication between trachea and esophagus below the epiglottis

Question 29

steps of deglutination

Answer 29

(SWALLOWING)
0: smell/chew food
1: (voluntary) pushing back the bolus against the soft palate (back of mouth) to move it from mouth to oropharynx
2. (involuntary and rapid) sealing odd of nasaopharynx from the oropharynx while the soft palate is elevated; shortening/widening of the pharynx from elevation of the larynx by the supra hyoid and anterior longitudinal muscles
[pharynx and larynx elevate]
3. (involuntary) sequential contraction of the 3 pharyngeal constrictor muscles to force bolus into esophagus; epiglottis deflects the food but does not completely seal off the larynx and trachea because we need to breath
“food rolls down epiglottis”