Head and Neck Overview Flashcards
What addtitional systems should be considered for head and neck.
musculoskeletal, neuro, lymph, endocrine, vascular
What should you inspect the head for?
head position, shape symmetry, skull shape, scalp, hair pattern
what should you auscultate the head for?
temporal arteries–> temporal bruits
What are the neck mass classifications?
congenital, inflammatory, and neoplastic
patient presents with midline anterior mass. it is about 2-4cm, and moves upon swallowing. what is the treatment?
thyroglossal duct cyst. occurs from the remanants of the descending thryoid tract. Can become infected. MOVES WITH SWALLOWING!! tx: surgical excision.
patient present with midline neck mass, it is in the submental area. it does not move with swallowing or tongue protrusion
demoid cyst. It is from ectodermal and mesodermal layers.
patient presents with a lesion on the floor of their mouth. It is midline. Why does this occur?
Ranula, occurs from mucus extravasation from blocked salivary duct. They can be simple or plunging. plunging goes into the muscle layers.
what are your three midline congential neck masses?
thyroglossal duct cyst, dermoid cyst, ranula
Patient presents with lateral mass on side of neck. Says it has been there for some time, and it is soft and painless to palpation. He noticed it after a URI.
Brachial Cleft cyst! they can occur anywhere long the SCM. 2nd cleft cysts are the most common. 1st brachial cysts appear high in the neck.
How do you treat congential neck masses?
surgical excision
How do you diagnose congential neck masses?
CT or excisional biopsy
what is the most common cause of an inflammatory neck mass?
reactive lymphadenopathy. usually secondary to an infection. enlarged tender lymph nodes. usually 2-4 cm in size. SUBMANDIB OR CERV!
What will patients usually show signs of with an inflammatory neck mass?
a uri or phayrngitis, with staph or strep or mono being the cause
How do you diagnose an inflammatory neck mass?
labs: rapid strep, throat culture, cbc, ppd, toxoplasma titers, HIv test, bartonella, monospot
FNAB
Excisional biopsy
U/S
What is the treatment for inflammatory neck masses
usually resolve on own, but keep an eye. IN GENERAL…ABX for 10-14 days if bacterial infection. (macro lid, PCN, ceph). Follow up.
Neoplastic neck masses are most common in…
adults
What are some examples of benign neoplastic masses?
lipomas, fibromas, sebaceous cysts, schwannomas
What is the most common cause of malignant neck masses?
metastatic squamous cell carcinoma
patient presents with enlarged lymph nodes, nontender, weight loss, night sweaters, the nodes are “rubbery”
lymphoma
rhabdomysarcoma’s are..
more common in kids. they are neoplastic. they are painless and enlarging.
a hard midline nodule that you can feel on the thryoid you may think…
thyroid cancer.
How do you diagnose neoplastic neck masses?
CT scan with contrast, FNAB
Treatment will most likely need excision and biopsy
Patient presents with painful enlargment of their parotid and submandibular glands. They are extremely tender to palapation. You notice purulent discharge from the duct.
Sialoadentitis. You want to treat with Abx, hyrdation, massage of gland, warm compress
Describe Parotitis
inflammation of parotid glands. Bacterial need Abx. Viral could be mumps.
What is the basis of sialolithiasis?
little stones cause intermittment swelling of the salivary glands (parotid and sub). Noticed more when eating, sxs subside in 24-48 hours.
