1Which nereve is responsible for high pitch
External branch of superior laryngel nerve -Cricothyroid muscle
2First investigation for thyroid disprorders
TSH levels
3Size of thr needle for FNAC
23-30 G needle
4Disadvantage of FnAC
It cannot differntiate between follicular adenoma and carcinoma
5Which classification is used to differentiate thyroid tumors
Bethedsda —Royal college of pathologist classiifcation
6Treatment for Thy3
Hemithyroidectomy
7Treatment for thy4 or thy 5
Hemi or total thyroidectomy
8What is the general shape of the thyroid gland?
Butterfly-shaped
9Thyroid scan
Tc 99-Only uptake
I123 —Uptake and organification
10Where is the thyroid gland situated?
In the lower part of the neck, in the front and sides of the trachea, inferior to the larynx.
11What is plummer disease
toxic nodular goitre
12Thyroiditis
Diffuse increase in uptake
13Embroyology of thyroid gland
Goramen caecum—>Thyroglossal tract —>Splits into two…Rest of the thyroglossal tract obliterates
14What are the two main lobes of the thyroid gland called?
The right lobe and the left lobe.
15Thyroglossal cysts
Remnant of throglossal tract
Midline neck swelling
Moves with protrusion of tongue
Diagnosis :FNAC
most common position :Subhyoid
Management :Sis trunk procedure—Removal of cyst+Tract till base of tongue + Part of hyoid bone
Incision and draingage can lead to thyroglossal fistula —Always acquired(Helps in differnetiating from branchial fistula )
Long standing cyst -Papillary thyroid cancer
16What intermediate structure joins the two lobes of the thyroid gland?
The isthmus.
17Subtotal thyroidectomy
Only small part of gland is left in both sides
18Near total thyroidectomy(Hartley dunhill procedure)
Lobectomy+Isthumusectomy+Subtotal lobectomy
19Position of patient
Rose position(Supine +30 degree head elevation—Venous blood goes down so bloodless field)
20Disadvantage of rose position
Air embolism
21Incision made during thyroid surgery
Collar incision—2 fingerprints above the suprasternal notch or one cm below the cricoid cartilage
22Which is the first vessel ligated during thyroid surgery
Middle thyroid vein
23At what level of the tracheal rings does the isthmus typically cross the trachea?
The level of the 2nd and 3rd tracheal rings.
24which drain is used after the thyroid surgery
Romavac negative pressure drain
25Which ligament attaches the thyroid with trachea
Berry’s ligament
26Which nerve injury is life threatening in thyroid surgery
Bilateral RLN injury
27Why is recurrent laryngeal nerve called recurrent laryngeal nerve
Left side has a longer course winds around arch of aorta and right side winds around subclavian artery.It goes down and comes up
28Earliest sign of hypoparathyroidism
Perioral numbness
29Chvostek and trousseau sign
Neuromuscular hyperexciatability
30What is the primary structural and functional unit of the thyroid gland?
The thyroid follicle.
31In 2% patients which nerve is present
Non recurrent nerve associated with abberant right subclavian artery
32What substance fills the thyroid follicles and acts as a storage compartment?
Colloid (which is thyroglobulin).
33What two arteries primarily supply the thyroid gland with blood?
The superior thyroid artery and the inferior thyroid artery.
34Which is the posterilateral projection of thyroid gland
Tubercle of Zuckerkandl
35Berrys ligament
Condensation of pretarcheal fascia,RLN can be injured here very commonly
36Beahr triangle
Common carotid artery
Inferior thyroid artery
Recurrent laryngeal nerve
37What is the name of the additional artery sometimes present that supplies the thyroid gland?
The thyroidea ima artery (or thyroid ima artery).
38What are the three veins that drain blood from the thyroid gland?
The superior, middle, and inferior thyroid veins.
39What two crucial nerves are in close proximity to the thyroid gland and are branches of the vagus nerve?
The external branch of the superior laryngeal nerve and the recurrent laryngeal nerve.
40What is the consolidation of connective tissue that anchors the thyroid lobes to the trachea?
The lateral suspensory ligament (or Berry ligament).
41What type of cells within the thyroid gland are responsible for producing T3 and T4 hormones?
Follicular cells (or principal cells).
42What type of cells are located between the follicles and secrete calcitonin?
Parafollicular cells (or C cells).
Would you like me to create flashcards on a specific related topic, such as the functions of the thyroid hormones or the clinical correlations of thyroid anatomy?
43What are the two main arteries that primarily supply the thyroid gland?
The superior thyroid artery (STA) and the inferior thyroid artery (ITA).
44What major artery does the superior thyroid artery (STA) typically branch from?
The external carotid artery (ECA).
45What arterial trunk does the inferior thyroid artery (ITA) typically originate from?
The thyrocervical trunk (which is a branch of the subclavian artery).
46What additional artery is sometimes present and supplies the thyroid gland (isthmus and anterior surface)?
The thyroid ima artery (or arteria thyroidea ima).
47What vessel is the most common origin of the thyroid ima artery?
The brachiocephalic trunk.
48The superior thyroid artery travels in close association with which nerve?
The external branch of the superior laryngeal nerve.
49The inferior thyroid artery is closely associated with which nerve?
The recurrent laryngeal nerve.
50Complication of inferior thyroid artery ligation
Hypoparathyroidism
51What are the three main veins that drain blood from the thyroid gland?
The superior, middle, and inferior thyroid veins.
52Into which major vein do the superior and middle thyroid veins typically drain?
The internal jugular vein.
53Into which major vein(s) does the inferior thyroid vein typically empty?
The brachiocephalic vein(s).
54The superior thyroid artery and the inferior thyroid artery typically connect to one another on the gland; what is this connection called?
An anastomosis.
55The superior thyroid artery terminates by dividing into how many branches at the gland?
Four (infrahyoid, superior laryngeal, cricothyroid, and glandular branches).
56What is the general term for the extensive network of veins on the thyroid gland that the superior, middle, and inferior thyroid veins originate from?
The thyroid venous plexus.
57What is the general term for the surgical procedure to remove all or part of the thyroid gland?
Thyroidectomy.
58What are the two most common procedures for surgically treating thyroid disorders?
Total thyroidectomy (removal of the entire gland) and thyroid lobectomy (removal of one lobe).
59What condition, which causes hyperthyroidism, is often treated with a total thyroidectomy, especially if there are eye symptoms?
Graves' disease.
60When is surgery considered a primary treatment for hyperthyroidism caused by a toxic goiter?
When the gland is massively enlarged and causing compressive symptoms (difficulty swallowing or breathing).
61If a patient undergoes a total thyroidectomy for hyperthyroidism or cancer, what lifelong treatment will they require?
Thyroid hormone replacement (e.g., Levothyroxine).
62What is the main indication for surgery in a patient with a goiter (enlarged thyroid), regardless of whether it causes hyper- or hypothyroidism?
When the goiter is causing compressive symptoms such as dysphagia (difficulty swallowing) or dyspnea (difficulty breathing).
63In thyroid surgery, what two critical structures are the surgeon most careful to identify and preserve to avoid complications?
The recurrent laryngeal nerve (to prevent voice changes) and the parathyroid glands (to prevent hypocalcemia).
64What is a modern surgical approach that avoids a visible scar on the neck by accessing the thyroid through an incision in the mouth?
Transoral thyroidectomy (or scarless thyroidectomy).
65If a total thyroidectomy is performed, what serious electrolyte imbalance is a potential complication due to unavoidable damage or removal of the parathyroid glands?
Hypocalcemia (low calcium levels).
66What is the main reason a patient with hypothyroidism might require a thyroidectomy?
If a large goiter is present that is causing compression symptoms or if there is thyroid cancer (as cancer treatment leads to hypothyroidism).
67What is the most common indication for performing a thyroidectomy?
Thyroid cancer (malignancy) or suspicion of cancer (high-risk nodules).
68What are the two main types of thyroidectomy procedures?
Total thyroidectomy (removal of the entire gland) and Thyroid lobectomy (removal of half/one lobe).
69When is surgery indicated for a benign goiter or thyroid nodule?
When it is large enough to cause compressive symptoms (e.g., difficulty swallowing/dysphagia, breathing/dyspnea).
70What is the most common complication following a total thyroidectomy?
Hypocalcemia (low calcium levels) due to injury or removal of the nearby parathyroid glands.
71What are the early signs of hypocalcemia that a patient may experience post-thyroidectomy?
Paresthesias (tingling and numbness) around the mouth, hands, and feet.
72What nerve is at risk of injury during thyroid surgery, and what is the potential complication?
The Recurrent Laryngeal Nerve (RLN), leading to vocal cord paralysis/hoarseness or permanent voice change.
73What is a potentially life-threatening complication that usually occurs within the first 24 hours post-thyroidectomy?
Hematoma (bleeding/swelling in the neck) that can compress the airway and cause respiratory distress.
74What immediate action may be necessary if a patient develops a large post-thyroidectomy hematoma causing airway compromise?
Emergent surgical evacuation (incision and drainage) to relieve tracheal compression.
75What is the term for a post-surgical complication characterized by muscle twitching or spasms, which can be elicited by signs like Trousseau's or Chvostek's?
Tetany, caused by severe hypocalcemia.
76Piszzillo’s method
Keeping the hand on occipital bone and pressing against it
77Lahey’s method
Gland is pushed to one side and ideal for palpating margins
78If a patient undergoes a total thyroidectomy, what medication must they take for the rest of their life?
Levothyroxine (thyroid hormone replacement)
79IONM
Intra operative nerve monitoring
Can help in identifying nerve and avoiding injuries