ENT 4SE external neck diagnostics Flashcards
3 cardinal symptoms of external neck
shape changes; pain; limitation of neck motion
how to palpate cervical soft tissues
preferable from behind; bimanually; deep palpation
how to evaluate pulsating masses
by auscultation AND palpation
standard method for investigating SOFT TISSUE LESIONS in the neck
2D B-Mode UTZ
for evaluating extracranial cerebral arteries and vascular tumors
Doppler UTZ
shows as COMPLEX pattern on UTZ
abscess; necrotic tumor (differentiate clinically)
shows as CYSTIC pattern on UTZ
lymphoma; hyperplastic node (do A-mode pattern or aspiration)
shows as SOLID pattern on UTZ
crystalline or colloid cyst (do A-mode pattern or aspiration)
undiagnosed neck masses (elderly, unilateral, fixed) are _______________ unless proven otherwise
METASTATIC CARCINOMA
direct and indirect evaluation made by
flexible nasopharyngoscope
imaging scan for “RADIOLOGIC TISSUE DIAGNOSIS”
axial CT scan
for defining location and relations of SOFT TISSUE LESIONS
coronal and sagittal images on MRI
locates mass within or outside the gland
radionucleide scan
for evaluating cervical spine and laryngeal fractures
plain radiograph
demonstrates inc uptake of fluorodeoxyglucose by tumors
PET scan
cytologic evaluation of CYSTIC masses
percutaenous needle aspiration
cytologic evaluation of SOLID masses
fine needle aspiration biopsy
histologic evaluation of tissue core
Core Biopsy
for long standing neck mass unresponsive to conservative tx
OPEN biopsy
removes jugulosubclavian LN
prescalene biopsy (DANIEL biopsy)
look for primary CA at ____ if with neck mass at POSTERIOR CERVICAL NODES
nasopharynx
look for primary CA at ____ if with neck mass at NECK HIGHER and MID JUGULAR
tonsil
look for primary CA at ____ if with neck mass at MID JUGULAR nodes
tongue base, pyriform sinus
look for primary CA at ____ if with neck mass at SUPRACLAVICULAR NODES
below the clavicles
