Final - Lymph Nodes Flashcards
What are lymph nodes
Small oval shaped clusters of WBCs covered by connective tissue capsule that filter lymphatic fluid
Lymph nodes can swell and react in response to what 4 things
- infection
- Inflammation
- medication
- malignancy
99% of reactive lymph nodes in general practice are benign
Lymphadenopathy (LAD) is
Enlarged lymph nodes
Lay term “swollen gland”
Lymphadenitis is
Inflammation lymph nodes (tenderness common)
Lay term “swollen glands”
What lymph nodes can we palpate on an exam
Superficial and deep cervical chain
What are 5 characteristics to look for when examining lymph nodes
What indicates cancer?
Characteristic (could be cancer)
- consistency (rock hard)
- movable? (Immovable)
- tender? (tender)
- distinct borders? (Thick and no borders)
- size (>1cm is large, >2cm cold be cancer)
Lymph nodes are “non-pathologic” if (
- soft or shotty (firm)
- mobile
- non-tender
- oil/flat with smooth borders
- small
- should go away/get smaller within about 4 weeks
A small lymph node could be
Normal, inflammation, infection
A firm lymph node could be
(Shotty)
Normal, post-infection
Firm-rubbery lymph nodes could be
Lymphoma
Rock hard lymph nodes could be
Metastatic cancer
What is the malignancy prevalence? What age, duration, mobility and location increase the risk for malignancy
~1.1%
- > 40 years old
- 2-4 weeks
- fixed to surrounding tissue
- supraclavicular location
Metastatic malignant lymph nodes are ___ cm, (hard/soft), (tender/not tender), (margins defined/not), (fixed/mobile), (bilateral/unilateral)
>1cm Hard Not tender Margins less defined Fixed Often unilateral
Lymphoma lymph nodes are ___cm, (soft/rubbery), (movable/immovable), (tender/not), (margins defined/not)
- > 1cm
- rubbery (to firm)
- not moveable
- not tender
- discrete margins
What four associated symptoms might a reason with lymphoma have?
- Night sweats,
- Weight loss (10% body mass over 6 months)
- Fevers
- cough
Infectious lymphadenopathy (aka lymphadenitis) is ___cm, (hard/soft), (movable/immovable), (tender/not), (defined margins/not), and _____
> 1cm
- soft
- movable
- tender
- discrete margins
- sometimes, overlying red skin
Acute infections LAD (Mono) is due to the ________, most common in ________, and the symptoms (5)
- Epstein-Barr virus> transmission via saliva
- teens/young adults
Symptoms
- fatigue (extreme)
- body aches
- fever
- sore throat
- swollen lymph nodes in neck
Which 3 lymph node areas are common for mono (LR?)
What other two signs are common with mono
- Posterior cervical lymphadenopathy (+LR 12)
- axillary lymphadenopathy (+LR 21)
- tonsil or pharyngeal exudates
- splenomegaly/hepatomegaly
How do you make the dx for mono
- rule out strep throat
- monospot test (blood test)
- CBC with differential (blood test)
- liver function tests (blood test)
What is the treatment for mono (2 things)
- Caution patients to avoid exercise/ intact sports for ~4 weeks to decrease risk of splenic rupture
- rest
Shotty LAD: old infection (aka hyper plastic nodes) are ___cm, (hard/soft), (movable/ immovable), (tender/non-tender), (discrete margins) and ______
<1cm
- soft or firm
- movable
- non-tender
- discrete margins
- Eschar
If you see a large lymph node in the occipital regions (Base of hairline)
- look in hair for ring worm, cut on scalp, lice)
If you find lymph nodes in the post-auricular area, where do you look
Inside the ear
If someone has pre-auricular nodes, where do you look
Conjunctiva (eyes) & skin of the cheek, eyelids, and temporal region
