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35 Cards in this Set
- Front
- Back
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how to differentiate the true from false vocal folds on axial imaging
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false vocal folds are fatty (and superior to the true vocal cords)
true cords are soft tissue in density |
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what are the anatomic subdivisions of the larynx
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draw two lines, 1 through the ventricle and 1 1cm below the ventricle
the supraglottic larynx is above line 1, the glottic larynx is between the 2 lines, and infraglottic larynx is below ine 2, to the bottom of the cricoid cartilage |
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what is contained in the supraglottic larynx
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epiglottic
aryepiglottic folds false vocal flds pre-epiglottic fat/space paraglottic fat |
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what is contained in the glottic region
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true vocal cords
anterior and posterior commissure |
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how to differentiate the hyoid bone from the thyroid cartilage based on shape
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the hyoid bone is u shaped, tripartitie, the thyroid bone is shield shaped, incomplete ring
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appearance of the cricoid cartilage
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complte ring
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imaging findings associated wiht vocal cord palsy
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dilated pyriform sinus
dilated laryngeal ventricle paramedian aryepiglottic folds paramedian/atrophied true vocal cord arytenoid cartilage is anterior and medialized |
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etiologies of vocal cord paralysis
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may be neural or laryngeal
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how to determine a neural cause for vocal crd palsy
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follow course of the vagus nerve from the jugular foramen to the tracheo-esophageal groove
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course of hte L and R recurrent laryngeal nerves
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L: hooks below aortic arch
R: loops under the R subclavian artery |
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laryngocele caused by
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obx at the ventricle (look for lesion at this level)
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most common type of laryngeal malignancy
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squamous cell CA
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what are the 3 parts of the hypopharynx
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pyriform sinus
posterior pharyngeal wall ppostcricoid region |
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what are the anatomic boundaries of the hypopharynx
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tip of the epiglottis to the inferior cricoid
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recommendations of FNA of thyroid nodule
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<1cm or entirely cystic, no FNA
1cm + solid with microcalcs - FNA >1.5cm, solid iwht macrocalcs >2cm : FNA anything with a solid component |
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most common type of thyroid ca
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papillary
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imaging feature to suggest vagus glomare
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splaying the ECA and ICA at the carotid bifurcation, tumor around vessels
intense early enhancement, minimal washout |
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what is the primary LN drainage route of nasopharynx
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retropharyngeal
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what is the primary LN drainage route of the oral cavity
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level I and II
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what is the primary drainage route of the oropharynx
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levels II and III
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priamry drainage routes of the supraglottic larynx
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II and III
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primary drainage route hypopharynx
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III
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where are level Ia and b nodes
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lvl I nodes are underneath mandible and above the hyoid bone
Ia: midline btwn anterior bellies of digastric muscles Ib: nodes anterior to submandibular gland |
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level IIa/b nodes
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beneath SCM, from skull base to hyoid bone
IIa: anterior, medial, lateral or posterior and touching the IJ IIb: posterior and separate from teh IJ |
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level III
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beneath the SCM, from hyoid to inferior margin of the cricoid
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level IV nodes
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deep to SCM, between cricoid and clavicle
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level V nodes
Va/Vb |
posterior to posterior border of SCM
Va: nodes above the cricoid cartilage level Vb: nodes between the cricoid and clavicle |
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which malignancies most commonly involve level V nodes
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lymphoma, melanoma, systemic mets
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nodes that may be calcified
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mycobacterium
treated bacterial infx sarcoid differentiated thyroid ca breast, lung, colon CA tx'd lymphoma |
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bright or enhancing nodes
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inflammatory
papillary/follicular thyroid ca castleman's disease kaposi |
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necrotizing fasciitis/myositis in the neck often assoc w
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osteomyelitis.
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complications of a MRSA retropharyngeal abscess
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pseudoaneuryms if it gets close to the carotid artery or other vasculature
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typical h/o lemierre's syndrome
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sore throat 2 wks prior with fevers --> septic thrombosis of IJV --> septic pulm emboli
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bezold's abscess
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walled off pus in and around SCM
assoc with focus of dehiscence of the mastoid tip deep to the area of the abscess |
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another name for phlegmon in the retropharyngeal space
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retropharyngeal cellulitis
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