Neck Review

The superior thyroid artery is a branch of what artery? a. common carotid b. internal carotid c. external carotid d. thyrocervical e. inferior thyroid

c. external carotid

During transverse imaging of the thyroid, you detect a hypoechoic, round nodule posterior and medial to the thyroid. How can you determine if this is the esophagus or a nodule? a. image the patient in both inspiration and expiration b. have the patient perform a valsalva maneuver c. have the patient swallow while scanning the area d. scan the patient in an upright position e. all of the above

c. have the patient swallow while scanning the area

Which of the following arteries arises first from the ICA? a. basilar artery b. vertebral artery c. ophthalmic artery d. superior thyroid artery e. middle cerebral artery

c. ophthalmic artery

Development of which of the following conditions is linked to hyperthyroidism? a. kidney failure b. acute pancreatitis c. osteoporosis d. hepatomegaly e. pleural effusion

c. osteoporosis

Hypercalcemia is associated with which of the following? a. grave's disease b. thyroglossal duct cyst c. parathyroid adenoma d. thyroid adenoma

c. parathyroid adenoma

Pancreatitis, hypertension, and hypercalcemia are clinical findings associated with which of the following neoplasms? a. thyroid adenoma b. multinodular goiter c. parathyroid adenoma d. thyroid carcinoma e. parathyroid carcinoma

c. parathyroid adenoma

Secretion of the thyroid hormones is stimulated by which of the following structures? a. cerebellum b. thyroid gland c. pituitary gland d. parathyroid gland e. hypothalamus

c. pituitary gland

Clinical findings associated with graves disease may include all of the following except: a. dyspnea b. dysphagia c. exophthalmos d. hypothyroidism e. palpable neck mass

d. hypothyroidism

The majority of blood supplied to the brain is through the: a. vertebral arteries b. external carotid arteries c. circle of willis d. internal carotid arteries e. common carotid arteries

d. internal carotid arteries

Normally, how many parathyroid glands are found within the adult neck? a. 3 b. 4 c. 6 d. 8

b. 4

A 30-year-old patient presents to the ultrasound department for a thyroid sonogram with a history of weight loss, hair loss, and hyperthyroidism. You note that the patient has bulging eyes. What is the most likely diagnosis? a. Hashimoto thyroiditis b. Grave's disease c. hyperparathyroidism d. cervical lymphadenopathy

b. Grave's disease

During transverse insonation of the thyroid gland, you detect two large vessels just lateral to the thyroid. What is the most lateral vessel? a. CCA b. IJV c. vertebral artery d. SCA e. EJV

b. IJV

A homogeneous mass is identified within the inferior portion of a thyroid love. A prominent hypoechoic ring surrounds this mass. These sonographic findings are most suspicious with which of the following neoplasms? a. lipoma b. adenoma c. lymph node d. complex cyst e. papillary carcinoma

b. adenoma

The vertebral arteries join at the base of the skull to form the: a. circle of willis b. basilar artery c. carotid sinus d. ophthalmic artery e. brachiocephalic artery

b. basilar artery

A solitary hypoechoic thyroid nodule demonstrating irregular borders and microcalcifications is most suspicious for: a. thyroiditis b. carcinoma c. an adenoma d. diffuse hyperplasia e. a hemangioma

b. carcinoma

All of the following are sonographic findings of an abnormal lymph node except: a. rounded shape b. echogenic hilum c. calcifications d. enlargement

b. echogenic hilum

All of the following are sonographic findings of malignant thyroid nodules except: a. internal calcifications b. echogenic mass c. cervical node involvement e. solitary mass

b. echogenic mass

The fluid produced by the thyroid gland that contains thyroid hormones is referred to as: a. thyroxine b. calcitonin c. colloid d. triiodothyronine

c. colloid

Examination techniques used in thyroid imaging include all of the following except: a. multiple imaging focal zones b. 7 MHz or higher linear transducer c. decreasing the dynamic range d. hyperextension of the patient's neck e. low PRF in Doppler imaging

c. decreasing the dynamic range

Pronounced swelling of the neck is most often caused by a(n): a. thyroglossal cyst b. carotid body tumor c. enlarging thyroid gland d. thrombosis in the jugular vein e. aneurysm of the carotid artery

c. enlarging thyroid gland

Which of the following muscles is located lateral to the thyroid lobes just beneath the subcutaneous tissues in the neck? a. longus colli b. sternohyoid c. platysma d. omohoid e. sternocleidomastoid

c. platysma

A parathyroid mass may be suspected when an abnormality is located: a. superior to the thyroid isthmus b. lateral to a thyroid lobe c. posterior to a thyroid lobe d. anterior to the thyroid isthmus e. posterior to the longus colli muscle

c. posterior to a thyroid lobe

What is the first branch of the external carotid artery? a. ICA b. optic artery c. superior thyroid artery d. inferior thyroid artery

c. superior thyroid artery

Which of the following arteries is the first branch of the ECA? a. lingual artery b. fascial artery c. superior thyroid artery d. ascending pharyngeal artery e. superficial temporal artery

c. superior thyroid artery

Which of the following statements about the carotid artery is true? a. the right CCA arises from the aortic arch b. the ECA courses lateral to the ICA c. the ICA terminates at the COW d. the CCA has multiple extracranial branches e. the ICA lies anterior to the ECA

c. the ICA terminates at the COW

The first indication of thyroid gland failure is linked with a decrease in: a. thyroxine b. calcitonin c. thyrotropin d. triiodothyronine e. progesterone

c. thyrotropin

In the presence of Hashimoto thyroiditis, the thyroid produces: a. too many thyroid hormones b. too much calcium c. too few thyroid hormones d. too much iodine

c. too few thyroid hormones

A normal lymph node will not measure greater than: a. 8 mm b. 5 mm c. 12 mm d. 10 mm

d. 10 mm

A thyroid isthmus that measures greater than ____ is indicative of thyroid enlargement. a. 8 mm b. 5 mm c. 12 mm d. 10 mm

d. 10 mm

You are performing an ultrasound exam on a patient with parathyroid hyperplasia. How many glands are usually involved in this condition? a. 1 b. 2 c. 3 d. 4 e. 5

d. 4

The normal length of an adult thyroid lobe is approximately: a. 1 cm b. 2 cm c. 3 cm d. 4 cm e. 6 cm

d. 4 cm

Which vascular structure is located closest to the thyroid lobes? a. external carotid vein b. external carotid artery c. IJV d. ICA

d. ICA

You have identified the thyrocervical trunk in a patient with a hypervascular thyroid nodule. The thyrocervical trunk arises from what artery? a. CCA b. ICA c. ECA d. SCA e. vertebral artery

d. SCA

Indications for a thyroid ultrasound examination may include all of the following except: a. fatigue b. dysphagia c. palpitations d. audible bruit e. palpable neck mass

d. audible bruit

Parathyroid glands control the release and absorption of which nutrient? a. thyroxine b. triiodothyronine c. calcitonin d. calcium

d. calcium

All of the following are diagnostic findings of benign thyroid nodules except: a. anechoic mass b. eggshell calcification c. hyperechoic mass d. cold nodule

d. cold nodule

You are performing a thyroid ultrasound on a patient with a history of Hashimoto's thyroiditis. What is the sonographic appearance of this condition? a. multiple, large, hypoechoic nodules throughout both lobes b. many small, echogenic nodules throughout both lobes c. small, shrunken thyroid with heterogeneous echo texture d. diffuse enlargement of the thyroid with heterogeneous echo texture e. enlarged thyroid with homogeneous, low-level echo texture

d. diffuse enlargement of the thyroid with heterogeneous echo texture

A patient has been referred for a thyroid ultrasound to locate a parathyroid adenoma. How many parathyroid glands are present in most people? a. one b. two c. three d. four e. six

d. four

What vessel is seen to course through the transverse foramina of the cervical spine? a. common carotid b. superior thyroid c. inferior thyroid d. thyrocervical e. vertebral

e. vertebral

A patient presents with a palpable anterior neck mass. The patient denies any recent surgery or fever. A nonvascular complex mass is identified extending from the superior portion of the isthmus to the patient's chin. On the basis of the clinical history, this is most suspicious for: a. cystic hygroma b. thyroid abscess c. thyroglossal cyst d. brachial cleft cyst e. multinodular goiter

c. thyroglossal cyst

Benign congenital cysts located superior to the thyroid gland and near the hyoid bone are referred o as: a. brachial cleft cysts b. follicular adenomas c. thyroglossal duct cyst d. parathyroid adenomas

c. thyroglossal duct cyst

A thyroglossal cyst is located between which of the following structures? a. hyoid bone and thyroid gland b. left thyroid lobe and tongue c. thyroid isthmus and tongue d. right thyroid lobe and tongue e. trachea and thyroid gland

c. thyroid isthmus and tongue

Primary carcinoma of the thyroid gland is known to extend to all of the following structures except: a. lung b. bone c. larynx d. liver e. lymph nodes

d. liver

Which of the following muscles is located posterior to the thyroid lobes? a. sternohyoid b. platsyma c. omohyoid d. longus colli e. sternocleidomastoid

d. longus colli

You are performing an ultrasound exam to rule out the presence of parathyroid adenoma. Hyperparathyroidism is usually caused by enlargement of how many parathyroid glands? a. 1 b. 2 c. 3 d. 4 e. 5

a. 1

During transverse insonation of the thyroid gland, you detect two large vessels just lateral to the thyroid. What is the most medial vessel? a. CCA b. IJV c. vertebral artery d. SCA e. EJV

a. CCA

Which of the following best describes the normal appearance of a cervical lymph node? a. a hypoechoic, oblong structure with a distinct echogenic hilum b. a rounded, echogenic structure with small calcifications c. a solid, hypoechoic mass that measures greater than 1 cm d. a solid, echogenic mass that measures less than 1 cm

a. a hypoechoic, oblong structure with a distinct echogenic hilum

The majority of the thyroid nodules identified on ultrasound are: a. benign b. fluid filled c. hypervascular d. malignant e. multilocular

a. benign

A cystic mass noted at the mandibular angle is most likely a: a. brachial cleft cyst b. follicular adenoma c. thyroglossal duct cyst d. parathyroid adenoma

a. brachial cleft cyst

Which of the following would more likely be a malignant thyroid nodule? a. cold nodule b. hot nodule

a. cold nodule

What type of gland is the thyroid gland? a. endocrine b. exocrine c. both a and b d. neither a nor b

a. endocrine

What structure may be confused for a thyroid or parathyroid mass because of its relationship to the trachea and the posterior aspect of the left thyroid gland? a. esophagus b. common carotid artery c. internal jugular vein d. sternothyroid

a. esophagus

What is the most common cause of hyperthyroidism? a. graves disease b. hashimoto thyroiditis c. papillary carcinoma d. parathyroid adenoma

a. graves disease

You are performing a thyroid study on a patient with an enlarged gland. Color Doppler shows markedly increased vascularity of both lobes. Which of the following is most likely? a. graves disease b. adenomatous goiter c. hashimoto's thyroiditis d. follicular adenoma e. colloid nodule

a. graves disease

You are performing a thyroid sonogram on a patient with a nodule suspicious for malignancy. What is the most common form of thyroid cancer? a. papillary carcinoma b. follicular carcinoma c. medullary carcinoma d. lymphoma e. metastatic disease

a. papillary carcinoma

Which muscles are located lateral to each thyroid lobe? a. sternocleidomastoid b. longus colli c. sternohyoid d. omohyoid

a. sternocleidomastoid

Which of the following is the hormone that is the most abundantly produced by the thyroid? a. thyroxine b. iodine c. triiodothyronine d. calcitonin

a. thyroxine

During sonographic imaging of the thyroid, you detect several cervical lymph nodes. Which of the following is not true regarding these lymph nodes? a. ultrasound cannot detect normal lymph nodes b. visualization of inflammatory lymph nodes in the neck is common c. most normal cervical lymph nodes have an oblong or oval shape d. the greatest dimension in normal cervical lymph nodes is the sagittal axis e. most inflammatory lymph nodes exhibit an echogenic hilum

a. ultrasound cannot detect normal lymph nodes

Multlocular nodules are demonstrated on a sonogram of a thyroid gland. This is most consistent with which of the following conditions? a. caroli disease b. graves disease c. DeQuervain syndrome d. hashimoto disease e. addison syndrome

b. graves disease

Which abnormality is associated with the sonographic findings of a thyroid inferno? a. hashimoto thyroiditis b. graves disease c. hyperparathyroidism d. cervical lymphadenopathy

b. graves disease

Which of the following conditions is considered a predisposing factor for developing a thyroid malignancy? a. graves disease b. hashimoto disease c. DeQuervain syndrome d. caroli disease e. marfan syndrome

b. hashimoto disease

What is the most common cause of hypothyroidism? a. graves disease b. hashimoto thyroiditis c. papillary carcinoma d. parathyroid adenoma

b. hashimoto thyroiditis

All of the following are hormones produced by the thyroid except: a. thyroxine b. iodine c. triiodothyronine d. calcitonin

b. iodine

The thyroid gland utilizes which of the following to produce its hormone? a. colloid b. iodine c. iron d. calcium

b. iodine

What muscle is located posterior to each lobe of the thyroid? a. sternocleidomastoid b. longus colli c. sternohyoid d. sternothyroid e. both c and d

b. longus colli

Which muscles are located posterior to each thyroid lobe? a. sternocleidomastoid b. longus colli c. sternohyoid d. omohyoid

b. longus colli

A congenital anomaly associated with an additional thyroid lobe arising from the isthmus is termed a(n): a. accessory lobe b. pyramidal lobe c. ectopic lobe d. duplicated isthmus e. vertebral lobe

b. pyramidal lobe

Serial evaluation of a multinodular goiter should include measurements of the overall length, height, and width of a thyroid lobe along with measurements of length, height, and width of: a. each individual nodule b. the largest nodule(s) c. the complex nodule(s) d. the posterior nodule(s) e. the hypervascular nodule(s)

b. the largest nodule(s)

A patient with a history of hyperthyrodism followed by hypothyroidism, dysphagia, and leukocytosis. A sonogram demonstrates an enlarged hypervascular thyroid gland. On the basis of this clinical history, the sonographic findings are most suspicious for which of the following conditions? a. goiter b. thyroiditis c. hyperplasia d. metastatic disease e. hyperparathyroidism

b. thyroiditis

Including iodide in your diet is required for the normal production of: a. calcium b. thyroxine c. calcitonin d. thyrotropin e. triiodothyronine

b. thyroxine

Clinical symptoms of hypothyroidism include all of the following except: a. arthritis b. tremors c. muscle cramps d. weight gain e. skin dryness

b. tremors

Which of the following vascular structures receives blood from the posterior brain and empties into the brachiocephalic vein? a. subclavian vein b. vertebral vein c. innominate vein d. external jugular vein e. inferior mammary vein

b. vertebral vein

How many parathyroid glands are found in the majority of the population? a. 2 b. 3 c. 4 d. 5 e. 6

c. 4

You are performing a thyroid ultrasound on a young woman with hypothyroidism. You detect a moderately enlarged, hypoechoic thyroid with a coarsened parenchymal echo texture. Which of the following conditions is most likely present, considering the history and findings? a. Grave's disease b. multinodular adenomatous goiter c. Hashimoto's thyroiditis d. papillary carcinoma e. normal thyroid

c. Hashimoto's thyroiditis

Which of the following is not true regarding thyroid nodules? a. the overwhelming majority of thyroid nodules are benign b. thyroid nodules are very common c. a solitary thyroid nodule is usually malignant d. nodules with significant cystic component are usually benign e. nodules may be hyperechoic or hypoechoic to the thyroid

c. a solitary thyroid nodule is usually malignant

Which of the following is the most common etiology of hyperparathyroidism? a. carotid body tumor b. cyst of a parathyroid gland c. adenoma of a parathyroid gland d. hyperplasia of a parathyroid gland e. multinodular goiter of a thyroid gland

c. adenoma of a parathyroid gland

A patient presents with a superficial neck mass located near the angle of the jaw. On ultrasound, the mass demonstrates a few swirling echoes within an anechoic mass. On the basis of this clinical history, the sonographic findings are most suspicious for a: a. cystic hygroma b. thyroglossal cyst c. branchial cleft cyst d. carotid body tumor e. parthyroid cyst

c. branchial cleft cyst

A 32-year-old female presents with a 2-month history of fatigue, sore throat, and dysphagia following an episode of cellulitis. The results of the lab tests are pending. On the basis of the clinical history, the most likely diagnosis is: a. hyperplasia b. graves disease c. metastatic disease d. hashimoto disease e. carotidy body tumor

d. hashimoto disease

Which of the following is most commonly associated with hypothyroidism? a. graves disease b. cushing disease c. addison disease d. hashimoto disease e. DeQuervain syndrome

d. hashimoto disease

You have been asked to identify a parathyroid adenoma. What is the typical sonographic appearance of this structure? a. hyperechoic, round, solid nodule b. heterogeneous, oval, solid nodule c. round, solid nodule, isoechoic to the thyroid gland d. homogeneous, hypoechoic, solid-oval shaped nodule e. hypoechoic nodule with a highly echogenic hilum

d. homogeneous, hypoechoic, solid-oval shaped nodule

A cystic hygroma is most likely related to which of the following abnormalities? a. thyroglossal cyst b. hyperparathyroidism c. arteriovenous fistula d. inadequate drainage of lymph fluid e. impaired synthesis of thyroid hormone

d. inadequate drainage of lymph fluid

Which of the following muscles is most often affected by a whiplash injury? a. scalene b. platysma c. sternohyoid d. longus colli e. sternocleidomastoid

d. longus colli

Symptoms of hyperthyroidism may include all of the following except: a. nervousness b. weight loss c. exophthalmos d. muscle cramps e. increased heart rate

d. muscle cramps

Which of the following is the most common form of thyroid cancer? a. follicular b. anaplastic c. lymphoma d. papillary

d. papillary

You are performing a thyroid ultrasound on a patient with increased serum calcium levels. What pathology are you searching for? a. Hashimoto's thyroiditis b. Grave's disease c. adenomatous thyroid nodule d. parathyroid adenoma e, colloid cyst

d. parathyroid adenoma

The superior extension of the thyroid isthmus is referred to as: a. thyroglossal duct b. brachial cleft c. yodeler's lobe d. pyramidal lobe

d. pyramidal lobe

Which muscles are located anterior to the thyroid gland? a. sternocleidomastoid b. longus colli c. thyrocervical trunk d. strap

d. strap

1. Which of the following veins empties directly into the IJV? a. vertebral b. subclavian c. brachiocephalic d. superior thyroid e. external jugular

d. superior thyroid

Which of the following describes the correct patient positioning for sonographic evaluation of the thyroid? a. the patient is spine in a reversed trendelenburg position b. the right thyroid lobe is examined with the patient in a LLA position, and the left thyroid lobe is examined with the patient in RLD position c. the patient is prone with the neck extended d. the patient is supine with the neck hyperextended by a pad underneath the scapulae e. the patient is best examined in an upright position with the chin on the chest

d. the patient is supine with the neck hyperextended by a pad underneath the scapulae

Tissue metabolism is regulated by which of the following hormones? a. thyrotropin b. thyroxine c. calcitonin d. triiodothyronine e. parathormone

d. triiodothyronine

You have been requested to perform a thyroid ultrasound on a patient with a palpable nodule in the left neck. Which of the following transducers would provide the most optimal scan? a. 2.25 MHz curved linear array b. 3.5 MHz curved linear array c. 5.0 MHz curved linear array d. 7.5 MHz curved linear array e. 10.0 MHz linear array

e. 10.0 MHz linear array

Inflammation of the thyroid gland secondary to a viral infection is most commonly associated with which of the following conditions? a. graves disease b. caroli disease c. mirizzi syndrome d. addison syndrome e. DeQuervain syndrome

e. DeQuervain syndrome

Which of the following symptoms is most likely related to hypercalcemia? a. fatigue b. weight gain c. palpitations d. tingling feet e. abdominal pain

e. abdominal pain

Which performing a thyroid ultrasound, you detect a lymph node suspicious for malignancy. Which of the following sonographic features is consistent with nodal malignancy in the neck? a. rounded lymph node b. heterogeneous echo texture c. intranodal calcification d. absence of the echogenic hilum e. all of the above

e. all of the above

On the left side of the neck, the common carotid artery arises from what artery? a. innominate b. subclavian c. right common carotid d. internal jugular e. aortic arch

e. aortic arch

What muscle is seen as thin, hypoechoic bands immediately anterior to each thyroid lobe? a. sternocleidomastoid b. longus colli c. sternohyoid d. sternothyroid e. both c and d

e. both c and d

Which of the following is considered a function of the parathyroid gland? a. producing hormones b. secreting calcitonin c. regulating serum electrolytes d. initiating an immune reaction e. maintaining homeostasis of blood calcium concentrations

e. maintaining homeostasis of blood calcium concentrations

What is the role of color Doppler in evaluating thyroid nodules? a, increased color Doppler flow within a nodule indicates malignancy b. identification of a vascular halo around a nodules indicates a benign condition c. hyperemia of a heterogeneous thyroid by color Doppler indicates malignancy. d. a,b, and c e. neither color nor spectral Doppler have been shown to be sensitive in determining if a thyroid nodule is benign or malignant

e. neither color nor spectral Doppler have been shown to be sensitive in determining if a thyroid nodule is benign or malignant

Exposure to ionizing radiation is a predisposing factor for development of which of the following neoplasms? a. thyroglossal cyst b. cystic hygroma c. thyroid adenoma d. parathyroid cyst e. parathyroid adenoma

e. parathyroid adenoma