Ch. 12 The Face and Neck Flashcards
(118 cards)
1
Q
Fluid produced by the salivary glands which aids in digestion
A
saliva
2
Q
Salivary glands are exocrine glands whose primary function is to produce _____ that is ultimately released into the oral cavity through ducts
A
Saliva
3
Q
Saliva, which aids in digestion, is mostly composed of what?
A
Water
4
Q
Besides water, what is in saliva?
A
Enzymes like amylase and electrolytes
5
Q
What are the three paired groups of salivary glands?
A
parotid, submandibular, sublingual
6
Q
What transducer is most often used when imaging the salivary glands?
A
High frequency linear transducer
7
Q
What does the salivary glands typically look like in ultrasound?
A
Typically hyperechoic compared to the adjacent musculature
8
Q
The largest of the salivary glands
A
parotid gland
9
Q
The parotid gland can be separated into 3 lobes, the main duct referred to as
A
stensen duct
10
Q
The submandibular gland is drained by?
A
Wharton’s duct
11
Q
Located bilaterally just under the tongue & anterior to the submandibular gland
A
sublinguial glands
12
Q
Located bilaterally anterior to the ears extends inferiorly where its bounded anteriorly by the rami of the mandibles & posteriorly by the mastoid processes of the temporal bones
A
Parotid glands
13
Q
Located beneath the floor of the mouth & are bordered laterally by the body of the mandible and superiorly by musculature
A
submandibular glands
14
Q
Parotid glands appear ___ in sagittal and ___ in transverse.
A
elliptical, round
15
Q
Sublingual glands are ___ in shape
A
round
16
Q
Submandibular glands are more ___ in shape
A
triangular
17
Q
Mucus retention cyst in the floor of the mouth arising from an obstructed sublingual or minor salivary duct
Sono: Well-defined, homogeneous, hypoechoic, or anechoic mass. Infected cyst will appear complex
A
ranula
18
Q
An autoimmune disease that affects all glands that produce moisture, leads to dysfunction of salivary glands and severe dryness of the eyes, nose, skin, and mouth
Sono:Heterogeneous, hyperemic, visibly enlarged, and may contain diffuse hypoechoic regions
A
Sjogren syndrome
19
Q
Inflammation of the salivary glands
Sono:Heterogeneous, hyperemic, visibly enlarged, and may contain diffuse hypoechoic regions
A
sialadenitis
20
Q
Salivary duct stones, most commonly located within the submandibular glands
Sono:Dilated duct containing a shadowing, echogenic focus or foci
A
sialolithiasis
21
Q
Benign, painless enlargement of the salivary glands, usually affects both parotid glands
Sono:Enlarged gland without hypervascularity
A
sialadenosis
22
Q
Benign and most frequent tumor of the salivary glands; most commonly seen in the parotid gland
Sono:Hypoechoic mass; biopsy is often warranted
A
Pleomorphic adenoma
23
Q
Most common malignancy of the salivary glands; typically starts in the parotid gland
Sono: Hypoechoic or heterogeneous mass with moderate to marked internal vascularity; biopsy is often warranted
A
Mucoepidermoid carcinoma
24
Q
The word part “sial(o)” means
A
saliva
25
Especially when malignancy is suspected, an evaluation of the cervical _____ should be performed
lymphatic chain
26
Crucial endocrine gland that develops within 3rd week of gestation
Crucial endocrine gland that develops within 3rd week of gestation
27
The Thyroid is fully functional by the end of the _____ trimester.
first
28
the embryonic duct that is located from the base of the tongue to the midportion of the anterior neck
thyroglossal duct
29
Where is the thyroid gland located anatomically?
It descends down the thyroglossal duct to ultimately rest anterior to the trachea
30
Normal variant of the thyroid gland in which there is a superior extension of the isthmus
pyramidal lobe
31
Bridge on thyroid gland
isthmus
32
The thyroid uses ____ to produce its hormones
iodine
33
The hypothalaums produces thyroid releasing hormone which controls the release of ___ by the anterior pituitary gland.
TSH- thyroid stimulating hormone
34
As a result of TSH released by the pituitary gland the thyroid releases the hormones contained within its cells
thyroxine (T4), triiodothyronine (T3), calcitonin
35
Thyroid hormone that aids in metabolism of fats, proteins and carbohydrates
thyroxine (T4), thriiodothyronin (T3)
36
Thyroid hormone that's responsible for removing calcium from the blood for storage in the bones
calcitonin
37
Most abundant hormone produced by the thyroid
Thyroxine (T4)
38
Normal thyroid tissue is homogeneous and consists of medium to high level echogenicities similar to
the testes
39
Each adult pear shaped thyroid lobes meausres
4-6 cm in length, 2-3 cm width, 1-2cm thickness (rt lobe usually largest)
40
The isthmus normally measures between
2-6mm in AP
41
The neck muscles appear more __________ than the normal thyroid tissue.
hypoechoic
42
Surrounding structure to thyroid most often seen on the left side posterior to trachea and thyroid
esophagus (have pt swallow to differentiate from mass can see saliva passing in real time)
43
increased vascularity or hyperemia may be evident of
Graves disease and Hashimotos
44
The fluid produced by the thyroid gland that contains thyroid hormones is referred to as
colloid
45
The thyroid consists of what?
Multiple follicles that contain a fluid called colloid
46
What are the two prominent vascular structures that can be seen lateral to the thyroid gland?
CCA and internal jugular vein
47
When examining the thyroid, what should the sonographer do before the actual exam?
The sonographer should determine whether there are any palpable nodules by standing behind the patient and palpating the thyroid gland
48
The ______ is the first branch of the external carotid artery. The inferior thyroid artery is a branch of the thyrocervical trunk of the subclavian artery.
superior thyroid artery
49
Strap muscles (sternohyoid, sternothyroid, thyrohyoid, and omohyoid) is _____to each lobe. The much larger sternocleidomastoid muscles pass _____ to the thyroid lobes. The longus colli muscles are seen ______ to each lobe.
anterior, lateral, posterior
50
________is a highly efficient way to determine the characteristics of clinically palpable and sonographically identifiable thyroid nodules. The use of sonographic guidance for FNA is especially beneficial. During this minimally invasive procedure, the tissue is identified with sonography, and a small needle is inserted into the nodule. An FNA is considered a low-risk procedure.
Fine-needle aspiration (FNA)
51
The most common cause of hyperthyroidism that produces bulging eyes, heat intolerance, nervousness, weight loss, and hair loss
Graves disease
52
The most common cause of hypothyroidism in the United States
Hashimoto thyroiditis
53
An enlarged, hyperplastic thyroid glands (causes include iodine deficiency, Graves, thyrioditis), isthmus may measure greater than 1cm
goiter
54
Enlarged thyroid gland that contains multiple nodules with cystic and solid components
multinodular goiter or adenomatous goiter
55
Most common mass identified within the thyroid gland (up to 68%)
benign thyroid nodules
56
Clinical findings of a ______:
1. Palpable (and possibly visually) enlarged thyroid gland
2. Dyspnea
3. Dysphagia
4. Feeling of tightening in the throat
5. Coughing
6. Hoarseness
Goiter
57
Sonographic findings of a ______:
1. Enlarged thyroid gland (isthmus that exceeds 1 cm in the anteroposterior plane)
2. Diffusely heterogeneous echotexture
3. Multiple nodules with cystic and solid components
Goiter
58
________ is the general term for thyroid enlargement that can result from inadequate iodine intake. However, there can be other underlying causes.
goiter
59
A condition that results from the overproduction of thyroid hormones
hyperthyroidism
60
Most common cause of thyroid nodules
nodular hyperplasia
61
most often small, round, and can have varying sonographic appearances, including completely anechoic, isoechoic, or hyperechoic. They may also have a surrounding halo
Follicular adenomas
62
difficulty swallowing
dysphagia
63
difficulty breathing
dyspnea
64
______is the most common cause of thyroid nodules. Hyperplastic nodules, also referred to as adenomatous nodules, are almost always multiple and also have varying sonographic appearances.
Nodular hyperplasia
65
With elastography ___ nodules in the thyroid compared to the tissue around them have an increased risk for malignancy.
stiffer
66
Graves disease, which may also be referred to as a _______, is the most common cause of hyperthyroidism
diffuse toxic goiter
67
bulging eyes
exophthalmos
68
clinical finding associated with Graves disease in which there is thickening of the skin and edema on the anterior legs
pretibial myxedema
69
infrequent or light menstrual periods
oligomenorrhea
70
Clinical findings of _______:
Bulging eyes (exophthalmos)
Heat intolerance
Nervousness
Weight loss (with increased appetite)
Hair loss
Tachycardia, palpitations, high-output heart failure
Muscle wasting
Fine tremors
Oligomenorrhea
Pretibial myxedema
Graves Disease
71
Sonographic findings of ______:
1. Enlarged gland
2. Heterogeneous or diffusely hypoechoic echotexture
3. Thyroid inferno
Graves Disease
72
What is the other term for Hashimoto thyroiditis?
Chronic autoimmune lymphocytic thyroiditis
73
With this condition, the thyroid becomes inflamed, and as a result, the thyroid produces smaller amounts of thyroid hormones.
Hashimoto thyroiditis
74
_______is an autoimmune disease and is the most common cause of hypothyroidism in the United States.
Hashimoto thyroiditis
75
Clinical findings of______:
(in early stage pts are asymptomatic)
Depression
Increased cold sensitivity
Elevated blood cholesterol levels
Slight weight gain may occur
Puffy face and puffiness under the eyes
Menorrhagia
Pallor
Hashimoto Thyroiditis
76
Sonographic findings of _______
1. Mild enlargement of the thyroid gland (initially)
2. Heterogenous echotexture
3. Multiple, ill-defined hypoechoic regions separated by fibrous hyperechoic tissue
4. Hypervascular gland
Hashimotos Thyroiditis
77
Most common form of thyroid cancer. Other forms of thyroid malignancies include follicular carcinoma, medullary carcinoma, anaplastic carcinoma, lymphoma, and metastases of the thyroid
Papillary carcinoma
78
______characteristics of thyroid nodules
Extensive cystic components
Cysts <5 mm
Hyperechoic mass
“Eggshell” calcifications
Spongiform composition
Wider-than-tall shape
“Hot” nodule (nuclear medicine finding)
Benign
79
______characteristics of thyroid nodules
Hypoechoic mass
Taller-than-wide shape
Mass with internal microcalcifications (psammoma bodies)
Solitary mass
Marked vascularity within the central part of the nodule
Interrupted peripheral calcification
Extracapsular invasion
Lobulated margins
Enlargement of the cervical lymph nodes (metastasis)
“Cold” nodule (nuclear medicine finding)
Malignant
80
Microcalcifications within a thyroid mass can increased the likelyhood of _______ in the thyroid
Malignancy
81
Round, calcified deposits that appear punctate (marked w dots) hypoerechoic foci w/o shadowing
psammoma bodies
82
What is the standardized reporting and description system of sosnographically identified thyroid nodules called?
TI-RADS (5 levels based on 5 features: composition, echogenicity, shape, margin, punctate echogenic foci)
83
The highest category of TI-RAD is
TR5, highly suspicious (more point = high risk of malignancy)
84
Nuclear medicine utilizes this study to classify thyroid nodules as either hyperfunctioning or hypofunctioning.
Scintigraphy
85
Hyperfunctioning or "hot nodules" yield dark areas on a thyroid scan (nuc med schintigraphy) almost always
benign
86
Hypofunctioning or "cold nodules" yield light or blank areas on a thyroid scan "nuc med schinitgraphy)
malignant potential
87
This examination includes the injection of a radiopharmaceutical that is high in iodine
Scintigraphy
88
Their are typically ___ parathyroid glands, some people have 5
4 (2 pairs)
89
Normal parathyroid gland measurement (sono appearance is similar to thyroid tissue)
5mm x 3mm x 1mm
90
Parathyroid gland is commonly located near (their locations are variable)
the posterior aspect of the midportion of each lobe, one often inferior to each lobe
91
Serves as calcium regulators of the body, controls the release & absorption of calcium by producing PTH
parathyroid gland
92
Most common cause of enlargement of a parathyroid gland (elevated serum calcium levels and PTH)
parathyroid adenoma (appears as hypoechoic mass adjacent to thyroid)
93
Enlargement of the cervical lymph nodes
cervical lymphadenopathy
94
If the patient has elevated serum calcium (hypercalcemia), what should the sonographer do?
Analyze the neck carefully for signs of parathyroid adenoma
95
hyperparathyroidism can cause ____
hypercalcemia
96
Clinical findings of a _______:
1. Elevated serum calcium
2. Elevated PTH
Parathyroid Adenoma
97
Sonographic findings of a ________:
1. hypoechoic mass adjacent to thyroid
Parathyroid Adenoma
98
What is the normal size of cervical lymph nodes?
Less than 1cm
99
What does cervical lymph nodes look like in sonography?
Oblong shaped hypoechoic structures with a distinguishable echogenic hilum
100
Abnormal lymph nodes can result from infections and malignancy. They may also be more ______ in shape, _____ their normal hilar feature, contain calcifications, or demonstrate abnormal vascular patterns
rounded, lose
101
The postsurgical neck sonogram—especially in those who require imaging following a thyroidectomy (removal of thyroid) because of cancer—should include a thorough examination of the neck for ________(i.e., metastatic disease to the nodes).
lymphadenopathy
102
Clinical findings of _______:
1. palpable neck mass (possibly)
2. enlarged nodes may be painful
Abnormal Lymph Nodes
103
Sonographic findings of _______:
1. enlargement of the node >1cm
2. rounded shape
3. loss of echogenic hilum
4. calcifications
5. May be hyperemic or demonstrate abnormal vascular patterns with color Doppler
Abnormal Lymph Nodes
104
Benign congenital cysts located within the midline of the neck superior to the thyroid gland and are typically located below the level the hyoid bone
Thyroglossal duct cysts
105
rare pediatric fibrous tumor located within the sternocleidomastoid muscle
fibromatosis collic
106
Clinical findings of a _______:
1. palpable mass within the midline of the neck superior to the thyroid gland
2. infected cysts may be painful
Thyroglossal Duct Cyst
107
Sonographic findings of a ______:
1. anechoic, well defined, and unilocular cyst with posterior enhancement
2. may have internal components
Thyroglossal Duct Cyst
108
As the tissues of the neck develop in utero from the branchial apparatus, branchial clefts, which normally involute, may be maintained. ________are congenital neck cysts that result from this maldevelopment.They are found most often near the angle of the mandible, but may occur in the lower, lateral neck.
Branchial cleft cysts
109
A branchial cleft ______ can also occur in the same region.______ may allow fluid to leak to the skin surface.
fistulas
110
Clinical findings of a _______:
1. Palpable neck mass located near the angle of the mandible
2. Infected cysts may be painful
Branchial Cleft Cyst
111
Sonographic findings of a ________:
1. Anechoic mass near the angle of the mandible
Branchial Cleft Cyst
112
Clinical findings of _______:
1. Pediatric palpapble neck mass
2. Torticollis
Fibromatosis Coli
113
Sonographic findings of ______:
1. Fusiform-shaped mass within the sternocleidomastoid muscle that is hypoechoic, hyperechoic, or even isoechoic to the adjacent tissue
2. May also contain calcifications that shadow
3. May yield a hyperemic pattern with color Doppler
Fibromatosis Coli
114
Because of the mass within the sternocleidomastoid muscle, the muscle shortens, resulting in the twisting of the infant’s chin toward the nonaffected side—termed congenital muscular _____.
torticollis (twisted neck)
115
Clinical Findings of a ______:
Pediatric palpable neck mass
Asymptomatic or painful due to infection or hemorrhage
Lymphangioma
116
Sonographic Findings of ______:
Thin-walled, hypoechoic or anechoic, septated mass
Lymphangioma
117
A lymphangioma, also referred to as ______, is a neck mass that may require sonographic evaluation. These masses are typically found in the posterior neck in utero or in the neonatal period.
cystic hygroma
118
They consist of a buildup of lymphatic fluid
Lymphangioma
