Normal thyroid

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Questions and Answers

What is the primary function of the external jugular vein?

To supply oxygenated blood to the brain

To drain deoxygenated blood from the face and scalp (correct)

To unite with the superior vena cava

To transport blood to the carotid artery

Into which vein does the internal jugular vein unite before draining?

Superior vena cava

Subclavian vein (correct)

Brachiocephalic vein

Radial vein

Which statement accurately describes the wall structure of arteries compared to veins?

Arteries have thinner walls and are less pulsatile

Veins have thicker walls and are pulsatile

Both arteries and veins have the same wall structure

Arteries have thicker walls and are pulsatile (correct)

What is the ultimate destination of blood drained by the internal jugular vein?

Superior vena cava Signup and view all the answers

Which of the following vessels primarily supplies blood to the upper extremity?

Subclavian vein Signup and view all the answers

Which artery is not a branch of the aortic arch?

Right Subclavian Artery Signup and view all the answers

What are the main branches of the right common carotid artery?

Right Internal Carotid Artery and Right External Carotid Artery Signup and view all the answers

Which structures are primarily drained by the internal jugular vein?

Brain and superficial face structures Signup and view all the answers

Which muscle associated with the neck is primarily responsible for rotating the head?

Sternocleidomastoid Signup and view all the answers

Which of the following pairs of organs are located in the neck region?

Thyroid gland and esophagus Signup and view all the answers

The right vertebral artery branches off from which artery?

Right Subclavian Artery Signup and view all the answers

Which of the following arteries does not have a direct branch from the aortic arch?

Right Internal Carotid Artery Signup and view all the answers

What is the primary function of the parathyroid glands?

Control calcium levels in the blood Signup and view all the answers

What is the primary function of the Common Carotid Artery (CCA)?

Supplies blood to the face, scalp, and brain Signup and view all the answers

Which statement correctly describes the Internal Carotid Artery (ICA)?

Supplies blood to the brain and retina Signup and view all the answers

What effect does the 'Temporal Tap' have on the External Carotid Artery (ECA)?

Causes thumping artifact Signup and view all the answers

How does the External Carotid Artery (ECA) compare to the Internal Carotid Artery (ICA) in terms of blood flow resistance?

ECA has higher resistance to blood flow Signup and view all the answers

What anatomical feature is associated with the carotid bulb?

It is a site for plaque build-up Signup and view all the answers

Where does the Vertebral Artery ascend?

Within the transverse foramina of the cervical spine vertebrae Signup and view all the answers

What is a notable characteristic of the thyroid gland?

It straddles the trachea and has variable size Signup and view all the answers

What percentage of blood flow does the External Carotid Artery (ECA) contribute compared to the Common Carotid Artery (CCA)?

20% Signup and view all the answers

Which artery is the first branch of the external carotid artery (ECA) that supplies the thyroid gland?

Superior thyroid artery Signup and view all the answers

What hormone is secreted by parafollicular cells (C-cells) in the thyroid gland?

Calcitonin Signup and view all the answers

How many hormonal secretions does the thyroid gland produce and store under the influence of TSH?

3 hormones Signup and view all the answers

Which landmark is NOT a medial border of the thyroid gland?

Sternocleidomastoid muscle Signup and view all the answers

What regulates the function of the thyroid gland by releasing Thyroid Stimulating Hormone (TSH)?

Anterior pituitary gland Signup and view all the answers

What are the size dimensions of the parathyroid glands?

5-7mm length, 3-4mm width, 1-2mm thickness Signup and view all the answers

What is the function of the thyroid hormones in the body?

Regulate basal metabolism Signup and view all the answers

Which structure is a part of the anterolateral border of the thyroid gland?

Sternohyoid muscle Signup and view all the answers

What hormone is secreted by the parathyroid gland to regulate blood calcium levels?

Parathyroid Hormone (PTH) Signup and view all the answers

Which group of salivary glands is the largest?

Parotid glands Signup and view all the answers

What is the purpose of neck ultrasound in the assessment of thyroid and parathyroid glands?

To determine the presence of nodules Signup and view all the answers

What patient positioning is recommended during a neck ultrasound?

Supine with head turned slightly and neck hyperextended Signup and view all the answers

What equipment may be necessary when performing a neck ultrasound for thyroid evaluations?

12-15 MHz linear transducer Signup and view all the answers

Which characteristic typically differentiates parathyroid nodules when assessed via ultrasound?

Their size and location Signup and view all the answers

What tissue characteristic is assessed during a neck ultrasound?

Echogenicity and echotexture Signup and view all the answers

During a neck ultrasound, which structure must be scanned thoroughly?

Entire neck region Signup and view all the answers

What condition would neck ultrasound help identify in relation to lymph nodes?

Presence/absence of lymphadenopathy Signup and view all the answers

In which condition might follow-up neck ultrasound studies be especially helpful?

After thyroid surgery Signup and view all the answers

What describes the sonographic appearance of the thyroid gland?

Homogeneous echotexture with medium- to high-level echogenicity Signup and view all the answers

Which neck muscle is positioned lateral to the thyroid gland?

Sternocleidomastoid Signup and view all the answers

What is the typical location of the esophagus in relation to the thyroid gland?

Lateral to trachea, medial to vessels Signup and view all the answers

In a carotid ultrasound, which of the following features is characteristic of veins?

Anechoic lumen with occasional RBC reflectors Signup and view all the answers

Which clinical manifestation is associated with transient monocular blindness?

Amaurosis fugax Signup and view all the answers

The sonographic appearance of malignant lymph nodes typically shows what characteristic?

Round to oval shape with a long/transverse ratio of 2:1 Signup and view all the answers

What is the typical appearance of the longus colli muscle on an ultrasound?

Hypoechoic and tubular or triangular depending on the image plane Signup and view all the answers

Which sonographic technique is NOT typically used for carotid ultrasound?

Computed tomography Signup and view all the answers

During a carotid ultrasound, what is the optimal patient positioning?

Supine with neck extended and head turned slightly toward the contralateral side Signup and view all the answers

What key symptom is associated with disturbances in movement coordination in TIAs or strokes?

Ataxia Signup and view all the answers

Which aspect is a sonographic characteristic of arteries?

Non-compressible and pulsatile Signup and view all the answers

What is the echogenic appearance of the esophagus in a transverse view on ultrasound?

Target-shaped with an echogenic center Signup and view all the answers

Which muscle is the closest to the thyroid gland?

Sternothyroid Signup and view all the answers

What role does color Doppler play in evaluating the thyroid gland?

Identifying vascular structures and flow patterns Signup and view all the answers

Study Notes

Neck Anatomy and Sonography

The neck is a complex area containing blood vessels, glands, muscles, lymph nodes, and the trachea and esophagus.
Structures include: carotid artery, jugular vein, trachea, thyroid gland, parathyroid glands, esophagus, muscles, lymph nodes, and salivary glands.
The ascending aorta becomes the aortic arch, which branches into three vessels (Right Brachiocephalic Artery, Left Common Carotid Artery, Left Subclavian Artery).
The Right Brachiocephalic Artery (Innominate Artery), Right Common Carotid Artery, and Right Subclavian Artery branch from the aortic arch.
The Left Common Carotid Artery and Left Subclavian Artery branch directly from the aortic arch..
The Internal Jugular Vein drains blood from the brain.
The External Jugular Vein drains blood from the face and scalp.
Both veins drain into the Subclavian vein, then into the Brachiocephalic Vein (Innominate), and finally into the Superior Vena Cava.
Extracranial cerebral arteries supply oxygenated blood to the face, scalp, brain, and upper extremities.
Extracranial cerebral veins carry deoxygenated blood away from these same areas.
Arteries have thicker walls and are pulsatile.
Veins have thinner walls and are compressible.
The Common Carotid Artery (CCA) supplies blood to the face, scalp, and brain, branches into the Internal Carotid Artery (ICA) and the External Carotid Artery (ECA).
The ICA is a larger branch (80% of CCA flow), providing blood to the brain and retina (opthalmic artery), with no branches until it becomes intracranial.
The ECA is a smaller branch (20% of CCA flow), supplying the neck, face, and scalp. It has multiple branches, including the superior thyroid artery.
The Vertebral Artery is a branch of the subclavian arteries, ascending within the transverse foramina of the cervical vertebrae, supplying the posterior aspect of the brain via the Basilar artery.
The thyroid gland is an endocrine gland located in the anterior neck, straddling the trachea.
It secretes hormones (T3 and T4) directly into the bloodstream.
The Thyroid gland has two lobes and an isthmus. Normal variations in size and pyramidal lobe presence exist.
Thyroid sonography is used to assess size, echogenicity, echotexture, and presence of nodules. The location, number, size, and type (solid, cystic, or complex) of nodules are key parameters for evaluation.
Parathyroid glands are four small endocrine glands located posterior to the thyroid gland and along its surface, also seen with ultrasound, particularly with abnormalities.
These glands secrete Parathyroid Hormone (PTH) to maintain blood calcium homeostasis.
Ultrasound-guided needle aspiration/biopsys are employed for further diagnostic evaluation as needed.
Salivary glands are located near the mandible, submandibular space (under the jawbone), and below the tongue.
Carotid ultrasound is used to assess blood flow abnormalities and evaluate vascular anatomy. It's useful for evaluating potential atherosclerotic disease and assessing the effectiveness of carotid repairs.
Transient Ischemic Attacks (TIAs) are brief episodes of neurologic dysfunction caused by focal brain or retinal ischemia, often resolving within one hour.
Clinical manifestations of TIAs/strokes include hemiparesis/hemiplegia, ataxia, dysphasia, and amaurosis fugax.
Assessing for lymph nodes, echogenicity, size, and shape is an element of a neck and thyroid assessment.
Vascular characteristics of the neck vessels are important considerations for imaging.
Understanding the plane of image/scan and the proper technique for assessing vessels is critical.
Specific patterns present with ultrasound images may be considered artifacts

Neck Muscle Anatomy

The sternocleidomastoid is the largest muscle in the neck, situated lateral to the thyroid.
Strap muscles (sternohyoid, sternothyroid, omohyoid) are located anterior to the thyroid, and omohyoid is closest to the thyroid.
Longus colli muscles are posterior to the thyroid and may be mistaken for pathology in imaging.
The ultrasound appearance of these muscles depends on anatomical plane.

Esophagus Anatomy

The esophagus typically sits on the left side of the neck, posterior to the trachea, and medial to vessels.
Ultrasound visualization reveals a tubular structure with echogenic mucus linings. Peristalsis (swallowing) is apparent.

Lymph Nodes

Benign lymph nodes are oval, hypoechoic, and 1-2 cm in size; malignant lymph nodes are round-oval, hypoechoic, and with a transverse to long axis ratio of less than 2.

Thyroid Gland Sonographic Appearance

Homogeneous echotexture with medium to high echogenicity, comparable to liver, spleen, and testes.
A thin, hyperechoic capsule encloses the thyroid.
Vascularity is clearly visible using color Doppler, with a uniform distribution.

###Parathyroid Gland Sonographic Appearance

Upper and lower poles require attention during parathyroid assessment.
Lower parathyroids are typically easier to visualize than upper ones.

###Salivary Glands Sonographic Appearance

Homogeneous in appearance with echogenicity consistent with neighboring muscles.
Presence of surrounding lymph nodes is sometimes observable.

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