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IHD Part 2 - BDS 3 > ENT swelling in head and neck > Flashcards

ENT swelling in head and neck Flashcards

1
Q

common neck masses can be catagorised into

A

neoplastic
congenital/developmental
inflammatory

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2
Q

anatomical considerations

A

look at triangles of neck, prominent landmarks e.g. thyroid cartilage
lymph nodes

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3
Q

what can tonsilittues progress to and then following that

A 
peritonisillar abcess
symptoms
- trismus
building of peritonsillar area
deviated uvula
severe pain

can then lead to deep neck space abcess if not treated

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4
Q

spaces in the neck

A 
peritonsillar area
parapharyngeal space
reteropharYngeal space
danger space
prevertebral space
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5
Q

Ludwig’s angina

A

usually from odontogenic infection
spreads from supra hyoid spaces in floor of mouth

symptoms
- pain trismus drooling
tongue protrusion, fever

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6
Q

acute viral parotitis

A

caused by paramyxovirus (mumps)
mostly bilateral swelling
managed by rehydration and analgesia

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7
Q

acute bacterial parottitis

A

pain swelling pyre dehydration

by staph aureus

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8
Q

ranula

A

painless masses that do not change in size in response to chewing eating or swallowing
mucous filled cyst from sublingual salivary glands

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9
Q

infective lymphadenopathy

A

increase in size of the cervial lymph nodes in response to infection

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10
Q

neoplasia lymahtdenoptjy

A

haematological malignancy that commonly causes lymphadenopthy

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11
Q

diagnostic step history

A
  • developmental time course (how long have they had the lymphadenopathy)
  • associated symptoms (dysphagia, otalgia, voice)
  • personal habits (tobacco, alcohol)
  • previous irradiation or surgery
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12
Q

diagnostic tests

A
  • fine needle aspiration cytology (FNAC) – usually for thyroid
  • needle core biopsy – for any other masses
  • Computed tomography (CT)
  • magnetic resonance imagine (MRI)
  • ultrasonography
  • radionucleotide scanning
  • PET scan (usually for metastatic lympathdeopathy)
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13
Q

primary tumours can be

A

1) thyroid mass
2) lymphoma
3) salivary tumours
4) lipoma
- benign
5) carotid body and glomus tumours
6) neurogenic tumours

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14
Q

lymphoma signs and symptosm

A
  • lateral neck mass only (discrete, rubbery)
  • fever
  • Hepatosplenomegaly
  • diffuse adenopathy
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15
Q

salivary gland tumours

A

parotid
sub mandibular
sublingual

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16
Q

malignant salivar gland timours

A

Benign
- asymptomatic except for mass
Malignant
- rapid growth, skin fixation, cranial nerve palsies
- CT/MRI deep lobe tumours, intra vs extra parotid
prefer core biopsy than FNAC (more specimen, more accurate)

17
Q

carotid body tumour

A

Pulsatile compressive mass

  • mobile medial/lateral not superior/inferior
  • generally at level of carotid bulb

Clinical diagnosis confirmed by
- angiogram or CT
Treatment
- irradiation or close observation in elderly
- surgical resection for small tumours in young patients
- try and treat conservatively due to complications

18
Q

lipoma

A

small ill defined mass

confrmed by full excision

19
Q

neurogenic tumours

A

arise from neural crest derivatives

20
Q

schwannoma

A

Signs and symptoms

  • medial tonsillar displacement
  • hoarsness (vagus nerve)
  • horners syndrome (sympathetic chain)
21
Q

congenital and developmental masses

A
  • epidermal and sebaceous cysts
  • branchial cleft cysts
  • thyroglossal duct cysts
  • vascular tumours
    Epidermal and sebaceous cysts
  • older age groups
    clinical diagnosis
  • elevation and movement of overlying skin
  • skin dimple or pore
22
Q

thyroglossal duct cyst

A

midline or near midline
usually inferior to hyoid bone
elevated on swallowing or protrusion of tongue

23
Q

vascular tumours

A

Lymphangiomas and hermangiomas most common
- haemangiomas often resolve spontaneously, lymphangiomas remain unchanged
CT/MRI can help determine extent of disease

Treatment

1) lymphangiomas
- surgical excision for easily accessible or lesions affecting vital functions
2) haemangiomas
- surgical excision for those with rapid growth involving vital structures or associated thrombocytopenia that fails medical therapy (steroids/interferon)

24
Q

granola lymphadenitis

A

firm relatively fixed node with injection of skin

25
Q

typical m tuberculossi

A

posterior triangle nodes

usually response to anti TB meds

26
Q

atypical tyeberculosis

A

kids
anterior triangel nodes
pain and brawny skin
usually response to surgical excision

27
Q

cat scratch fever (bartonella

A

paediatric group

pre auricular and SM nodes

IHD Part 2 - BDS 3 (55 decks)

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