Chapter 9 Neck

retrotracheal; mediastinal; intrathyroid; and undescended near the carotid bifurcation

4 most common ectopic parathyroid locations

3.6%

5 year survival rate of anaplastic thyroid carcinoma

hypothyroidism

Hashimoto's thyroiditis is associated with

Hyperthyroidism symptoms

Nervousness, weight loss, excessive sweating and heat intolerance, palpitations, frequent bowel movements, muscular weakness, tremor, prominent eyes, cardiovascular symptoms

halo or hypoechoic rim

a _ or _ is present around the adenoma in 50% of the cases

benign colloid nodule or adenomatous nodule that has undergone degeneration or hemorrhage

a nodule that has a significant cystic component is usually a

pyramidal lobe

a normal variant of the thyroid gland in which there is a superior extension of the isthmus

Thyroglossal duct cyst

a palpable cystic midline mass in the neck due to incomplete closure of the thyroglossal duct.

young-middle aged women

age group associated with Hashimoto's

a rapidly growing mass extending beyond the gland and invading adjacent structures

anaplastic thyroid cancer typically presents as

superior and inferior thyroid artery

arterial supply to the thyroid comes from the

well-defined, hypoechoic mass

benign follicular adenoma US appearance

thyroid enlargement and increased vascularity

increased production of the thyroid hormone (hyperthyroidism) causes

thyrocervical artery

inferior thyroid artery (supplies inferior thyroid) are branches of the

innominate vein

inferior thyroid vein drains into the

peripheral or eggshell-like

location/pattern of calcification associated with a benign nodule

posterior, lateral

longus colli muscles is _ and slightly _ to the thyroid

posterior (not usually visualized)

parathyroid gland is located _ to the thyroid

fine punctate

pattern of calcifications associated with a malignant nodule

benign

predominantly hyperechoic nodule is more likely to be

serum parathyroid hormone (PTH) and serum calcium levels

primary hyperparathyroidism is confirmed with increased levels of

single parathyroid adenoma

primary hyperparathyroidism is usually caused by a

worse than follicular cancer

prognosis of patients with medullary carcinoma

carotid body tumor

rare and highly vascular tumor arising from the carotid body at the bifurcation (chemodectoma or paragaanglioma)

Invasive fibrous thyroiditis (Riedel's struma)

rarest type of inflammatory thyroid disease; results in complete destruction of the gland

Anaplastic thyroid carcinoma

represents one of the most lethal human solid tumors (typically in elderly)

chronic renal failure

secondary hyperparathyroidism is found in patients with

reverberation

trachea gives off a characteristic curvilinear reflecting surface which is associated with what artifact

superior and middle thyroid veins; inferior thyroid vein

venous drainage from the thyroid is accomplished by

round laminated calcifications (psammona bodies)

what can be a distinguishing feature of papillary carcinoma

lateral

CCA and IJV are _ to the thyroid

chronic autoimmune (Hashimoto's) thyroiditis; colloid or adenomatous goiter; Graves disease

conditions that produce thyroid gland enlargement

goiter

diffuse enlargement of the thyroid gland

hypoechoic to thyroid tissue

echogenicity of parathyroid adenomas

brachial cleft cyst

embryonic brachial cleft remnant that develops as a a cystic in the neck at the angle of the mandible

Hypothyroidism symptoms

fatigue; weakness; weight gain; coarse, dry hair; dry, rough pale skin; hair loss; cold intolerance; muscle cramps; constipation; depression; irritability; memory loss; abnormal menstrual cycles; decreased libido

blood stream

follicular cancers spreads via the

encapsulated (similar to benign counterpart-may be indistinguishable)

follicular carcinoma appearance

children

majority of patients with brachial cleft cysts are

irregular, poorly defined

malignant lesions tend to have _ or _ _ margins

MEN type II syndromes

medullary carcinoma is associated with

calcitonin

medullary carcinoma secretes the hormone

lung and bone

mets from follicular carcinoma will normally present in the

posterior

minor neurovascular bundle is _ to the thyroid (between the longus colli muscle and thyroid gland)

recurrent laryngeal nerve and inferior thyroid vessels

minor neurovascular bundle is composed of

20-30%

mortality rate of follicular carcinoma after 20 years

6% (good prognosis)

mortality rate of papillary carcinoma after 20 years

Graves disease

most common cause worldwide of hyperthyroidism

papillary carcinoma

most common primary thyroid cancer (75-90% cases)

chronic lymphocytic (Hashimoto's) thyroiditis

most common type of thyroiditis

colloid or adenomatous nodules

most commonly encountered benign thyroid nodule (cystic)

FNA

most effective method for diagnosing malignancy in the thyroid nodule

increased serum phosphate levels, decreased serum calcium levels, parathyroid hyperplasia

signs of secondary hyperparathyroidism

anterolateral

sternocleidomastoid is _ to the thyroid

anterior

strap muscles are _ to the thyroid

sternohyoid and sternothyroid

strap muscles include

IVC

superior and middle thyroid veins drains into the

ECA

superior thyroid artery (supplies superior thyroid) are branches of the

lymphatics, lymph nodes

the major route papillary carcinoma spreads is through the _ to near by cervical _

benign

the majority of thyroid nodules are

malignant nodule

thick incomplete peripheral halo =

benign nodule

thin complete peripheral halo =