Exam 1 - Lymph packet

Question 1

Risk factors for malignancy in lymphadenopathy? (4)

Answer 1

1. increasing age 2. lasts longer than 2 weeks 3. node that is “fixed” 4. supraclavicular location

Question 2

Can normal lymph nodes be seen or palpated?

Answer 2

No

Question 3

What happens when lymph nodes react to stimuli?

Answer 3

Extra fibrous tissue deposited in capsule and septa of lymph node

Question 4

What does stretching of the fibrous capsule cause?

Answer 4

Pain

Question 5

What does inflammation cause in the fibrous capsule?

Answer 5

Thickening of capsule

Question 6

What is lympadenopathy?

Answer 6

abnormality in node size, consistency, or number

Question 7

What is the most common lymphadenopathy?

Answer 7

Hyperplastic nodes

Question 8

General characteristics of hyperplastic nodes?

Answer 8

firm, moveable, non-tender, discrete margins

Question 9

What is “reactive lymphadenopathy”?

Answer 9

immune response to an antigen

Question 10

What is lymphadenitis?

Answer 10

inflammatory cells from an infection infiltrate the node

Question 11

What are the characteristics of lymphadenitis?

Answer 11

soft/fluctuant, moveable, tender/painful, discrete margins

Question 12

What is metastasis?

Answer 12

neoplastic cells carried to node by lymphatic fluid/blood

Question 13

Characteristics of malignant nodes?

Answer 13

hard/indurated, not moveable, not pain-sensitive, no discrete margins, larger than 1 cm

Question 14

What is lymphoma?

Answer 14

localized neoplastic proliferation of lymphocytes or macrophages

Question 15

Characteristics of lymphoma?

Answer 15

rubbery, not moveable, not pain-sensitivie, discrete margins

Question 16

Superficial cervico-facial nodes? (6)

Answer 16

1. sub occipital 2. post-auricular 3. pre-auricular/infra-auricular 4. submandibular 5. submental 6. anterior/posterior superficial cervical

Question 17

Deep cervicofacial nodes? (3)

Answer 17

1. supraclavicular 2. internal jugular 3. tonsilar

Question 18

What does enlargement of right supraclavicular node suggest?

Answer 18

lung, GI, or retroperitoneal cancer

Question 19

What does enlargement of left supraclavicular node suggest?

Answer 19

lymphoma, intra-thoracic cancer, or systemic infection

Question 20

What is Virchow’s node (sentinel node)?

Answer 20

enlargement of LEFT supraclavicular node

Question 21

What is the risk of malignancy in supraclavicular lymphadenopathy?

Answer 21

90% in pts over 40

Question 22

What do the epitrochlear lymph nodes drain?

Answer 22

ulnar aspect of forearm and hand

Question 23

What do axillary nodes drain?

Answer 23

arm, thoracic wall, breast (75% of drainage from breast)

Question 24

What do infraclavicular nodes drain?

Answer 24

axillary nodes

Question 25

Five divisions of axillary nodes?

Answer 25

1. lateral (humeral) group 2. anterior (pectoral) group 3. central group 4. apical (subclavian) group 5. posterior (subscapular) group

Question 26

Where does breast adenocarcinoma initially metastasize?

Answer 26

anterior and central axillary nodes

Question 27

What does enlargement of infraclavicular nodes usually present as?

Answer 27

"fullness" of the supraclavicular fossa

Question 28

What are the most common etiologies for inguinal lymphadenopathy?

Answer 28

benign reactive lymphadenopathy and infection

Question 29

Is the normal thyroid gland usually visible on inspection?

Answer 29

No

Question 30

Where is thyroid enlargement most often noticeable?

Answer 30

Below cricoid cartilage

Question 31

What is "nodularity"?

Answer 31

A distinct focal enlargement on one lobe of thyroid

Question 32

How should you inspect a pts thyroid?

Answer 32

With neck extended, and from the side

Question 33

Why should you have pt swallow when examining thyroid?

Answer 33

Might bring out enlargement/nodules that are not otherwise visible. Also, thyroid and trachea will move upward during swallow

Question 34

How should you palpate a pts thyroid?

Answer 34

With neck slightly flexed, use one hand to gently displace thyroid into fingers of other hand

Question 35

What should you assess thyroid gland for? (4)

Answer 35

1. size 2. consistency 3. texture 4. tenderness

Question 36

What is a goiter?

Answer 36

enlargement of thyroid gland

Question 37

What do the majority (80%) of pts with goiter have?

Answer 37

Euthyroid goiter

Question 38

What is euthyroid goiter?

Answer 38

goiter with no clinical manifestations of thyroid disease

Question 39

What do palpable thyroid nodules usually represent?

Answer 39

Benign disease

Question 40

What percentage of solitary thyroid nodules are malignant?

Answer 40

5-10%