neck

Question 1

what are the anatomical contents in the neck?

Answer 1

Arteries
Veins
Nerves
Lymph nodes
Lymphatic channels
Thyroid gland
Parathyroid glands
Muscles
Trachea

Question 2

what is the superior boundry of the neck?

Answer 2

mandible

Question 3

what is the inferior boundry of the neck?

Answer 3

clavicle

Question 4

what is the anterior boundry of the neck?

Answer 4

anterior midline

Question 5

what is the posterior boundry of the neck?

Answer 5

trapezius

Question 6

what is anterior to the anterior triangle of the neck?

Answer 6

midline of the neck

Question 7

what is posterior to the anterior triangle of the neck?

Answer 7

anterior border of sternocleidomastoid

Question 8

what is anterior to the posterior triangle of the neck?

Answer 8

posterior border of sternocleidomastoid

Question 9

what is posterior to the posterior triangle of the neck?

Answer 9

anterior border of trapezius

Question 10

what are the contents of the anterior triangle?

Answer 10

Common carotid artery	
Internal carotid artery
External carotid artery	
Internal jugular vein
Facial artery			
Facial vein
Hypoglossal nerves		Accessory nerves
Vagus nerves			Laryngeal nerves
Glossopharyngeal nerves	
Submandibular nodes	Submental nodes

Question 11

what are the posterior triangle contents of the neck?

Answer 11

Accessory nerve		
Cervical nerve plexus
Occipital artery		
External jugular vein
Lymph nodes

Question 12

indications for central lines

Answer 12

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

Question 13

complications of central lines

Answer 13

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

Question 14

how many lymph nodes are there in the head and neck

Answer 14

600

Question 15

where do lymphh nodes in head anad neck drain to?

Answer 15

cisterna chyli then drain to thoracic duct

Question 16

where does the parotid node drain from?

Answer 16

scalp, face and parotid gland

Question 17

where does the occipital node drain from?

Answer 17

scalp

Question 18

where does the superficial cervical node drain from?

Answer 18

final drainage pathway to thoracic duct

Question 19

where does the submandibular node drain from?

Answer 19

tongue, nose, paranasal sinuses, submandibular gland and oral cavity

Question 20

where does the submental nodes drain from?

Answer 20

lips and floor of mouth

Question 21

where do the supraclaviculas node drain from?

Answer 21

breast, oesophagus and solid viscera

Question 22

what is Lymphadenopathy

Answer 22

disease of the lymph nodes, in which they are abnormal in size or consistency

Question 23

what type of gland is the thyroid gland?

Answer 23

endocrine gland

Question 24

how many lobes does the thyroid gland have?

Answer 24

2

Question 25

what are the lobes joined by in the thyroid gland?

Answer 25

isthmus

Question 26

what does the thyroid gland produce?

Answer 26

thyroid hormone and calcitonin

Question 27

what is the function of calcitonin?

Answer 27

acts to lower calcium and raise phosphate

Question 28

what is a thyroglossal cyst?

Answer 28

dilation of thyroglossal duct remnant

Question 29

who is more likely to get a solitary thyroid nodule?

Answer 29

female of 30-40 years old

Question 30

how do you investigate a solitary thyroid nodule?

Answer 30

fine-needle aspiration cytology and ulrasound scanning

Question 31

can a fine needle aspiration cytology distinguish between a follicular adenoma and a follicular carcinoma

Answer 31

no

Question 32

what is papillary thyroid cancer?

Answer 32

lymphatic metastasis

Question 33

what is follicular thyroid cancer

Answer 33

haematogenous metastesis

Question 34

what is medullary thyroid cancer?

Answer 34

familial association 10% arise from parafollicular C cells

Question 35

what is anaplastic thyroid cancer?

Answer 35

aggressive, local spread, very old, poor prognosis

Question 36

how does Colloid goitre form

Answer 36

``` due to gland hyperplasia iodine deficiency puberty, pregnancy, lactation ```

Question 37

what is graves disease?

Answer 37

autoimmune disorder that causes hyperthyroidism, or overactive thyroid. With this disease, your immune system attacks the thyroid and causes it to make more thyroid hormone than your body needs

Question 38

treatment for graves disease

Answer 38

anti-thyroids beta blockers radio-iodine surgery

Question 39

indications for thyroidectomy

Answer 39

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

Question 40

complications of thyroidectomy

Answer 40

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

Question 41

why would someone get multi-nodular goitre?

Answer 41

due to graves disease or toxic goitre

Question 42

whos more likely to get multi- nodular goitre?

Answer 42

women, middle aged with hyperthyroidism

Question 43

how many parathyroid glands are there?

Answer 43

4 usually

Question 44

function of the parathyroid glands?

Answer 44

Regulate calcium & phosphate levels

Question 45

where are the parathyroid glands locarted?

Answer 45

posterior to poles of thyroid

Question 46

what can parathyroid disease cause?

Answer 46

``` PAINFUL STONES ACHING BONES PSYCHIC MOANS ABDOMINAL GROANS Renal calculi, polyuria, renal failure Pathological fractures, osteoporosis, bone pain ``` Abdominal pain, constipation, peptic ulceration, pancreatitis, weight loss Anxiety & depression, confusion, paranoia

Question 47

how to investigate parathyroid disease

Answer 47

``` Urea & electrolytes, creatinine, calcium, phosphate Parathyroid hormone, bicarbonate Vitamin D Ultrasound scan CT/MRI: identify ectopic glands Isotope scanning: detect diseased glands ```

Question 48

treatment of parathyroid disease

Answer 48

surgery

Question 49

fascia of the neck

Answer 49

``` 4 Fascial layers Pre-tracheal Pre-vertebral Deep cervical Carotid sheath ```

Question 50

indications for tracheostomy

Answer 50

Airway obstruction Airway protection Poor ventilation to reduce dead space

Question 51

treatment for stridor

Answer 51

O2, Nebulised Adrenaline, IV Dexamethasone, (Heliox), (Definitive) airway management

Question 52

how does a branchial cysts occur?

Answer 52

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

Question 53

what is a pharyngeal pouch?

Answer 53

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

Question 54

symptoms of pharyngeal pouch

Answer 54

Voice hoarseness Regurgitation Dysphagia Weight loss Aspiration pneumonia Neoplasia 1%

Question 55

investigation of pharyngeal pouch

Answer 55

Barium swallow; excision (endoscopic or open); dilate