Thyroid Powerpoint Flashcards

1
Q

Thyroid gland length

A

4-6 cm

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2
Q

Thyroid gland AP

A

2-3 cm

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3
Q

Throid gland width

A

2 cm

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4
Q

Isthmus diameter

A

4-6 mm

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5
Q

Thyroid in relations with trachea

A

lateral

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6
Q

Thyroid in relations with esophagus and cervical spine

A

anterior

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7
Q

Thyroid in relations with IJV and carotid artery

A

medial

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8
Q

Pyramidal Lobe

A

a normal variant extending superior to the isthmus May be seen in pediatric but usually atrophies in the adult present in 15 to 30% of thyroids

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9
Q

Vascular Supply

A

right and left superior thyroid arteries and inferior thyroid arteries

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10
Q

First branch off the ECA

A

right and left superior thyroid arteries

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11
Q

Venous Drainage

A

superior and middle thyroid veins into the jugular vein and the inferior thyroid veins into the inominate vein

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12
Q

Strap Muscles

A

thin sonolucent bands along the anterior surface of thyroid Sternohyoid Omohyoid Sternothyroid

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13
Q

Sternocleidomastoid muscle location

A

anterolaterally to thyroid

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14
Q

Common Carotid artery and internal jugular vein location

A

lateral to thyroid glands

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15
Q

Longus collie muscle

A

Posterior to the thyroid wedge-shaped sonolucent structure adjacent to the cervical vertebrae

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16
Q

Esophagus is usually hidden because of what

A

Trachea

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17
Q

Minor neurovascular bundle location

A

posterior to thyroid

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18
Q

Parathyroid location

A

posterior to thyroid

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19
Q

Thyroid gland function

A

Endocrine gland T3 T4 CALCITONIN

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20
Q

The production and releae of the thyroid hormones are under the control of

A

TSH

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21
Q

What is TSH produced by

A

anterior pituitary gland which is located in the brain

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22
Q

Hormones affects

A

Metabolic rate Body’s growth and development Heart and blood vessel functions Brain function Behavior

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23
Q

Calcitonin is important for

A

calcium metabolism

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24
Q

Euthyroid

A

state in which the thyroid is producing the right amount of thyroid hormone

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25
Q

When does hyperthroidism occur

A

increased production of T-3 and T-4

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26
Q

Hyperthyroidism results in

A

Thyroid enlargement Increased metabolic rate Weight loss Nervousness

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27
Q

Thyroid Storm

A

acute situation with uncontrolled hyperthyroidism, usually precipitated by infection or surgery

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28
Q

Hyperthyroidism may be life threatening because

A

of resulting hyperthermia, tachycardia, heart failure and delirium

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29
Q

Sonographic Appearance of hyperthyroidism

A

Hypoechoic with diffuse enlargement without palpable nodules Doppler shows increased vascularity (thyroid inferno)

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30
Q

Diffuse thyroid disease (Thyroiditis)

A

inflammation of thyroid causing swelling and tenderness due to infection

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31
Q

Diffuse thyroid disease (Thyroiditis) is caused by

A

caused by infection or autoimmune disorder

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32
Q

Diffuse thyroid disease (Thyroiditis) sonographic appearance

A

enlarged and hypoechoic

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33
Q

De Quervain’s (sub acute granulamatous)

A

usually viral diffuse enlargement tenderness/mild to severe transient hyperthyroidism

34
Q

Hashimoto’s Thyroiditis

A

goitrous from of autoimmune thyroiditis-(chronic) a. Most common form b. auto-immune- chronic inflammation c. diffuse enlargement possibly asymmetric d. painless/ may develop mild pain over time e. eventual hypothyroidism f. more prevalent in women

35
Q

Hashimoto’s Thyroiditis Sonopgraphic appearance

A

a. possibly hypoechoic/normal echo texture b. thick fibrous strands c. Color flow variable can be increased or decreased vascularity with color doppler

36
Q

Hypothroidism occurs when theres a

A

decreased production of T-3 and T-4

37
Q

Hypothyroidism may be caused by

A

thyroid failure, or abnormalites of the pituitary gland or hypothalamus

38
Q

Hypothyroidsm for adults

A

thick skin,puffy face,course hair, husky voice

39
Q

Hypothyroidsm for infants and children

A

decreased physical and mental growth

40
Q

Hypothyroidism with a normal functioning pituitary and hypothalmus

A

increased TSH decreased T4/T3

41
Q

Hyperthyroidism with a normal functioning pituitary and hypothalmus

A

decreased TSH increased T4/T3

42
Q

Nuclear medicine

A

Differentiates between hyperfunctioning “hot”nodules and hypofuntioning “cold” nodules. “Cold” nodules have a higher risk of malignancy

43
Q

Indications for exam

A

Palpable enlargement Abnormal thyroid hormone level (s) Palpable mass in neck/thyroid Swelling of the neck Asymmetry of neck Redness and/or tenderness

44
Q

Normal gland is

A

homogenous with fine echogenicity

45
Q

Multinodular goiter

A

most common abnormality, most common in females age 50-70 Appears as an enlarged, heterogenous

46
Q

Follicular adenomas

A

benign, usually single tumors Appears as a well defined hypoechoic mass 50% will have a halo or ring surrounding

47
Q

Endemic goiter

A

due to low iodine intake Low T-3 and T-4 levels. More prevelant in females during puberty Uncommon in the US

48
Q

Graves Disease

A

autoimmune disorder which produces hyperthyoidism Protruding eyeballs, thickening of the skin on the feet Appears as a diffusely enlarged thyroid Increased color doppler due to overactivity of the gland

49
Q

Graves Disease: Sonographic appearance

A

heterogenous gland, increased color flow “thyroid inferno”

50
Q

Graves Disease: Clinical Findings

A

hypermetabolism, diffuse toxic goiter, exopthalamos

51
Q

Graves Disease: more common in what gender and age Hyperthyroidism

A

women over 30

52
Q

Malignant

A

papillary, follicular, medullary

53
Q

Tumor characteristics

A

may be isoechoic, hypoechoic, cystic or solid

54
Q

Risk of malignancy decreases when

A

multiple nodules are present

55
Q

FNA is necessary for

A

definitive diagnosis

56
Q

Parathyroid

A

4 glands 2 superior 2 inferior

57
Q

Parathyroid secretes

A

PTH (parathormone) which maintains the proper calcium levels in the blood

58
Q

Thyroglossal duct cyst

A

congenital,benign cysts located within the midline of the neck superior to the thyroid gland near the hyoid bone Asymptomatic, although may become painful when inflammed

59
Q

Branchial cleft cysts

A

benign congenital cysts found most often near the angle of the mandible

60
Q

Cervical Lymph nodes

A

Enlargement termed lymphadenopathy Greater than 1cm (Beth says 2cm) Can result from infections and malignancies May lose their normal hilar features and contain calcifications

61
Q

Thyroid FNA’s

A

Performed by Radiologist Guided by ultrasound Cells read by Pathologist Results to endocrinologist

62
Q

Disorder associated with hyperthyroidism

A

diffuse toxic hyperplasia (Graves Disease) Toxic Multinodular Goiter Toxic Adenoma makes up 99% of cases

63
Q

Nontoxic Simple Goiter Clinical Findings

A

Thyroid enlargement

64
Q

Nontoxic Simple Goiter Sonographic Appearance

A

sometimes smooth, sometime nodular possible compressoin of surrounding tissue

65
Q

Nontoxic Simple Goiter Differential Considerations

A

Thyroidism Hypothyroidism Neoplasm

66
Q

Toxic Multinodular Goiter Clinical Findings

A

Thyroid Enlargment

67
Q

Toxic Multinodular Goiter Sonographic Appearance

A

enlarged inhomogeneous gland can have focal scarring, focal ischemia, necrosis, and cyst formation

68
Q

Toxic Multinodular Goiter Differential Consideration

A

Neoplasm Cyst

69
Q

Graves Disease Clinical Findings

A

Diffuse toxic goiter

70
Q

Graves Disease Sonographic Findings

A

Diffusely homogeneous and enlarge

71
Q

Graves Disease Differential Consideration

A

Neoplasm Ophthalmopathy Cutaneous manifestation Hyperthyroidism

72
Q

Thyroidism Clinical Findings

A

swelling and tenderness of thyroid later hypthyroidism

73
Q

Thyroidism Sonographic Appearacne

A

homogeneous enlargement with nodularity later inhomogeneous

74
Q

Thyroidism Differential Consideration

A

Neoplasm

75
Q

Cyst Clinical Findings

A

solitary nodule or multiple nodule

76
Q

Cyst Sonographic Appearance

A

Anechoic areas, echogenic fluid, or moving fluid levels1

77
Q

Cyst Differential Consideration

A

Toxic multinodular goiter

78
Q

Adenoma Clinical Findings

A

Usually euthyroid or hyperthyroid

79
Q

Adenoma Sonographic Appearance

A

Compression of adjacent structure fibrous encapsulation ranges from anechoic to hyperechoic may have a halo

80
Q

Adenoma Differential Consideration

A

Grave’s Disease