Head and Neck Flashcards
resolution of aphthous ulcers
spontaneously in 7-10 days
clinical forms of candidiasis
pseudomembranous aka thrush
hyperplastic
erythematous
hairy leukoplakia
lateral border
cannot be scraped off
associated with EBV
cause of precancerous lesions
tobacco
most common lesion of head and neck
squamous cell carcinoma
HPV associated with sinonasal papilloma
6 and 11
virus nasopharyngeal carcinoma
EBV
presentation nasopharyngeal carcinoma
nasal obstruction and epistaxis
ostosclerosis
bilateral hearing loss
abnormal middle ear bone deposition
treatment of most head and neck neoplasms
excision
paraganglioma
clusters of neuroendocrine cells
components of pleomorphic adenoma
mixed-epithelial and myoepithelial
benign and painless tumor
location of warthin tumor
restricted to parotid gland
mucoepidermoid carcinoma
most common malignant tumor
t(11;19)(q21;p13)
adenoid cystic carcinoma
perineural invasion
PAINFUL MASS
parotid and submandibular glands
location of thyroglossal duct cyst
most common
midline
course of thyroglossal duct cyst
asymptomatic until infected
painless midline swelling
moves with swallowing or sticking out tongue
can be associated with ectopic thyroid
embryology causing thyroglossal duct cyst
connects thyroid and foramen cecum
at 5th week fragments, mesoderm condenses into hyoid bone
atrophies by end of 8th week
characteristics of thyroglossal duct cyst
epithelial lined cyst
from failure of normal obliteration
infrahyoid most common
imaging of thyroglossal duct cyst
ultrasound to diagnose
CT may be used
treat with surgical resection
origin of dermoid
outer layers of skin do not properly grow together
lined with epithelium, contains hair, sebaceous glands, sweat glands
characteristics of dermoid
moves independently with skin
doughy
origin of branchial cleft cyst
remnants of embryonic development from failure of obliteration of one of the branchial clefts
epithelial lined cyst
location branchial cleft cyst
lateral neck
cyst
no external or internal opening
sinus
internal or external opening
fistula
both internal and external openings
first branchial cleft cyst
type 2 more common
type 1 duplication of auditory canal
type 2 at angle of mandible
most common branchial cleft cyst
second
characteristics of second branchial cleft cyst
inferior to mandible and anterior to SCM
sinus or fistula
tract can extend to ipsi tonsil
third branchial cleft cyst
anterior to SCM lower in neck
end in pharynx at thyrohyoid member
often presents with lower neck infection
L>R
characteristics of cystic hygroma
lymphatic malformation
multi-loculated lesion in left posterior triangle
presentation of cystic hygroma
soft, painless, doughy mass
may transilluminate
evaluate for tracheal deviation or evidence of impending airway obstruction
hemangiomas
usually not present at birth
bright red macule or papule rash with clear boundaries
liver MRI and hemangiomas
if 5 or more cutaneous
proliferative phase of hemangiomas
continues for up to 15 to 18 months
reach 85% of size by 5 months of age
may ulcerate
involutional phase of hemangiomas
superficial lesions change to dull red, then gray
flatten and soften
most complete by 10 yo
subglottic hemangioma
high risk with segmental beard distribution-preauricular, chin, lower lip, neck
biphasic stridor
initially diagnosed as croup
hemangiomas on MRI
gadolinium MRI study of choice
well circumscribed, lobulated mass
salt and pepper pattern
dilated vessels
indications to intervene for hemangiomas
accelerated growth hemorrhage infection ulceration problems breathing, swallowing high output CHF
pharmacological treatment of hemangiomas
propranolol
congenital torticollis
SCM is tight and shortened
usually discovered in first 6-8 weeks of life
injury causes scarring that leaves it tight
associated with hip dysplasia
presentation torticollis
tilted in a laterally, bending toward affected muscle
rotate to opposite side
concerning lymphadenopathy
generalized occipital, auricular, supraclavicular, mediastinal, epitrochlear, posterior cervical nodes firm matted nontender >2cm systemic symptoms
biopsy LN
supraclavicular
2-6 weeks, >3cm, not responding to antibiotics or risk factors for malignancy
common cause of lymphadenopathy
viral most common
MAI lymphadenopathy
submandibular common
firm, painless mass that does not respond to antibiotics
may enlarge and become fluctuant
violaceous hue
treatment MAI
macrolides-azithromycin
also rifampin, ethambutol, aminoglycosides, or fluroquinolones
treated with 3 antimicrobials for 12 months
excision but not incision and drainage
cat scratch disease
bartonella
primary inoculation at lesion
self limited 6-12 weeks
treat with doxy, erythro, azithro
Kawasaki disease
fever >5 days cervical lymphadenopathy edema/eryhtema palms and soles conjunctivitis strawberry tongue
most common neoplasm causing lymphadenopathy in children
lymphoma
lymphoma
painless neck mass
hodgkin in adolescents; non-hodgkin in 2-12 yo
M>F
hodgkin from EBV
concern for lymphoma
> 3cm and firm
multiple regions
supraclavicular or posterior triangle location
rhabdomyosarcoma
arise from soft tissue-skeletal muscle
embryonal rhabdomyosarcoma
head and neck or GU
alveolar rhabdomyosarcoma
arms, legs, chest, abdomen, genital organs or anal area
anaplastic rhabdomyosarcoma
rare in children
presentation rhabdomyosarcoma
depend on location
commonly a lump or swelling that keeps getting bigger
