Anatomy and physiology of the neck Flashcards
(48 cards)
Anatomical contents of the neck…
Arteries, veins, nerves, lymphs, lymphatic channels, thyroid gland, parathyroid gland, muscles, trachea
4 boundaries of the neck
superior - mandible
inferior - clavicle
posterior - trapezius
anterior - anterior midline
Anterior triangle boundaries
midline of neck to anterior border of SCM
Posterior triangle boundaries
posterior border of SCM to anterior border of trapezius
Contents of anterior triangle
common carotid artery, ECA, ICA
IJV, facial vein
hypoglossal, accessory, laryngeal, vagus, glossopharyngeal
submandibular and submental nodes
Contents of posterior triangle
occipital artery
EJV
accessory nerve, cervical nerve plexus
lymph nodes
What does the accessory nerve supply?
SCM and trapezius
What level does the common carotid artery bifurcate and which artery goes on to give off branches in the neck?
C4
external carotid artery
ECA branches
superior thyroid, maxilla, occipital, lingual, frontal, superficial temporal, facial, ascending pharyngeal, posterior pharyngeal
indications for a central line
monitor central venous pressure IV nutrition drug administration cardiac pacing blood samples haemodialysis
Complications of a central line
pneumothorax
chylothorax, haematoma, sepsis, air embolism, thrombosis, cardiac tamponade
Where do the lymph nodes from the head and neck drain?
cisterna chyli –> thoracic duct on the left
7 levels of lymph nodes
1 - submental and submandibular
2,3,4 - SCM in thirds
5 posterior triangle
6,7 - midline - important for thoracic cancer
Groups of lymph nodes and what they drain
parotid - scalp, face, parotid duct
submental - lips, floor of mouth
submandibular - tongue, nose, oral cavity, paranasal sinus, sub mandibular gland
occipital - scalp
superficial cervical - breast and solid viscera
deep cervical - final drainage pathway to thoracic duct
supraclavicular - breast, oesophagus, solid viscera
3 broad categories leading to lymphadenopathy
infective, inflammatory, malignant
What does the thyroid gland produce?
calcitonin and thyroid hormone
Calcitonin function
lower calcium, raise phosphate
Thyroglossal cyst
remnant of the thyroglossal duct dilated which moves on tongue protrusion in the midline which grows with age and may become infected
USS and removal
3 broad reasons for a thyroid mass
solitary nodule
multinodular goitre
diffuse enlargement
Reasons for a solitary nodule
cyst, adenoma, carcinoma, lymphoma, prominent nodule in multinodular goitre
Solitary thyroid nodule epidemiology
Female, 30-40, 50% malignant of young
How are solitary thyroid nodules investigated?
FNAC, USS
thyroid lobectomy
Why is a biopsy needed after FNAC?
cannot tell follicular adenoma and carcinoma apart
4 types of thyroid cancer - modes of spread, epidemiology
papillary - lymphatic metastasis
follicular - haematogenous metastasis
medullary - 10% familial, parafollicular C cells
Anaplastic - aggressive, local spread, very old, poor prognosis
