Thyroid

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created 5 years ago by Annabelle
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1

What is the purpose of a thyroid exam?

determine anatomy and mass characteristics

echogenicity

echotexture

2

How would you determine thyroid function?

Nuclear medicine

3

Where is the thyroid located?

anterior neck at the level of the cricoid cartilage

4

How does the thyroid lie to the larynx and trachea?

lateral to the junction

5

What is Hashimoto’s Thyroiditis?

Autoimmune disorder of chronic inflammation

Invasion of the thyroid by lymph tissue.

6

Where is the thyroid to the sternocleidomastoid?

medial

7

What is the sonographic appearance of a Degenerating follicular adenoma?

Simple or complex

Anechoic

8

What does the thyroid consist of?

2 lobes connected by an isthmus

9

How long is the thyroid?

4-6 cm

10

How wide is the thyroid?

1-2 cm

11

How thick is the thyroid?

2-3 cm

12

What are the normal variants of the thyroid?

pyramidal lobe

13

How does the trachea appear in a thyroid exam?

shadowed out

14

What vessels drain the thryoid?

Superior thyroid - drains into internal jugular

inferior thyroid - drains into L innominate vein

15

Where is the sternocleidomastoid muscle?

card image

outer

16

Where is the sternohyoid muscle to the thyroid?

card image

anterior and most medial

17

Where is the sternothyroid muscle to the thyroid?

card image

anterior and lateral to sternohyoid

18

Where is the thyrohyoid muscle?

card image
19

Where is the carotid to the thyroid?

card image

posterior lateral

20

Where is the trachea to the thyroid?

card image

posterior medial

21

Where is the esophagus to the thyroid?

card image
22

Where do the lobes of the thyroid lie to the larynx and pharynx?

lateral

23

Where are the parathyroid glands?

usually 4

posterior on superior and inferior poles

24

What is the sonographic appearance of the parathyroid glands?

usually not seen unless enlarged

isiechoic

25

How do abnormal parathyroids show on an exam?

elongated mass

between the thyroid and strap muscles

26

What is the function of the parathyroid glands?

calcium sensing organ

tells bones to release calcium

27

What does the parathyroid secrete?

parathyroid hormone

28

What is the function of the thyroid?

maintain basal metabolic rate

normal growth and development

extracts iodine from blood to make T3 & T4

29

what is the blood supply of the thyroid?

Superior thyroid arising from the external carotid

inferior thyroid arising from the subclavian (thyrocervial trunk)

30

What vessels drain the thryoid?

Superior thyroid - drains into internal jugular

middle thyroid - drains into the internal jugular

inferior thyroid - drains into the L innominate vein

31

What does the hypothalamus relate to the thyroid?

hypothalamus detects decrease in basal metabolic rate

stimulates the release of Thyrotropin releasing hormone

Pituitary releases thyroid releasing hormone

thyroid releases T3 & T4

BMR increases

32

How does the thyroid control calcium

releases calcitonin

calcium is stored in bones

33

What hormones does the thyroid secrete?

T3 - triiodothyronine

T4 - thyroxine

calcitonin

34

What is the prep of a thyroid exam?

place a pillow behind neck to hyperextend neck

35

What is the sonographic appearance of the thyroid?

homogeneous

medium to high level echoes

36

What position should patient be in for a thyroid exam?

supine

37

What transducer should be used for a thyroid exam?

7.5 - 12 MHz linear

38

What does Hyper-parathyroid Disease cause?

causes hypercalcemia, nephrolithiasis and osteopenia

39

What blood test are used to check thyroid function

Blood test to check T3 & T4

40

What is Hyperthyroidism?

increased T3 & T4

41

What is hypothyroidism

decreased T3 & T4

42

How does Nuclear medicine check for thyroid function?

the amount of iodine uptake by the thyroid is noted over 24 hours

43

What is Nodular Thyroid Disease?

Nontoxic Simple goiter

toxic multinodular goiter

Graves disease

thyroiditis

cysts

adenoma

44

What is a Degenerating follicular adenoma?

Cysts: Most common benign solid lesion in adults.

45

What is a Thyroid Adenomas?

benign encapsulated fibrous mass.

Mainly in Females

46

What is the sonographic appearance of a thyroid Adenomas?

Hypoechoic or hyperechoic

Complete fibrous

Encapsulation

Calcified

Halo

47

A sudden increase in size in a thyroid Adenomas is usually caused by what?

hemorrhage.

48

What is the halo around a thyroid Adenomas due to?

compression of normal thyroid tissue

49

What is the female/male ratio of thyroid Adenomas?

7:1

50

What are the characteristics of a Thyroid Nodule

usually benign

common

cystic are usually benign

hyper or hypo echoic

51

What is Nontoxic Simple Goiter?

Most common thyroid abnormality.

Enlargement of the thyroid to collect more iodine from the blood

52

What is the sonographic appearance of a Nontoxic Simple Goiter?

Smooth, uniform, symmetric

Older cases – heterogeneity

nodularity

53

What is the most common cause of a Nontoxic Simple Goiter?

Iodine deficiency.

54

What is a Toxic Multinodular Goiter?

Nodular goiter

AKA adenomatous hyperplasia

55

What is another name for Toxic Multinodular Goiter?

adenomatous hyperplasia

56

What is the sonographic appearance of a Toxic Multinodular Goiter?

Multiple nodules

Areas of necrosis

Areas of hemorrhage

Cysts

57

What is Graves Disease?

Diffuse toxic goiter

58

What is the sonographic appearance of Graves Disease?

Diffuse toxic goiter

increased vascularity

59

What is the presentation of Graves Disease?

bulging eyes

thickening of feet

60

What is ophthalmopathy?

eye disease

61

What is exophthalmos?

bulging eyes

62

What is Thyroiditis?

Swollen

tender thyroid

63

What is the sonographic appearance of Thyroiditis?

Enlarged

Uniform

Can be heterogeneous

64

What is DeQuervain’s Thyroiditis?

Granulomatous thyroiditis: Opportunistic, following an upper respiratory infection

65

What is the sonographic appearance of DeQuervain’s Thyroiditis?

transient

66

What s Hashimoto’s Thyroiditis?

Autoimmune disorder of chronic inflammation

Invasion of the thyroid by lymph tissue.

67

What is the sonographic appearance of Hashimoto’s Thyroiditis?

hypoechoic

hetergeneous

diffuse enlargement

course

68

What is the cause of a goiter in regions of adequate iodine?

Hashimoto’s Thyroiditis

69

In the thyroid what percentage of solitary lesions are malignant?

25%

70

What are the types of Thyroid cancer?

Medullary

anaplastic

papillary

follicular

71

What is Thyroid Medullary Carcinoma?

Aggressive, 10% of thyroid cancer

Only cure is a thyroidectomy

72

What is the sonographic appearance of Thyroid Medullary Carcinoma?

Solid

Bright, echogenic foci

Hard, bulky mass

Mets

73

What is labs for Thyroid Medullary Carcinoma?

elevated calcitonin levels

74

What is Anaplastic Carcinoma?

Rare cancer in 50+ patients

Invades trachea

causes asphyxiation

75

What is the sonographic appearance of Anaplastic Carcinoma?

Hypoechoic

Hard

Fixed mass

76

What is Papillary Carcinoma?

Most common thyroid malignancy

Prominent cause of thyroid cancer in children

77

What is the sonographic appearance of Papillary Carcinoma?

Hyperechoic lesion

microcalcification

78

What is Follicular Carcinoma?

aggressive solitary mass

79

What are the sonographic appearance of Follicular Carcinoma?

Irregular

Firm

Nodular

enlargement

80

Why are invasive procedures on the thyroid performed?

to investigate suspicious nodules

81

What is fine needle aspiration?

small needle inserted into a nodule under ultrasound guidance

usually a 25 or 27 gauge 1.5 inch needle

82

What does a fine needle aspiration require?

presence of a cytopathologist

83

What is nephrolithiasis?

kidney stone

84

What is osteopenia?

low bone density

85

What does Hyperparathyroid Disease cause?

hypercalcemia

nephrolithiasis

osteopenia

86

What is the sonographic appearance of Hyperparathyroid Disease?

One or more enlarged parathyroid gland

usually one

87

What are the lab values for Hyperparathyroid Disease?

↑ blood calcium

hypercalcemia

88

What is Parathyroid Adenoma?

Most common cause of hyperparathyroidism

parathyroid enlarges into a tumor and excretes to much parathyroid hormone

89

What is the sonographic appearance of Parathyroid Adenoma?

Singular mass

Encapsulated

solid

Oval

Discrete borders

Less than 3 cm

Homogeneous

Hypoechoic

90

What is parathyroid hyperplasia?

enlargement of all four parathyroid glands

91

How many glands are involved with parathyroid hyperplasia

four

92

What is the Sonographic appearance of lymph node nodular malignancy?

rounded lymph node

hetergeneous

intranodal calcification

absence of an echogenic hilum

93

Where is the thyrocervical trunk?

arises from the subclavian

turns into inferior thyroid artery

has two other banches

94

What is true about lymph nodes?

inflammatory lymph nodes in the neck are common

cervical = oblong or oval

inflamatory lymph nodes exhibit echogenic helium