Cervical Lymph Nodes and Neck Lumps Flashcards
What are the main functions of the lymphatic system?
- Remove excess fluid from interstitial space 2. Return small proteins (including pathogens) and fluid that leaked from capillaries and can’t be taken up at venule end 3. Key role in immune defence and surveillance
Why do lymph nodes swell and englarge during infection?
Proliferation of lymphocytes in response to antigen presentation
Give 3 features of lymph nodes
- Physcial barrier 2. Phagocytic barrier 3. Full of lymphocytes (T&B cells)
Where are nearly 1/2 of all the body’s lymph nodes found?
In the neck
Which 3 regions are lymph nodes most palpable?
Neck (cervical) Armpit (axillary) Groin (femoral)
What is lymphadenopathy?
An enlarged lymph node
What are the 2 different reasons for lymphadenopathy? How would you differentiate between the two?
- infection (most common) 2. Malignancy Can be differentiated by comprehensive history, examination of the node
How do all lymph nodes drain?
From Superficial to deep
Where are superficial lymph nodes found?
In the superficial fascia
Where are deep lymph nodes found?
Associated with the IJV along its length, in the carotid sheath
Name the superficial lymph nodes 1-8
- Submental 2. submandibular 3. Pre-auricular 4. Post-auricular 5. Occipital 6. Superficial cervical 7. Posterior cervical 8. Anterior cervical
Which areas of the head and neck drain to each lymph node?
Name deep lymph nodes 9-11
- Jugulo-digastric
- Jugulo-omohyoid
- Supraclavicular lymph nodes
Which lymph node may swell in tonsillitis?
Jugulo- Digastric
When might the Jugulo-omohyoid lymph node swell?
tongue cancers
When might supraclavicular lymph nodes swell?
In GI cancers (receives draining from chest and upper GI)
Which lymph node may swell in conjunctivitis?
Pre-auricular lymph node
What is Waldeyer’s Ring?
An annular collection of lymphoid tissue surrounding the upper aerodigestive tract
Which tonsils are visible at the back of the throat?
Palatine Tonsils
If a neck lump moves up and down when swallowing, what is the most likely reason for the lump?
Related to the thyroid gland
Name some reasons for superficial neck lumps
- sebaceous cyst - dermoid cyst - lipoma (fatty lump) - skin abcess
What things may cause an inflammatory/ infected lymph node?
Tonsillitis or mouth ulcers
Where is a branchial cyst most likely to be located?
In the lateral aspect of the anterior triangle
Name some congenital causes of neck lumps
- Branchial cyst - Dermoid cyst - Thyroglossal duct cyst
Where is a dermoid cyst most likely to be located and what is it?
Along the midline of the anterior triangle, high in the neck
It is an epithelial lined cyst
Where is a thryoglassal duct more likely to be located and what is it?
Along the midline of the anterior triangle, high in the neck
A cyst filled with fluid
What is a distinguishing feature between diagnosing dermoid cysts and thyroglossal duct cyst?
A thryoglossbal duct cyst will move with swallowing and when sticking out the tongue
What are some red flag signs for lymphadenopathy?
- Persisting longer than 6 weeks
- fixed, hard and irregular
- rapidly growing in size
- associated generalised lymphadenopathy - associated systemic signs of weight loss and night sweats
- persistent unexplained change in voice/ difficulty swallowing
Typically what is the 1st line imagine choice for investigating a lump in the neck and why?
Ultrasound
Cheap and no radiation, will give enough info to decide on next steps
