Physiology of the Neck Flashcards
What is the only artery with branches in the neck?
external carotid
Lymph node groups all drain to the ……….. ……. then drain to the ….. …… on the left
cisterna chyli
thoracic duct
scalp, face and parotid gland is drained by which lymph nodes?
parotid nodes
scalp is drained by which lymph nodes?
occipital nodes
breast and solid viscera is drained by which lymph nodes?
superficial cervical nodes
thyroglossal cyst is a remnant of
dilatation of the thyroglossal duct
how would you investigate a thyroglossal cyst?
FNAC and Ultrasound
fine needle aspiration cytology
How to treat a thyroglossal cyst?
thyroid lobectomy
Causes of Thyroid enlargement
colloid goitre (due to hyperplasia)
Grave’s disease
thyroiditis
What disease is characterized by auto-antibodies against thyroid-stimulating hormone receptor stimulating receptor ?
Grave’s disease
Treatment for Grave’s disease
anti-thyroids
beta-blockade
radio-iodine
surgery
Indications there is a need for a thyroidectomy
airway obstruction
malignancy
thyrotoxicosis
Complications of a thyroidectomy
Bleeding-primary or secondary Voice hoarseness Thyroid storm Infection Hypoparathyroidism Hypothyroidism Scar (keloid/ hypertrophic)
Causes of multi-nodular goitre
graves disease
toxic goitre
graves disease usually occurs in…
women
middle aged
over activity (hyperthyroidism)
tests for multi nodular goitre
thyroid function tests
FNAC
chest X-ray
What do parathyroid glands regulate?
calcium and phosphate levels
parathyroid 4 part rhyme….
PAINFUL STONES
ACHING BONES
PSYCHIC MOANS
ABDOMINAL GROANS
Parathyroid disease features…
Renal calculi polyuria renal failure osteoporosis bone pain
Parathyroid disease symptoms
abdominal pain
constipation
peptic ulceration
pancreatitis
weight loss
Investigations for parathyroid disease
Urea & electrolytes, creatinine, calcium, phosphate
Parathyroid hormone, bicarbonate
Vitamin D
Ultrasound scan
CT/MRI: identify ectopic glands
Isotope scanning: detect diseased glands
Management of Parathyroid Disease
medical treatment
surgery
remove adenomas (single or multiple)
4 Fascia of the neck
Pre-tracheal
Pre-vertebral
Deep cervical
Carotid sheath
Stridor treatment
O2 Nebulised Adrenaline IV Dexamethasone (Heliox) (Definitive) airway management
What is a branchial cyst a remnant of?
failure of branchial arches to fuse
What is a Pharyngeal pouch?
herniation of the pharyngeal mucosa between the thyropharyngeus and cricopharyngeus muscles of the inferior constrictor of the pharynx