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Neck and Thyroid Gland
Built from Behrbohm — Ear, Nose and Throat Diseases with Head and Neck Surgery
What’s inside
12 sections · 134 slides
Overview
- How to read this deck, and why the neck matters
Applied Anatomy and Physiology
The crowded corridor: what is packed into the neck, and how it is organised
- What the neck is and what it holds
- Surface landmarks you can see and feel
- Regions: the SCM divides the neck into two
- The lateral region and the omohyoid landmark
- Regions and triangles of the neck
- Contents of the superior carotid triangle
- Cervical fascia: the wrappings that organise the neck
- The danger space and the carotid sheath
- The fascial envelopes of the neck in cross-section
- Why the interfascial spaces matter clinically
- Cervical interfascial spaces and the danger space
- The deep neck spaces: a map of where infection hides
- Retropharyngeal, danger and prevertebral spaces
- Parapharyngeal and submandibular spaces
- Vascular anatomy: the common carotid artery
- The external carotid artery and its eight branches
- The external carotid artery and its branches
- The internal carotid, vertebral and subclavian supply
- The subclavian artery and its branches
- The carotid sinus and carotid body: the neck's sensors
- Venous drainage of the head and neck
- The cervical venous system
- When brain arteries fail: collaterals and syndromes
- Two named vascular syndromes to recognise
- Collateral circulation and subclavian steal
- The cervical lymphatic system
- The final lymph stations
- Classification of cervical lymph nodes into levels
- Central lymph spaces at the base of the neck
- Nerves of the neck: motor supply
- Motor nerves in the neck
- Sensory supply and Erb's point
- Sensory nerves in the neck
- The vagal nerve system: mixed nerves
- The sympathetic chain and Horner syndrome
- Basic physiology: coughing, straining and Valsalva
Examining the Neck
History, inspection, palpation, imaging and biopsy
- Taking the history: the typical symptoms
- Inspection and palpation of the neck
- Systematic palpation of the cervical lymph nodes
- Differential diagnosis of a cervical swelling
- Diagnostic imaging: the main techniques
- Special imaging and biopsy
Inflammatory Disease of the Neck
From superficial boils to deep-space infections and the specific lymphadenopathies
- Soft-tissue infection: superficial versus deep
- Superficial infections: furuncles and carbuncles
- Deep neck abscesses
- Mediastinitis: when neck infection descends
- Actinomycosis
- Acute cervical lymphadenitis
- Chronic cervical lymphadenitis
- Tuberculous lymphadenopathy (scrofula)
- Skin reaction over a tuberculous cervical node
- Tuberculous lymphadenopathy: diagnosis and treatment
- Syphilis and sarcoidosis of the neck nodes
- Cat-scratch disease and tularemia
- Toxoplasmosis
- Lyme disease
Cervical Syndrome and Neck Trauma
The imprecise 'cervical spine syndrome', and blunt, penetrating and vascular injury
- Cervical spine syndrome
- Injuries to the cervical spine
- Injuries to the aerodigestive tract and vessels
Congenital and Skeletal Anomalies
Midline, lateral and skeletal lesions of the neck
- Thyroglossal duct cysts
- A thyroglossal duct cyst in the midline neck
- Median cervical fistula and the Sistrunk operation
- Typical sites for cervical cysts and ducts
- Branchial cysts: the embryology
- What each branchial arch becomes (selected derivatives)
- Branchial fistulas
- Branchial cysts
- A branchial cyst on MRI with inflammation
- Neck deformities: named syndromes
Vascular Malformations and Neoplasia
Hemangiomas, malformations, lymphangiomas, aneurysms and paragangliomas
- A cleaner vocabulary for vascular anomalies
- Hemangiomas
- Vascular malformations and lymphangiomas
- Cervical aneurysms
- Paragangliomas and carotid body tumors: presentation
- Paragangliomas: pathogenesis and genetics
- Paragangliomas: diagnosis and treatment
Cervical Tumors and Metastases
Benign lumps, lymphomas, nodal metastases and unknown primaries
- Benign cervical tumors: lipoma
- Neurogenic tumors: schwannoma and neurofibroma
- Cervical lipoma and vagal schwannoma
- Malignant lymphomas of the neck
- Malignant lymphoma presenting in the neck
- Lymphoma: diagnosis and staging
- Lugano staging of lymphomas (Cheson 2014)
- Lymph-node metastases: how cancer reaches the neck
- Lymph-node metastases in the neck
- What decides where and how much a cancer spreads
- Metastasis rate by primary site (selected)
- Typical sites of regional lymph-node metastases
- N classification of neck nodes (TNM 8th ed.)
- The six cervical node levels (Robbins 2008)
- Predictable drainage, and two named nodes
- Carcinoma of unknown primary (CUP)
- CUP: targeted biopsy, treatment and prognosis
Principles of Neck Surgery
Mediastinoscopy and the neck dissection family
- Mediastinoscopy and biopsy
- Mediastinoscopy technique
- Neck dissection: the principle
- Appearance after modified radical neck dissection
- Classification of neck dissections (Robbins 1991, 2008)
- Neck levels and the types of neck dissection
- Neck dissection: prognosis and a key rule
The Thyroid Gland
Anatomy, function, diagnostics, goiter, thyroid dysfunction, thyroiditis and cancer
- Topographic anatomy of the thyroid
- Topography of the thyroid gland in cross-section
- Blood supply and the nerves at risk
- Blood supply and innervation of the thyroid
- What the thyroid does
- Diagnosing thyroid disorders
- EU-TIRADS ultrasound risk categories (Russ 2017)
- Goiter
- When to operate on a benign goiter
- Hypothyroidism
- Hyperthyroidism and Graves disease
- Types of thyroiditis (inflammation of the thyroid)
- Thyroid malignancy: the four types
- TNM staging of thyroid carcinoma (Brierley 2017)
- Thyroid cancer: genetics, presentation and surgery
The Parathyroid Glands
Primary, secondary and tertiary hyperparathyroidism
- Parathyroid anatomy and primary hyperparathyroidism
- Parathyroid disease: clinical picture and management
Bringing It Together
The essentials to carry away
- Three ideas that tie the topic together
- Why does thyroid surgery specifically risk vocal cord paralysis, and how is the risk minimised?
- References and Sources
- Ear, Nose, and Throat Diseases: With Head and Neck Surgery