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Head and Neck > Lymph nodes and neck lumps > Flashcards

Lymph nodes and neck lumps Flashcards

1
Q

What does the lymphatics system do?

A

1) Removes excess fluid from interstitial fluid preventing accumulation
2) Key role in immune defence and surveillance (source of lymphocytes)
3) returns small proteins and pathogens and fluids that leaked from the capillaries (Can’t return at venue end of capillary so are taken up by the lymph node)

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2
Q

What is lymphoedema?

A

swelling in body tissues

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3
Q

Is lymphedema common in the head and neck?

A

No - gravity aids in drainage

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4
Q

What is lymphadenopathy?

A

Swollen lymph nodes due to infection or malignancy

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5
Q

What do lymph nodes do?

A

They act as a physical, phagocytic filter and are full of T and B lymphocytes

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6
Q

What do T and B lymphocytes do?

A

They activate and proliferate in response to antigens causing them to swell giving an immune reaction

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7
Q

Where are most the lymph nodes in the body found?

A

neck, groin and armpit

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8
Q

What is lymphadenopathy a common cause of ?

A

Neck lumps

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9
Q

How would a patient present if they had a neck lump due to infection?

A

Lump would be tender and mobile

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10
Q

How would a patient present if they had a neck lump due to malignancy?

A
  • Hard and matted but not tender

- rubbery, mobile and fast growing (lymphadenopathy with lymphoma)

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11
Q

What would you do if a lymph node was enlarged?

A
  • history
  • examine
  • examine other lymph nodes and body systems
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12
Q

What are regional lymph nodes?

A

lymph notdes that are superficial (lie in the superficial cervical fascia) and easily palpated when enlarged

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13
Q

What are examples of regional lymph nodes?

A

submental, submandibular, pre-auricular, post-auricular/mastoid, occipital

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14
Q

Where are terminal lymph nodes?

A

lie depp to the investing layer of deep cervical fascia

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15
Q

What do terminal lymph nodes receive compared to regional ones?

A

all the lymph from the head and neck including lymph drained first via the regional groups (that drain specific areas)

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16
Q

Where do deep tissues and structures of the neck drain into?

A

termina lymph nodes

17
Q

What is the juglo-digastric node and where is it located?

A

tonsillar node - located below and behind the angle of the mandible

18
Q

What does the tonsillar node drain?

A

tonsil, oral cavity, tongue

19
Q

When is the tonislar node swollen and tender?

A

in tonsillitis or malignancies affecting the structures that it drains

20
Q

What does the juggle-omohyod node drain?

A

tongue oral cavity, trachea, oesophagus, thyroid gland

21
Q

Where are the supraclavicular nodes found?

A

in the posterior triangle

22
Q

When will the supraclavicular nodes enlarge?

A

later stages of malignancies of the abdomen and thorax because they receive lymph from these areas before it drains via the thoracic duct into the venous circulation

23
Q

What does the left supraclavicular node drain?

A

abdomen and thorax AKA virchows node

24
Q

What does the right supraclavicular node drain?

A

mid section chest, oesophagus and lungs

25
Q

What is waldeyer’s ring of lymphoid tissue?

A

annular arraignment of lymphoid tissue in the pharynx

26
Q

What is the first line of imaging for neck lumps?

A

USS

27
Q

If an adult patient had a lump that mo bed when swallowing what would be the diagnosis?

A

Thyroid swelling - goitre

28
Q

Why would a goitre move with swallowing?

A

In the pre-trachea fascia and the trachea and cartilages are attached to the hyoid bone which moves up when swallowing bringing the whole gland with it

29
Q

What is a thyroglossal duct cyst?

A

-common congenital abnormality

30
Q

Why do TDC’s arise?

A

due to the persistence of the thyroglassal duct which the thyroid gland migrates down from the tongue to is anatomical position during fetal development

31
Q

What happens if the duct doesn’t disappear during fetal life?

A

cysts can develop on it, become infected, cause sinuses

32
Q

Where are TDC’s normally found?

A

in the midline just below the hyoid bone

33
Q

How would TDC’s feel?

A
  • fluctuant to palpate (fluid filled)
  • swelling will move when sticking tongue out and swallowing
  • non tender
34
Q

How should you treat a TDC?

A

surgically removed as can cause future problems (sinuses/infections)

35
Q

What is a dermoid cyst?

A

congenital epithelial lined cyst that doesn’t move when swallowing

36
Q

What are the red flags for neck lumps?

A
  • longer than 6 weeks
  • fixed/hard/irregular
  • rapidly growing in size
  • associated with generalise lymphadenopathy
  • weight loss/night sweats
  • hoarseness in voice/difficulty swallowing
37
Q

Why would a patient with a neck lump have difficulty swallowing?

A

Lump could compress on the pharynx/larynx causing food to stick

38
Q

What are other differentials of lymphadenopathy?

A 
TB
HIV
Carotid artery anurysm
Sebaceous cyst
Lipoma
Skin access
Salivary gland tumour

Head and Neck (13 decks)

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