Thyroid Gland

2 Lobes (C5-T1) & isthmus (2nd & 3rd tracheal rings) Covered by pretracheal layer Of deep cervical fascia

Thyroid Relations
Anterolateral: sup. Belly of omo. (upper) ant. border of SCM (lower) sternohyoid & sternothyroid muscles (middle) Medial: thyroid & cricoid cartilages (upper) upper 6 tracheal rings (lower) Posterior: CCA inf. thyroid a. parathyroid glands

Vasculature of Thyroid Gland

Read your text for detailed arterial bld. Supply & venous drainage of the thyroid gland

Clinical Notes: Thyroid Gland

Pyramidal Lobe of Thyroid Gland

Accessory thyroid tissue superior to the isthmus of the gland - Attached sup. To hyoid bone

- 50% of population

- A remnant of thyroglossal duct: endodermal tube carrying thyroid forming tissue from post. 1/3 of the tongue in the embryo

Risks of Surgery on Thyroid Gland

Thyroid surgery is often necessitated due to several reasons, mainly neoplastic growth (cancer) into the gland Risks: 1. Recurrent laryngeal nerve dysphonia (hoarseness)

2. Parathyroid glands: inadvertent removal serum Ca2+ Tetany

3. Postoperative Bleeding: 2 a. + 3 v. * hemorrhage can be confined within the space surrounded by pretracheal fascia compress the trachea difficulty in breathing

Tetany
generalized convulsive disorder characterized by involuntary muscle spasms

Radiological Anatomy of Head & Neck

Radiographic Principles
1. The radiograph is a record of radiodensity of structures Through which x-ray beam has passed: Radiodensity: (radioopacity radiolucency) bone > soft tissue > space (air) Tooth: enamel > dentin & cementum > pulp 2. The radiograph is a 2-dimensional representation of 3-dimensional objects: superimposition 3. Magnification: x-ray beam spreads depends on distance between ??

Head & Neck Radiography

Extra-Oral: Post.-Ant. of skull lat. View of the skull oblique post.-ant. (occipitomental) Panorama Intra-Oral: Bitewing Periapical Occlusal

Post. Ant. of The Skull

Forehead & nose against the film cassette X-ray tube perpendicular to the film at level of ?? X-ray beam passes from post. to ant. For cranial vault examination (fractures) & frontal air sinuses

Lateral View of The Skull

Sagittal plane parallel to the cassette. X-ray tube is centered over the region of ??

Lateral View of The Skull

For: Cranial base & vault examination diploic bone str. (tables of c.v. bones) Paranasal sinuses: frontal, maxillary, sphenoidal, mastoid ethmoid (obsecured)

Occipitomental (oblique PA)

Chin touching the cassette & head tilted backwards (45O) For: Investigation of max. sinus Avoid superimposition by petrous part of temporal bone

Panoramic Radiograph
For: Mandibular Fractures Minor Oral Surgeries (MOS): Extraction of impacted wisdom teeth Orthodontics

Bitewing Radiographs
Taken in initial & routine dental examination To disclose caries in post. teeth *specially class II

Provides view of the crowns & pulp chambers only

Periapical Radiographs
To examine the roots of teeth & surrounding tissues Fields of Application: Endodontics Perodontics Crowns & Bridges (Post & Core) Extraction of curved or remnant roots *14 films are required for entire dentition

Surface Anatomy of The Head & Neck

Self Reading

Midline Structures
Symphesis Menti: union of 2 halves of mandible in midline Hyoid Bone: U-shaped bone located in midline posterior to the mandible & at the level of C3 Thyroid Cartilage: located at level of C4-C5, easily felt & moves with swallowing Suprasternal Notch: between medial ends of clavicles & opposite to lower border of T2 vertebra

Arterial Pulses
Carotid Pulse: opposite to anterior border of SCM (Common carotid artery) Facial Pulse: palpated on the inferior border of the mandible (facial artery) Temporal Pulse: palpated anterior to the auricle of the ear, specifically opposite to the tragus. (superficial temporal artery)

Lateral & Posterior Landmarks

Lateral Zygomatic Arch: from anterior aspect beneath the orbit to the ear, it provide attachment for masseter muscle Mastoid process of temporal bone: projects downwards forwards behind the ear Posterior External Occipital Protuberance (EOP): at midline posteriorly Superior Nuchal Line: curved ridge that runs laterally from EOP to the mastoid process