Anatomy & Physiology of the Neck

Question 1

What is the only artery in the neck with branches?

Answer 1

ECA

Question 2

What are the eight branches of the ECA?

Answer 2

Superior thyroid
Ascending pharyngeal
Lingual
Occipital
Facial
Posterior auricular
Maxillary
Superficial temporal

Question 3

What two hormones does the thyroid gland produce?

Answer 3

Thyroid hormone

Calcitonin

Question 4

What does calcitonin react to?

Answer 4

Lower calcium and raises phosphate

Question 5

What is the role of the parathyroid gland?

Answer 5

Regulate calcium and phosphate levels

Question 6

What are the diseases of parathyroid glands?

Answer 6

Painful stones
Aching bones
Psychic moans
Abdominal groans

Question 7

What are the signs and symptoms of parathyroid disease? (8)

Answer 7

Constipation
Peptic ulceration
Pancreatitis 
Weight loss
Anxiety & Depression
Confusion
Paranoia
Osteoperosis

Question 8

What investigations should be done for parathyroid gland disease?

Answer 8

U+E'S
PTH
Vitamin D
Ultrasound
CT/MRI
Isotope scanning

Question 9

What are the three causes of hyperparathyroidism?

Answer 9

Adenoma (80%)
Hyperplasia (12%)
Malignancy - Rare

Question 10

What is a thyroglossal cyst?

Answer 10

Dilation of the thyroglossal duct remnant

Question 11

Where is a thyroglossal cyst found and when does it move?

Answer 11

In the midline where it grows with age

Moves on tongue protrusion

Question 12

What are the three types of thyroid mass?

Answer 12

Solitary nodule
Diffuse enlargment
Multi-nodular goitre

Question 13

In what type of person are thyroid masses most common?

Answer 13

Female and in those upwards of 30-40 years old

Question 14

What is a FNAC and what does it do?

Answer 14

Fine-needle aspiration cytology

Allows physicians to work out exactly what the mass is

Question 15

What type of metastasis occur for papillary and follicular cancer?

Answer 15

Papillary - Lymphatic

Follicular - Haematogenous

Question 16

What is Anaplastic cancer like?

Answer 16

Aggressive
Local spread
Poor prognosis

Question 17

What are the indications for a central line? (7)

Answer 17

Central venous pressure
Fluid resuscitation
Drug administration Haemodialysis
Cardiac pacing
Intravenous nutrition
Blood sampling

Question 18

What are the possible complications of a central line? (9)

Answer 18

Pneumothorax
Air embolism
Thrombosis
Haematoma 
Chylothorax
Sepsis
Cardiac tamponade
False passage
Line blockage

Question 19

What do the parotid lymph nodes drain?

Answer 19

Scalp
Face
Parotid gland

Question 20

What do the occipital nodes drain?

Answer 20

Scalp

Question 21

What do the superficial cervical nodes drain?

Answer 21

Breast

Solid viscera

Question 22

What do the submandibular nodes drain?

Answer 22

Tongue
Nose
Paranasal sinuses Submandibular gland Oral cavity

Question 23

What do the submental nodes drain?

Answer 23

Lips

Floor of mouth

Question 24

What do the supraclavicular nodes drain?

Answer 24

Breasts
Oesophagus
Solid viscera

Question 25

What are the three causes of lymphadenopathy?

Answer 25

Infection Inflammation Malignancy

Question 26

What are the indications for thyroidectomy?

Answer 26

``` Airway obstruction Malignancy or suspected malignancy Thyrotoxicosis Cosmesis Retrosternal extension ```

Question 27

What are the possible complications of a thyroidectomy? (7)

Answer 27

``` Bleeding-primary or secondary Voice hoarseness Thyroid storm Infection Hypoparathyroidism Hypothyroidism Scar (keloid/ hypertrophic) ```

Question 28

What are the three indications for a tracheostomy?

Answer 28

Airway obstruction Airway protection Poor ventilation

Question 29

What the different types of stridor and what are areas are they from?

Answer 29

Inspiratory - Laryngeal Expiratory - Tracheobronchial Biphasic - Glottic/Subglottic

Question 30

How does a brachial cyst form?

Answer 30

Remnant of fusion failure of branchial arches OR Lymph node cystic degeneration

Question 31

What is a pharyngeal pouch?

Answer 31

Herniation of pharyngeal mucosa between the thyropharyngeus and cricopharyngeus muscles of the inferior constrictor of the pharynx

Question 32

What are the signs and symptoms of a pharyngeal pouch? (6)

Answer 32

``` Voice hoarseness Regurgitation Dysphagia Weight loss Aspiration pneumonia Neoplasia (1%) ```

Question 33

What are the four layers of the fascia of the neck?

Answer 33

Pre-tracheal Pre-vertebral Deep cervical Carotid sheath