Neck

What is the sonographic presentation of patients with papillary carcinoma?

Hypoechoic thyroid mass Adjacent enlarged cervical nodes

What are sonographic findings of malignant thyroid nodules? (3)

Internal calficiations, cervical node involvement, solitary mass

The thyroid gland utilizes what to produce its hormones?

Iodine

What is the most common form of thyroid cancer?

Papillary

What is the most common malignancy of the thyroid gland?

Papillary carcinoma (75-90%)

What hormone helps maintain a steady level of serum calcium in the blood?

calcitonin

4 characteristics of secdonary hyperparathyroidism

chronic renal failure, increased serum phospates, decreased serum calcium, thyroid hyperplasia

The fluid produced by the thyroid gland that contains thyroid hormones is referred to as:

colloid

Benign features of a thyroid nodule (6)

cystic, hyperechoic, sharp-well defined borders, egg shell calcifications, thin, complete halo

Which structure lies posterior and medial to the left thyroid gland?

esophagus

Which abnormality is generally identified by a halo surrounding it?

follicular adenoma

What hormone is produced by the parathyroid glands?

parathormone

Hypercalcemia is associated with?

parathyroid adenoma

The longus colli muscle is ____ to the thyroid gland.

posterior

The minor neurovascular bundle is ____ to the thyroid gland.

posterior

The normally located parathyroid glands are ____ to the thyroid gland.

posterior

The superior extension of the thyroid isthmus is referred to as the:

pyramidal lobe

Malignant features of a thyroid nodule (5)

solid, hypoechoic, irregular borders, fine/punctuate calcs, psammoma bodies, thick incomplete halo

Which muscle is located anterior to the thyroid?

sternohyoid

ECA branches into:

superior thyroid artery

Benign congenital cysts located superior to the thyroid gland near the hyoid bone are referred to as:

thyroglossal duct cysts

What is the largest endocrine gland?

thyroid

Which hormone is most abundantly produced by the thyroid?

thyroxine

What hormones are produced by the thyroid?

thyroxine, triiodothyronine, calcitonin

In the presence of Hashimoto thyroiditis, the thyroid produces:

too few thyroid hormones

What is a thyroglossal duct cyst? (5)

1. Congenital anomaly 2. Superficial cyst in the midline 3. Anterior to the trachea and superior to the thyroid 4. Preschool-age children 5. Following an upper respiratory infection

A normal lymph node will not measure greater than?

10mm

A thyroid isthmus that measures greater than __________ is indicative of thyroid enlargement.

10mm

How many parathyroid glands are found within the adult neck?

4

What are diagnostic findings of benign thyroid nodules?

Anechoic mass, eggshell calcification, hyperechoic mass

What is a cold nodule?

Area of hypofunctioning

What is the thyroglossal duct?

As primitive cells migrate from the pharyngeal floor to become the thyroid, a residual thyroglossal duct is formed. The thyroglossal duct normally becomes obliterated in fetal life.

What are 4 clinical characteristics of chronic lymphocytic (Hashimoto's) thyroiditis?

Autoimmune disease Painless, diffuse enlargement of the thyroid Young to middle-aged women Associated with hypothyroidism

What mass commonly appears as a cold nodule in a nuclear medicine thyroid scintigram?

Benign thyroid nodules

A 6-year old patient presents with a lateral neck mass. The mass is anterior to the sternocleidomastoid muscle and lateral to the thyroid near the angle of the mandible. The mass is predominantly cystic, with enhanced through-transmission. What is the most likely diagnosis?

Branchial cleft cyst

Parathyroid glands control the release and absorption of which nutrient?

Calcium

Which could be a malignant thyroid nodule? A cold nodule or a hot nodule.

Cold nodule

Describe the sonographic features of Graves' disease. (3)

Diffusely enlarged Identical to a multinodular goiter Increased vascularity

Describe the sonographic presentation of chronic lymphocytic (Hashimoto's) thyroiditis. (3)

Diffusely, enlarged thyroid Homogenous but coarse parenchymal echo texture More hypoechoic

What are the symptoms of Graves' disease? (7)

Exophthalmos (bulging eyes) Palpable lymph nodes Muscle atrophy Localized myxedema Weight loss Tremors Nervousness

A 30-year-old patient presents 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?

Graves disease

Hyperthyroidism associated with a diffuse goiter is associated with:

Graves disease

What is the most common cause of hyperthyroidism?

Graves disease

Which abnormality is associated with the sonographic findings of a thyroid inferno?

Graves disease

What three diseases produce diffuse enlargement of the thyroid?

Graves, Hashimoto, acute thyroiditis

What is the most common cause of hypothyroidism?

Hashimoto thyroiditis

Multiple endocrine neoplasia is a familial, autosomal dominant, adenomatous hyperplasia. Name four tumors associated with multiple endocrine neoplasia that can be visualized sonographically.

Parathyroid adenoma Pancreatic islet cell tumor Pheochromocytoma Medullary Thyroid adenoma

Name 5 tumors associated with Multiple Endocrine Neoplasia (MEN) syndrome.

Pituitary adenoma Parathyroid adenoma Medullary thyroid carcinoma Pancreatic islet cell tumor Pheochromocytoma

What are sonographic findings of an abnormal lymph node? (3)

Rounded shape, calcifications, enlargement

Which muscles are located lateral to each thyroid lobe?

Sternocleidomastoid

Which muscles are located anterior to the thyroid gland?

Strap

What is the first branch of the external carotid artery?

Superior thyroid artery

The strap muscles of the neck are ____ to the thyroid gland.

anterior

The sternocleidomastoid muscle of the neck is ____ to the thyroid gland.

anterolateral

A cystic mass noted at the mandibular angle is most likely a:

branchial cleft cyst

Which cyst is located lateral to the neck near the carotid arteries?

branchial cleft cyst

What is the normal appearance of a cervical lymph node?

hypoechoic, oblong structure with a distinct echogenic hilum

3 characteristics of primary hyperparathyroidism

increased PTH, increased serum calcium, single parathyroid adenoma

Sup and middle thyroid veins drains into:

inernal jugular vein

Thyrocervical artery branches into:

inferior thyroid artery

Inferior thyroid vein drains into:

innominate vein

Which vascular structure is located closest to the thyroid lobes?

internal carotid artery

The common carotid artery and internal jugular vein are ____ to the thyroid gland.

lateral

Which muscles are located posterior to each thyroid lobe?

longus colli

Papillary carcinoma ______ 20% and ______ 48%.

multicentric, occult