Management of thyroid nodules Flashcards Preview

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Flashcards in Management of thyroid nodules Deck (21):
1

What are the boundaries of the anterior triangle in the neck ?

  • Superiorly - mandible 
  • Laterally - anterior aspect of SCM 
  • Medially - imaginary line down the midline 

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2

What are the boundaries of the posterior triangle of the neck ?

  • Inferiorly - clavicle 
  • Laterally - trapezuis 
  • Medially - posterior aspect of SCM 

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3

What are the superficial causes of neck lumps ?

  • Sebaceous cysts 
  • Lipomas 
  • Neurofibromas 

4

What are the main midline causes of neck lumps ?

  • Thyroid 
  • Thyroglossal cyst (remember thyroglossal duct in thyroid development)
  • Dermoid cyst (sack like growth on or in the skin present at birth)

5

What are the causes of neck lumps in the anterior triangle ?

  • Lymph nodes 
  • Branchial cysts 
  • Salivary glands 
  • Carotid body tumour 

6

What are the causes of neck lumps in the posterior triangle?

  • Lymph nodes 
  • Cystic hygroma 

7

What are the most common casuses of neck lumps ?

  1. Lymph nodes - 85%
  2. Goitre - 8% 
  3. Other 7% 

8

If a patient has cervical lymphadenopathy what do you also need to check ?

  • Look for other nodes 
  • Hepatosplenomegaly 

9

What are the potential causes of cervical lymphadenopathy ?

  • Infective 
  • Malignant 
  • Haemotoligcal - leukaemia/ lymphoma 

10

If the patient has hoarseness and neck lump what are you worried about ?

Cancer - potentially causing damage to the recurrent laryngeal nerve resulting in hoarness 

11

What can you do to find out the cause of a neck lump?

  • Exammine it 
  • USS FNA
     

12

What complication can develop in thyroglossal cysts and branchial cysts ?

The can fistulate and saliva can then come out the hole 

13

How do thyroglossal cysts commonly present ?

  • As a midline swelling 
  • They contain lymphatics which can become inflamed 
  • They move when the tongue is stuck out 
  • Usually present in teenage years 

14

How do dermoid cysts commonly present ?

  • Usually in teenage years 
  • As a midline swelling 
  • Described as a ''half filled water bottle''

15

What is a branchial cyst due to ?

Persisting second branchial arch 

16

On FNA aspiration of a branchial cyst what would be seen?

Cholestrol crystals 

17

When/where do cystic hygromas/lymphangiomas commonly present ?

  • In posterior triangle 
  • Majority in first year of life 
  • They are lymph filled and transilluminable 

18

Why should you remember to check the mouth ?

As the neck swelling could be due to salivary gland swelling 

19

What investigations would you do for a thyroid gland swelling ?

TSH and USS FNA 

20

When you stick your tongue out the swelling moves - what is the cause of this neck swelling ?

Thyroglossal cyst

21

If a midline swelling moves when you swallow what do you think is the cause ?

Thyroid - it moves because pretacheal fascia envelops it