Exam 1 - Lymph packet Flashcards
Risk factors for malignancy in lymphadenopathy? (4)
- increasing age 2. lasts longer than 2 weeks 3. node that is “fixed” 4. supraclavicular location
Can normal lymph nodes be seen or palpated?
No
What happens when lymph nodes react to stimuli?
Extra fibrous tissue deposited in capsule and septa of lymph node
What does stretching of the fibrous capsule cause?
Pain
What does inflammation cause in the fibrous capsule?
Thickening of capsule
What is lympadenopathy?
abnormality in node size, consistency, or number
What is the most common lymphadenopathy?
Hyperplastic nodes
General characteristics of hyperplastic nodes?
firm, moveable, non-tender, discrete margins
What is “reactive lymphadenopathy”?
immune response to an antigen
What is lymphadenitis?
inflammatory cells from an infection infiltrate the node
What are the characteristics of lymphadenitis?
soft/fluctuant, moveable, tender/painful, discrete margins
What is metastasis?
neoplastic cells carried to node by lymphatic fluid/blood
Characteristics of malignant nodes?
hard/indurated, not moveable, not pain-sensitive, no discrete margins, larger than 1 cm
What is lymphoma?
localized neoplastic proliferation of lymphocytes or macrophages
Characteristics of lymphoma?
rubbery, not moveable, not pain-sensitivie, discrete margins
Superficial cervico-facial nodes? (6)
- sub occipital 2. post-auricular 3. pre-auricular/infra-auricular 4. submandibular 5. submental 6. anterior/posterior superficial cervical
Deep cervicofacial nodes? (3)
- supraclavicular 2. internal jugular 3. tonsilar
What does enlargement of right supraclavicular node suggest?
lung, GI, or retroperitoneal cancer
What does enlargement of left supraclavicular node suggest?
lymphoma, intra-thoracic cancer, or systemic infection
What is Virchow’s node (sentinel node)?
enlargement of LEFT supraclavicular node
What is the risk of malignancy in supraclavicular lymphadenopathy?
90% in pts over 40
What do the epitrochlear lymph nodes drain?
ulnar aspect of forearm and hand
What do axillary nodes drain?
arm, thoracic wall, breast (75% of drainage from breast)
What do infraclavicular nodes drain?
axillary nodes
Five divisions of axillary nodes?
- lateral (humeral) group 2. anterior (pectoral) group 3. central group 4. apical (subclavian) group 5. posterior (subscapular) group
Where does breast adenocarcinoma initially metastasize?
anterior and central axillary nodes
What does enlargement of infraclavicular nodes usually present as?
“fullness” of the supraclavicular fossa
What are the most common etiologies for inguinal lymphadenopathy?
benign reactive lymphadenopathy and infection
Is the normal thyroid gland usually visible on inspection?
No
Where is thyroid enlargement most often noticeable?
Below cricoid cartilage
What is “nodularity”?
A distinct focal enlargement on one lobe of thyroid
How should you inspect a pts thyroid?
With neck extended, and from the side
Why should you have pt swallow when examining thyroid?
Might bring out enlargement/nodules that are not otherwise visible. Also, thyroid and trachea will move upward during swallow
How should you palpate a pts thyroid?
With neck slightly flexed, use one hand to gently displace thyroid into fingers of other hand
What should you assess thyroid gland for? (4)
- size 2. consistency 3. texture 4. tenderness
What is a goiter?
enlargement of thyroid gland
What do the majority (80%) of pts with goiter have?
Euthyroid goiter
What is euthyroid goiter?
goiter with no clinical manifestations of thyroid disease
What do palpable thyroid nodules usually represent?
Benign disease
What percentage of solitary thyroid nodules are malignant?
5-10%
