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J Endocrine > ANATOMY - thyroid and parathyroid > Flashcards

ANATOMY - thyroid and parathyroid Flashcards

1
Q

how many lobes are there in the thyroid

names

A

2 - right and left

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2
Q

what connects the 2 lobes of the thyroid

A

isthmus

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3
Q

name 2 anatomical variations in the thyroid gland

A

no/incomplete isthmus

pyramidal lobe - superior to rest of gland

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4
Q

embryologically where does the thyroid gland originate

A

foramen caecum

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5
Q

what is the path of the thyroid gland in embryology

A

thyroglossal duct

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6
Q

embryological abnormalities of thyroid (4)

A

failure of descent (lingual thyroid)
excessive descent (retrosternal thyroid)
thyroglossal duct cysts
ectopic thyroid tissue

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7
Q

where would you find a thyroglossal duct cyst

A

midline

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8
Q

where would you find ectopic thyroid tissue

A

anywhere along path of thyroid migration

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9
Q

how does the thyroid move on swallowing

A

superiorly then inferiorly

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10
Q

how do you feel for the thyroid gland

A

just below adams apple

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11
Q

spinal level of isthmus

A

C5-T1

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12
Q

in which layer is the platysma muscles

A

superficial fascia/subcut tissue

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13
Q

in which layer is the sternocleidomastoid and trapezius muscle in

A

investing deep fascia

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14
Q

what are the 2 layers of the neck that completely encircle the neck

A

superficial fascia

investing deep fascia

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15
Q

what are the attachments of the sternocleidomastoid muscle (3)

A

sternum
clavicle
mastoid process of temporal

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16
Q

what does the prevertebral deep fascia surround

A

postural neck muscles that surround the spine

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17
Q

where are the carotid sheaths in respect to the thyroid gland

A

anterolateral

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18
Q

contents of carotid sheath (4)

be specific

A

common carotid artery (just internal at C4)
internal jugular vein
vagus nerve
deep cervical lymph nodes

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19
Q

contents of pretracheal deep fascia (5)

A 
strap muscles 
thyroid gland
trachea 
oesophagus 
2 recurrent laryngeal nerves
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20
Q

what do the strap muscles do

A

pull hyoid bone down

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21
Q

what are the 4 strap muscles

A

sternohyoid
omohyoid
thyrohyoid
sternothyroid

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22
Q

where does the sternohyoid (strap muscle) go

A

from hyoid bone to sternum

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23
Q

where does the omohyoid (strap muscle) go

A

from shoulder (omo) to hyoid bone

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24
Q

where does thyrohyoid (strap muscle) go

A

from thyroid to hyoid bone

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25
Q

where does the sternothyroid (strap muscle) go

A

from manubrium of sternum to thyroid

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26
Q

which of the strap muscles has 2 bellies (superior and inferior)

A

omohyoid

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27
Q

which strap muscle has an ‘intermediate tendon’ attached to the clavicle, that changes the course of the muscle (bc of superior and inferior bellies)

A

omohyoid

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28
Q

what are the muscles in the superficial fascia of the neck called

A

platysma muscles (right and left)

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29
Q

which arteries supply the superior thyroid

A

superior thyroid arteries

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30
Q

which arteries supply the inferior thyroid

A

inferior thyroid arteries

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31
Q

which artery supplies the isthmus of the thyroid (anatomical variation)

A

thyroid ima artery

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32
Q

where does the superior thyroid arteries come from

A

external carotid arteries (left and right)

33
Q

where does the inferior thyroid arteries come from

A

subclavian arteries

34
Q

on which side does the subclavian artery come directly from the arch of the aorta

A

left

35
Q

where does the thyroid ima artery come from (if it exists)

A

right common carotid

36
Q

what is the general blood supply/drainage to each side of the thyroid

A

2 inputs - superior and inferior

3 outputs - superior, middle and inferior

37
Q

what drains the superior thyroid gland

A

superior thyroid vein

38
Q

what drains most of the inferior thyroid

A

middle thyroid vein

39
Q

what drains a little of the inferior thyroid

A

inferior thyroid vein

40
Q

where does the superior thyroid vein drain

A

internal jugular vein

41
Q

where does the middle thyroid vein drain

A

internal jugular vein

42
Q

where does the L inferior thyroid vein drain

A

L brachiocephalic vein

43
Q

where does the R inferior thyroid vein drain

A

L brachiocephalic (or R brachiocephalic or angle between the 2 brachiocephalics)

44
Q

where does the superior thyroid drain its lymph

A

superior deep cervical lymph nodes

45
Q

where does the inferior thyroid drain its lymph

A

inferior deep cervical lymph nodes
paratracheal lymph nodes
pretracheal lymph node

46
Q

where does lymph in the deep cervical lymph nodes drain

A

right lymphatic duct or thoracic duct (on the left) then into the right/left venous angle

47
Q

which nerve palsy may present with hoarse voice

A

vagus CN X

48
Q

what is most likely to be damage in a thyroidectomy

A

recurrent laryngeal branches of the vagus CN X

49
Q

in which layer of neck fascia does the vagus nerve travel in

A

carotid sheath

50
Q

next to which artery does the vagus nerve travel

A

common carotid artery

51
Q

what are the first branches of the vagus nerve

A

superior laryngeal branches

52
Q

what do the superior laryngeal branches of the vagus nerve supply

A

cricothyroid muscles and mucosa above the vocal cords

53
Q

which nerve are the superior laryngeal branches part of

A

vagus nerve CN X

54
Q

what happens to the superior laryngeal nerves after they branch off the vagus

A

split into internal and external superior laryngeal nerves

55
Q

what is supplied by the inferior laryngeal nerve

A

all laryngeal muscles apart from cricothyroid muscles

56
Q

where does the inferior laryngeal nerve come from

A

recurrent laryngeal nerve

57
Q

at what level does the recurrent laryngeal nerve change into the inferior thyroid nerve

A

cricothyroid joint

58
Q

what supplies the mucosa of the throat above the vocal cords

A

internal superior laryngeal nerve (branch of vagus)

the internal one bc muscosa is inside = internal

59
Q

what supplies the mucosa of the throat below the vocal cords

A

inferior laryngeal nerve (from the recurrent laryngeal nerve)

60
Q

what nerve supplies most of the laryngeal muscles

A

inferior laryngeal nerve (form the recurrent laryngeal nerve)

61
Q

what nerve supplies the cricothyroid muscles (diff from the rest of the laryngeal muscles)

A

external superior laryngeal nerve

the external one bc muscle is on the outside = external

62
Q

what is the anastomoses between the internal laryngeal nerve and the inferior laryngeal nerve called

A

galens anastomoses

63
Q

where does the right vagus go after it travels down the right trachea then right oesophagus

A

posterior oesophagus (laRP = right, posterior)

64
Q

where does the right recurrent laryngeal branch of the vagus nerve go under (loop round)

A

right subclavian artery (in neck)

65
Q

where does the left recurrent laryngeal branch of the vagus nerve go under (loop round)

A

ligamentum arteriosum (remnant of ductus arteriosum)

66
Q

where does the left vagus go after it travels down the left trachea and oesophagus

A

anterior oesophagus (LArp = left, anterior)

67
Q

which groove do the recurrent vagus nerves travel in

A

tracheoesophageal groove

68
Q

how does recurrent vagus nerve injury present

why

A

hoarseness

they supply the vocal cords

69
Q

what does the anterior jugular vein drain

A

face

70
Q

where does the anterior jugular vein drain into

A

external jugular vein

71
Q

what are langers lines

how were they found many years ago

A

the lines of skin tension

found on a cadaver

72
Q

where do you cut in a thyroidectomy

A

superior to clavicle and jugular notch

73
Q

what is berrys ligament

A

anchors the posterior thyroid gland in place

74
Q

why is berrys ligament significant in thyroidectomy

A

need to cut through it to mobilise thyroid

75
Q

what structure is close to berrys ligament and hence likely to be damaged in thyroidectomy

A

recurrent laryngeal branch of vagus

76
Q

how many parathyroid glands are there

A

4

77
Q

what are the names of the parathyroid glands

A

left superior
left inferior
right superior
right inferior

78
Q

where are the parathyroid glands location

A

behind thyroid gland (1 parathyroid gland behind each thyroid gland lobe)

J Endocrine (12 decks)

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