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Head And Neck > Final - Lymph Nodes > Flashcards

Final - Lymph Nodes Flashcards

1
Q

What are lymph nodes

A

Small oval shaped clusters of WBCs covered by connective tissue capsule that filter lymphatic fluid

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2
Q

Lymph nodes can swell and react in response to what 4 things

A
  • infection
  • Inflammation
  • medication
  • malignancy

99% of reactive lymph nodes in general practice are benign

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3
Q

Lymphadenopathy (LAD) is

A

Enlarged lymph nodes

Lay term “swollen gland”

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4
Q

Lymphadenitis is

A

Inflammation lymph nodes (tenderness common)

Lay term “swollen glands”

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5
Q

What lymph nodes can we palpate on an exam

A

Superficial and deep cervical chain

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6
Q

What are 5 characteristics to look for when examining lymph nodes

What indicates cancer?

A

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)
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7
Q

Lymph nodes are “non-pathologic” if (

A
  • soft or shotty (firm)
  • mobile
  • non-tender
  • oil/flat with smooth borders
  • small
  • should go away/get smaller within about 4 weeks
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8
Q

A small lymph node could be

A

Normal, inflammation, infection

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9
Q

A firm lymph node could be

A

(Shotty)

Normal, post-infection

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10
Q

Firm-rubbery lymph nodes could be

A

Lymphoma

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11
Q

Rock hard lymph nodes could be

A

Metastatic cancer

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12
Q

What is the malignancy prevalence? What age, duration, mobility and location increase the risk for malignancy

A

~1.1%

  • > 40 years old
  • 2-4 weeks
  • fixed to surrounding tissue
  • supraclavicular location
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13
Q

Metastatic malignant lymph nodes are ___ cm, (hard/soft), (tender/not tender), (margins defined/not), (fixed/mobile), (bilateral/unilateral)

A 
>1cm
Hard
Not tender
Margins less defined 
Fixed 
Often unilateral
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14
Q

Lymphoma lymph nodes are ___cm, (soft/rubbery), (movable/immovable), (tender/not), (margins defined/not)

A
  • > 1cm
  • rubbery (to firm)
  • not moveable
  • not tender
  • discrete margins
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15
Q

What four associated symptoms might a reason with lymphoma have?

A
  • Night sweats,
  • Weight loss (10% body mass over 6 months)
  • Fevers
  • cough
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16
Q

Infectious lymphadenopathy (aka lymphadenitis) is ___cm, (hard/soft), (movable/immovable), (tender/not), (defined margins/not), and _____

A

> 1cm

  • soft
  • movable
  • tender
  • discrete margins
  • sometimes, overlying red skin
17
Q

Acute infections LAD (Mono) is due to the ________, most common in ________, and the symptoms (5)

A
  • Epstein-Barr virus> transmission via saliva
  • teens/young adults

Symptoms

  • fatigue (extreme)
  • body aches
  • fever
  • sore throat
  • swollen lymph nodes in neck
18
Q

Which 3 lymph node areas are common for mono (LR?)

What other two signs are common with mono

A
  • Posterior cervical lymphadenopathy (+LR 12)
  • axillary lymphadenopathy (+LR 21)
  • tonsil or pharyngeal exudates
  • splenomegaly/hepatomegaly
19
Q

How do you make the dx for mono

A
  • rule out strep throat
  • monospot test (blood test)
  • CBC with differential (blood test)
  • liver function tests (blood test)
20
Q

What is the treatment for mono (2 things)

A
  • Caution patients to avoid exercise/ intact sports for ~4 weeks to decrease risk of splenic rupture
  • rest
21
Q

Shotty LAD: old infection (aka hyper plastic nodes) are ___cm, (hard/soft), (movable/ immovable), (tender/non-tender), (discrete margins) and ______

A

<1cm

  • soft or firm
  • movable
  • non-tender
  • discrete margins
  • Eschar
22
Q

If you see a large lymph node in the occipital regions (Base of hairline)

A
  • look in hair for ring worm, cut on scalp, lice)
23
Q

If you find lymph nodes in the post-auricular area, where do you look

A

Inside the ear

24
Q

If someone has pre-auricular nodes, where do you look

A

Conjunctiva (eyes) & skin of the cheek, eyelids, and temporal region

25
Q

If someone has submandibular submental nodes, where do you look?

A

Face and mouth

26
Q

If someone has anterior/posterior superficial cervical chains where do you look

A

All the scalp/ear/facial nodes

27
Q

if someone has Deep cervico - facial nodes, where do you look

A

Deep cervical nodes (typically not palpable)

28
Q

supraclavicular nodes have a high risk of _______.

Left supraclavicular LAD = _____ = _____

A

GI or intra-thoracic malignancy

Virchows node
Sentinel node

29
Q

Localized lymphadenopathy without clear source should prompt ____

A

Evaluation for generalized LAD

Head And Neck (18 decks)

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