Neck abnormalities Flashcards

1
Q

Causes of short neck

A
  1. Turner’s Syndrome
  2. Gorgylism
  3. Klippel- Feil Syndrome (Developmental anomaly of upper cervical vertebral column; with reduced number or fusion of them); Neck: vertebral fusion, cervical spina bifida, webbing and limited movement;
    Association: Torticollis, Hemivertebrae, fused rib; Neurodefect - moebius syndrome, syringomyelia, deafness, micrognathia, cleft palate, congenital heart disease
  4. Spondyloepiphyseal dysplasia
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2
Q

Steps in examination of Short Neck

A
  1. Note range of movement and any associated deformity like webbing, scar, low, M-shape hairline
  2. Note the height of patient and if there is facial dysmorphism
  3. Examine the limbs - short and deformed, limited flexion in gargoylism, increase carrying angle in Turner’s syndrome
  4. Spine examination - Abnormality and Sprengel shoulder (Congenital elevation of the scapula)
  5. Chest - Shield-like and widely spaced nipples, sign of COA
  6. Abdomen - hepatosplenomegaly
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3
Q

Causes of lateral neck masses

A
  1. Cervical LNs - viral (URI, Infectious Mononucleosis), Pyogenic, TB, Toxo, Kawasaki’s disease, tumor - Lymphoma, Leukaemia, secondary tumor
  2. Cystic Hygroma
  3. Branchial cyst
  4. Sternomastoid tumor
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4
Q

Steps in examination of neck masses

A
  1. Local examination - rmb to transluminate
  2. Look for infection or tumor in drainage areas: Throat, ears and scalp
  3. Other LN enlargement
  4. Hepatosplenomegaly
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5
Q

Causes of wry neck or torticollis or head tilting

A
  1. Muscular (sternomastoid tumor, myositis ossificans)
  2. Vertebral (Subluxation of atlanto-axial joint with URI;
    Rheumatoid arthritis; Klippel- Feil syndrome; Scoliosis)
  3. Soft tissue (cervical lymphadenitis; tonsillar abcess)
  4. Eye (4th nerve palsy)
  5. Ear (Vestibular disturbance)
  6. Brain (Posterior fossa tumor causing cerebellar damage)
  7. Drug induced dystonia (Phenothiazine, Metoclopramide)
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6
Q

Causes of webbing of neck

A
  1. Turner’s syndrome
  2. Noonan’s syndrome
  3. Escobak syndrome - Camptodactyly and Syndactyly)

Remark: Redundant skin fold at neck: Down’s; Patau’s; Klippel Feil syndrome

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7
Q

Brown Syndrome

A

Adduction of eye - Cannot elevate the eye so that eye becomes deviated (downwards) due to shortened superior oblique tendon/ adhesion between tendon and its sheath due to inflammation

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8
Q

Duane Syndrome

A

Defect in abduction with retraction of eyeball - adduction of affected eye - vertical /oblique movement of eyeball + narrowing of palpebral fissure;
Due to abnormal rectus muscle innervation or fibrosis of rectus muscle

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