Term
| Indications for thyroid exam |
|
Definition
-palpable or enlarged gland
-abnormal labs
-palpable neck mass
-neck "swelling" or asymmetry
-neck tenderness
-difficulty swallowing
-cold nodules on NM study
-guidance for bx/asp |
|
|
Term
| The endocrine system maintains ___________, _____________, and ____________. |
|
Definition
body metabolism
growth
development |
|
|
Term
| What are the three hormones produced and secreted by the thyroid? |
|
Definition
thyroxine (T4)
triiodothyroxine (T3)
calcitonin |
|
|
Term
| What does the pituitary gland secrete that controls thyroid secretion? |
|
Definition
|
|
Term
| The thyroid gland traps _________ from the blood and through a series of chemical reactions, produces hormones. |
|
Definition
|
|
Term
| What cells secrete Calcitonin? |
|
Definition
| parafollicular cells (C-cells) |
|
|
Term
| What is the primary function of Calcitonin? |
|
Definition
| decrease blood calcium levels to prevent hypercalcemia |
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|
Term
| When thyroid hormone is needed it is released into the bloodstream by the action of _____________, or thyroid-stimulating hormone (TSH), produced by the ___________ gland. |
|
Definition
|
|
Term
|
Definition
1. Rt lobe
2. Isthmus
3. Pyramidal lobe
4. Lt lobe
5. Parathyroid glands |
|
|
Term
| What is the location of the thyroid? |
|
Definition
| anteroinferior part of the neck below the larynx and anterior to the trachea |
|
|
Term
| In transverse, what outlines the thyroid posterolaterally? |
|
Definition
common carotid artery (CCA) and
internal jugular vein (IJV) |
|
|
Term
What muscles are included in the strap muscles?
*also called infrahyoid muscles |
|
Definition
| sternohyoid (SH), sternothyroid (ST), omohyoid (OH) |
|
|
Term
| In transverse, what marks the posterior border of the thyroid? |
|
Definition
| longus colli muscle (LCM), esophagus (E), and minor neurovascular bundle (MINB) |
|
|
Term
| In transverse, what outlines the thyroid medially? |
|
Definition
|
|
Term
| In transverse, what outlines the thyroid anterolaterally? |
|
Definition
| strap muscles and sternocleidomastoid muscles |
|
|
Term
| Name 6 normal variants possible for a thyroid. |
|
Definition
Pyramidal lobe
asymmetry
absent isthmus
agenesis
dysgenesis
ectopia |
|
|
Term
| Where are the parathyroid glands located? |
|
Definition
| posterior aspect of the thyroid |
|
|
Term
| What is a Pyramidal lobe? |
|
Definition
| an accessory lobe that extends superiorly (cephalad) from the isthmus and can ascend as far as the hyoid bone. |
|
|
Term
| A Pyramidal lobe is present in ____ to _____ percent of the population. |
|
Definition
|
|
Term
| Pyramidal lobes are most frequent on the _____ side. |
|
Definition
|
|
Term
| Size and shape of a thyroid varies with __________, _____, and ___________________. |
|
Definition
| gender, age, and body surface area |
|
|
Term
| Tall people tend to have _________ lobes. |
|
Definition
| longer (sup-inf/ lateral) |
|
|
Term
| Shorter people tend to have _______________ lobes. |
|
Definition
|
|
Term
| Which lobe is usually larger? |
|
Definition
| Right lobe is usually larger than the left. |
|
|
Term
| Average thyroid size in adult? |
|
Definition
4-6 cm (L), 1.3-1.8 cm (AP), and 1.5-2 cm (W)
Isthmus - 2-6 mm (AP) |
|
|
Term
| Average thyroid size in children. |
|
Definition
| 2-3 cm (L), .2-1.2 cm (AP), 1-1.5 cm (W) |
|
|
Term
|
Definition
- Strap muscles
- Trachea
- Sternocleidomastoid muscle
- Internal jugular vein
- Common carotid artery
- longus coli muscle
- vertebra
- esophagus
|
|
|
Term
| In transverse the esophagus is seen as a ________________. |
|
Definition
|
|
Term
| What can you do to help identify the esophagus? |
|
Definition
|
|
Term
| What is the minor neurovascular bundle composed of and what is its location? |
|
Definition
recurrent laryngeal nerve and inferior thyroid artery
located between the longus coli muscle and the thyroid gland (posterior to thyroid)
*vaguely seen sonographically |
|
|
Term
| Where are the strap muscles and how do they appear? |
|
Definition
| anterior to thyroid, appear as thin bands |
|
|
Term
| Where is the sternocleidomastoid muscle? |
|
Definition
|
|
Term
| Where is the longus colli muscle and how does it appear? |
|
Definition
| posterior to thyroid, appears wedge shaped |
|
|
Term
| The common carotid artery and internal jugular vein are __________ to the thyroid. |
|
Definition
|
|
Term
| Where is the trachea and how does it appear? |
|
Definition
midline, posterior to thyroid
appears as a curved reflecting surface with reverberation artifact |
|
|
Term
| Sonographically, normal thyroid parenchyma is __________ with __________ level echoes. |
|
Definition
homogenous
medium level echoes |
|
|
Term
|
Definition
- Superior thyroid artery
- larynx
- thyroid gland
- isthmus
- common carotid artery
- trachea
|
|
|
Term
Arterial supply to the thyroid is from the ___________________ and the ______________.
|
|
Definition
superior thyroid arteries
inferior thyroid arteries |
|
|
Term
| The superior thyroid artery is the 1st branch off the __________________. |
|
Definition
| external carotid arteries |
|
|
Term
| The inferior thyroid artery is the largest branch of the _______________________ of the _____________________________. |
|
Definition
thyrocervical trunk
subclavian artery |
|
|
Term
|
Definition
- superior thyroid veins
- middle thyroid veins
- inferior thyroid veins
|
|
|
Term
| Venous drainage flows into the ____(1)_____________ via the ____(2)_____, _____(3)______, and ____(4)______ thyroid veins. |
|
Definition
- internal jugular vein
- superior
- middle
- inferior
|
|
|
Term
|
Definition
| the under secretion of thyroid hormones |
|
|
Term
| Hyopthyroidism is caused by: |
|
Definition
-low intake of iodine (goiter) in the body
-inability of the thyroid to produce the proper amount of thyroid hormone
-problem in the pituitary gland that does not control the thyroid production |
|
|
Term
| Clinical signs and symptoms of hypothyroidism: |
|
Definition
-weight gain
-hair loss
-increased subcutaneous tissue around the eyes
-lethargy
-intellectual & motor slowing
-intolerance to cold
-constipation
-deep husky voice |
|
|
Term
|
Definition
| over secretion of thyroid hormones |
|
|
Term
| Causes of Hyperthyroidism: |
|
Definition
| -the entire gland is out of control, localized neoplasm causes over-production of the thyroid hormone |
|
|
Term
| Clinical signs/ symptoms of Hyperthyroidism |
|
Definition
-weight loss
-increased appetite
-high degree of nervous energy
-tremor
-excessive sweating
-intolerance to heat
-palpitations
-exophthalamos (protruding eyes) |
|
|
Term
| Name 4 lab tests (serum) to test thyroid function |
|
Definition
|
|
Term
| With hypothyroidism, describe what happens with lab values |
|
Definition
elevated TSH
decreased T4/T3 |
|
|
Term
| With Hyperthyroidism, describe what happens to lab values |
|
Definition
decreased TSH
elevated T4/T3 |
|
|
Term
| To test thyroid function, correlative testing called _________________ may be used. |
|
Definition
| Nuclear medicine (Scintigraphy) |
|
|
Term
| When using NM, radioactive tracers target the thyroid to determine whether a lesion is _______ or ________. |
|
Definition
|
|
Term
In NM...
a "hot" lesion is ______functioning.
|
|
Definition
|
|
Term
With NM.....
______% of "hot" lesions are malignant |
|
Definition
|
|
Term
With NM...
"cold" lesions are ____functioning/ _____ uptake |
|
Definition
|
|
Term
With NM...
_____% of "cold" lesions are malignant |
|
Definition
|
|
Term
| What correlative testing can give additional info or overview of the neck? |
|
Definition
Nuclear Medicine (Scintigraphy)
CT
MRI |
|
|
Term
| What is the most effective means for diagnosing malignant thyroid nodules? |
|
Definition
| FNA (with sonographic guidance) |
|
|
Term
| There are ____ parathyroid glands located _________ to the thyroid. |
|
Definition
4, posterior
*2 superior, 2 inferior
|
|
|
Term
| Normal parathyroid glands are not usually seen sonographically. But, IF they are, how do they appear? |
|
Definition
| oval shaped or flat and hypoechoic |
|
|
Term
| What is the size of a parathyroid gland? |
|
Definition
| approx. 5 mm (L) x 3 mm (W) x 1 mm (AP/thick) |
|
|
Term
| What is the function of parathyroid glands? |
|
Definition
| maintain homeostasis of blood calcium levels to prevent hypocalcemia |
|
|
Term
| What is the name of the hormone secreted by the parathyroid glands? |
|
Definition
parathyrin
*also called parathormone (PTH) |
|
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