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DMST 295 Abdomen 2 > Parathyroid and Salivary glands > Flashcards

Parathyroid and Salivary glands Flashcards

1
Q

How many pairs of parathyroid glands are typically located in the neck?

A

2 pairs

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2
Q

What is the relationship of the parathyroid glands to the thyroid glands?

A
  1. Most adults have two located superior posterior to the mid portion of the thyroid gland and two inferiors located in a slightly more variable position.
  2. The inferior parathyroid glands are located posterior or just inferior to the lower thyroid pole
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3
Q

What is the typical dimension and shape of a parathyroid gland?

A

1x3x5

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4
Q

What is the echogenicity of a normal parathyroid gland compared to the thyroid gland?

A

It is usually pretty hard to image the parathyroid because it is isoechoic to the thyroid

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5
Q

What is the main physiologic function of the parathyroid gland?

A

Production of parathyroid hormone, which has the most important endocrine regulator of calcium and phosphorous concentrations in extra cellular fluid

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6
Q

What is meant by a “False positive” parathyroid examination?

A

The test results suggest hyperparathyroidism or some other parathyroid disorder, but upon further analysis the individual does not actually have the condition

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7
Q

Name three structures that could create a “false positive” result during a parathyroid ultrasound?

A
  1. Esophagus
  2. Longus Coli
  3. Minor bundles
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8
Q

What is the most common cause of primary hyperparathyroidism?

A

Parathyroid edema

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9
Q

In primary hyperparathyroidism, indicate whether the substances below are increased or decreased serum levels?

  1. Calcium
  2. PTH
A

Both are increased

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10
Q

What is the most definitive treatment for hyperparathyroidism?

A

Surgery

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11
Q

What inherited disorder is strongly linked to parathyroid hyperplasia?

A

MEN type 1
(multiple endocrine neoplasia type 1)

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12
Q

What are the most common locations for ectopic superior and inferior adenomas?

A
  1. Most commonly found in the superior and inferior locations adjacent to the thyroid gland
  2. 3% of cases are found in the same ectopic locations as the parathyroid glands, which the low neck, mediastinum, reterotracheal/ retroesophageal, undescended/ carotid sheath, and intrathyroid gland
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13
Q

What are two causes of secondary hyperparathyroidism?

A
  1. Chronic renal insufficiency
  2. Vitamin D deficiency
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14
Q

What is the typical sonographic appearance of a parathyroid adenoma?

A
  1. Hypoechoic
  2. Homogenous solid masses
  3. Echogenicity is usually less than the thyroid gland and may be so hypoechoic as it simulates a cyst
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15
Q

What doppler patterns might assist you in differentiating a parathyroid adenoma from a lymph node?

A
  1. Hypervascular pattern with a prominent diastolic flow
  2. Peripheral vascular arc that may allow for differentiation from hyperplasiticity region lymph nodes, which has a similar hilar flow pattern
  3. Identify an extrathryoidal feeding artery supply the adenoma
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16
Q

What is the typical size and sonographic appearance of a parathyroid carcinoma?

A
  1. May demonstrate more attenuation than is typically seen with hyperplasia or adenomas
  2. lobular contour with a heterogenous internal structure and internal cystic components
  3. Similar to large benign adenomas or hyperplasia
  4. Typical size of a parathyroid carcinoma is more than 2 cm compared to average 1cm of adenomas
17
Q

List the three pairs of salivary glands

A
  1. Parotid glands
  2. Submandibular glands
  3. Sublingual gland s
18
Q

Identify the salivary gland in which each of the following ducts is located

Stensen’s duct
Wharton’s duct
Bartholins duct

A
  1. Partoid
  2. Submandibular
  3. Sublingual
19
Q

Which salivary gland is located anterior to the ear and sternocleidomastoid muscle?

A

Parotid

20
Q

Which salivary gland is located under the tongue?

A

Sublingual

21
Q

Which salivary gland is located medial and oblique to the mandible?

A

Submandibular

22
Q

What sonographic feature differentiates an intraparotid node from a parotid mass

A

Echogenic hilum

23
Q

Which salivary gland is most affected by sialolithiasis?

A

Submandibular

24
Q

Which salivary gland is typically affected by acute suppurative sialdenitis?

A

The parotid

25
Q

What is the most common sonographic appearance of acute inflammation of the salivary glands?

A

Enlarged and hypoechoic

26
Q

What is sialosis?

A

A non-inflammatory, non neoplasticism, recurrent, painless salivary gland swelling, usually bilateral, which most often concerns the parotid glands

27
Q

What is the name of the autoimmune disease that occurs in middle aged females causing chronic inflammation?

A

Sjogrens syndrome

28
Q

What is the most common patient presentation with a salivary gland tumor?

A

Palpable lump

29
Q

Which salivary glands are most likely to present with a malignant neoplasm?

A

The smaller glands: the submandibular and sublingual

30
Q

What is the most common benign parotid neoplasm?

A

Pleomorphic adenomas

31
Q

Describe the most common sonographic features of the neoplasms of pleomorphic adenomas?

A
  1. Hypoechoic
  2. Well defined
  3. Lobulated tumors
  4. Homogenous
  5. Posterior enhancement
32
Q

What is the name of the benign neoplasm that affects elderly men?

A

Warthin tumor

33
Q

Describe the most common sonographic features of the neoplasm warthin?

A
  1. Oval
  2. Hypoechoic
  3. Well-defined
  4. Contains multiple anechoic areas
  5. Heterogenous
  6. Anechoic with through transmission
34
Q

What are the two most common types of malignancy affect the salivary glands?

A
  1. Mucoepidemoid carcinomas
  2. Adenoid cystic carcinomas
35
Q

What is the most common malignant neoplasm of the submandibular gland?

A

Adenoid cystic carcinoma

36
Q

What are the most common sonographic features of adenoid cystic carcinomas?

A
  1. Irregular shape
  2. Irregular boarders with blurred margins
  3. Hypoechoic
  4. Can be homogenous or heterogenous
37
Q

How does the patient presentation of malignant salivary neoplasms differ from that of bening neoplasms?

A
  1. Grow rapidly
  2. Maybe tender or painful and palpation
  3. Can be fixed to the background
  4. Can cause facial nerve paralysis or paresis

DMST 295 Abdomen 2 (8 decks)

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