ENT - Throat Flashcards
Anatomy of neck form top to bottom
Hyoid bone
Thyroid cartilage
Cricoid cartilage
Thyroid gland
What are you looking for on inspection
Changes to voice
Scars
Obvious masses/lumps
Systemic signs e.g. cachexia, exopthalmus (might need full examination of thyroid status for tremor and eye)
What are you looking for on palpation
Lymph nodes
Thyroid gland - even? symmetrical?
Which lymph nodes are you feeling?
Submental Submandibular Anterior cervical chain above SCM Supraclavicular lymph nodes Posterior cervical chain Preauricular post auricular
(see osceguide youtube vid)
Thyroid gland examination
Palpate
Swallow water
Stick tongue out
For the last two, see if any masses move
If you find a neck lump, how would you describe it? (rule of three)
3Ss - Site, size, surface/skin
3Cs - colour, contour, consistency
3Ts - Tenderness, temperature, trnasilluminaitoin
2Fs - Fluctuance, fixed
How would lymph node enlargement feel if it was infective?
Firm Tender Mobile Warm Red
How would lymph node enlargement feel if it was malignanc?
Firm
non-tender
Tethered
Irregular
Accompanied by other symptoms: weight loss,
What is the sign called when you have virchow’s node and what is it suggestive of?
Troissier’s sign -
Gastric carcinoma
Sebaceous cyst features
Cottage cheese discharge
Lipoma features
Soft
Mobile
Non painful
Round appearance
Other causes of neck lumps
Sebaceous cyst
Lipma
If a midline lump doesn’t move with swallowing, what does it suggest?
Dermoid cyst
Chondroma
If a midline lump does move with swallowing, what does it suggest?
It’s related to the thyroid gland
If a midline lump does move with swallowing and with sticking out the tongue, what does it suggest?
Thryoglossal cyst
If a midline lump does move with swallowing and NOT with sticking out the tongue, what does it suggest?
Thyroid enlargement
What is the thyroglossal cyst?
Embryological remnant of thyroglossal duct?
Complications of thyroglossal cyst
Infection
Goitre can be caused by
Hypo or hyper thyroidism
- unilateral or bilateral? toxic?
Do TFTs
What is a chondroma?
Benign cartilagious tumour
What is a dermoid cyst?
Teratoma (germline)
Lumps in the anterior triangle
Carotid body tumour/aneurysm
Branchial cyst
Parotid gland swelling
Lumps in the posterior triangle
Cervical rib
Cystic hy
What is a carotid body tumour? How does it feel?
Benign tumour in the bifurcation
Pulsatile
What is the carotid body?
Chemoreceptors (oxygen and co2 monitors)
They release neurotransmitters
What is a branchial cyst?
Congenital epithelial cyst
Failure of obliteration of 2nd branchial cleft
Where do you get a branchial cyst?
Occurs in the upper third of anterior triangle
When does it present?
After an infection
What do you call blocking/inflammation of parotid duct?
gland swelling names
Sialadenitis
Bilateral parotid swelling causes
Mumps Bacterial TB HIV Autoimmune - sjorgrens parotid cancer (unilateral)
Complication of cervical rib
Thoracic outlet syndrome
Compression of lower trunk of brachial plexus/subclavian artery
What is cervical rib?
?literally an extra rib above the first rib?
What is cystic hygroma?
Congenital malformation
Lymphangioma - fluid filled sacks that contain lymph fluid in POSTERIOR triangle
What conditions are associated with cystic hydrogma/
Turner’s
Noonan’s
Complications of cystic hygroma
Airway obstruction
What is apharyngeal pouch?
Diverticulum of the mucousa of the pharynx
Symptoms of pharygneal pouch + epidemiology
Dysphagia
Gurgling
Regurgitation
Halitosis
older people
What is associated with
Oesophageal webs
Investigation and management of pharyngeal pouch
Barium swallow
Laser/stapling
What is halitosis?
bad breath
