a

Neck Ultrasound

hello and welcome to the University of

Florida

ultrasound module for the medical school

this is the neck ultrasound its module

number five but it will be module number

one for the first year class you're

going to learn how to evaluate the

anatomical structures in the neck mainly

the thyroid gland and the vessels that

are lying next to the gland and you will

able to see changes in the caliber of

those vessels with pressure changes

so you will learn from Anatomy that the

thyroid gland is located in the inferior

aspect of the neck and tear to the

trachea it mainly has three lobes right

left connected by the Isthmus and the

carotid common carotid vessels along

with internal jugular light lateral to

the lobes here we see in anatomical

drawing of the thyroid line insider

there and another broader picture of a

head and neck dissection clearly

identifying the thyroid gland we are

going to be scanning with a vascular

probe it's a high-frequency probe and it

gives us great images we're going to

make sure we are in between the thyroid

cartilage and the sternal notch that's

the area where the thyroid is located

and we're going to have the indicator

probe pointed towards the right of the

patient and this is a transverse view

we're going to see where the trachea is

there in the middle of the screen and

anterior to the trachea going to have a

thyroid you can have the right lobe and

the left lobe connected by the Isthmus

and then this is a moving image of that

transfer for you I'm going to be able to

do the trachea again you're going to see

the right lobe of the thyroid and you're

also going to see the common carotid

artery

if you move the transducer laterally

you're also going to be able to

visualize the internal jugular vein the

internal jugular lies lateral and

anterior to the carotid artery now let's

move the probe laterally so we can see

all the structures so in one image we

should be able to visualize the trachea

and the midline and as we move laterally

you'll see the right lobe of the thyroid

along with the common carotid and then

the internal jugular and the most

lateral part of the image in the

anterior portion of your image you're

going to see the sternocleidomastoid

muscle here's a moving image of the

ultrasound you see the pulsations of the

common carotid so now we're going to be

able to compress the vessels as we apply

pressure with our probe and what happens

is that the internal jugular collapses

when we apply the pressure and the more

round common carotid you can see that it

doesn't collapse well you know that's

because first of all there's difference

anatomical histological differences

between the two vessels with the

arteries having greater college into

position and stronger layers you'll see

that in histology but you're able in a

way with the ultrasound to visualize

those differences another concept we can

visualize with the ultrasound is a

concept of the valsalva valsalva

maneuver is named by an italian ear nose

and throat doctor antonio valsalva those

italian guys were naming everything so

basically it's a it's a maneuver when

there is a forced exhalation against the

closed airway so it's kind of when

you're kind of bearing down you know and

you're putting pressure so there there

are several phases of the valsalva but

basically there is a initial pressure

that rises in the chest when you perform

the maneuver and all those pressure

changes that you will talk about in visi

ology basically have a decreased return

to the

systemic circulation towards the heart

so if you think about it the jugular

vein brings the venous return basically

from the brain and from facial veins so

if your viewer have decreased blood flow

to the heart can't you're backing up so

you're going to see a dilatation of that

internal jugular vein veins dilate they

have higher compliance that's another

concept you'll probably talked about in

Physiology and you are also able to

visualize that with the ultrasound so

we've talked about basic thyroid Anatomy

and some of the vessels that lie next to

the thyroid you should be able to

definitely identify those vessels and

long as the thyroid structures right

lobe left lobes and Isthmus and you

should be able to see the changes in the

internal jugular with a valsalva

maneuver so that's all for now we will

see you guys in the lab thank you