Neck and Lymphatic System Flashcards
(1) For descriptive purposes, divide the neck into two triangles bound by ______ muscle.
(2) Anterior triangle of the neck: (3)
(3) For the posterior triangle: (3)
(4) Do not mistake this muscle for a mass on the clavicle
(5) What structures are you identifying for the midline of the neck?
(1) Sternomastoid
(2) Mandible, sternomastoid laterally, midline of the neck
(3) Sternomastoid muscle, trapezius, clavicle.
(4) Omohyoid muscle
(5)
1. Hyoid bone (below the mandible)
2. Thyroid cartilage
3. Cricoid cartilage
4. Tracheal rings
5. Thyroid gland
(1) In the supraclaviclar fossa, greater than ___cm is significant*
(2) In the axilla and inguinal areas, less than ___cm is insignificant
(3) Every other palpable lymph node, less than ___ cm is insignificant
(1) 1cm* [enlargement can suggest possible metastasis from a thoracic or abdominal malignancy]
(2) 3cm [Can be bigger in the axilla due to fat]
(3) 2cm
Where shouldn’t you feel lymph nodes? [Indicating malignancy]
- L Supraclavicular fossa [abdominal disease] have them bend their neck forward. Push down over the clavicle.
- Infraclavicular fossa [breast cancer, malignant lymphoma]
In some people the parotid gland can be felt where?
Angle of the mandible. Also feel submandibular glands.
Palpating lymph nodes, location.
Posterior auricular lymph nodes [infection]
Preauricular lymph nodes [infection]
Occipital
Down sternocleidomastoid muscle, palpate for jugular lymph nodes. Go up and down gently. Down to the clavicle.
Palpable lymph node areas
- epitrochlear
- axillary
- cervical and occipital
- supraclavicular
- para-aortic (rarely palpable)
- inguinal
- popliteal
8 groups of cervical / supraclavicular nodes
Submental (below chin) Submandibular (below jaw) Julgular chain (anterior to sternomastoid) Posterior triangle nodes (posterior sternomastoid) Occiptal nodes Postauricular node Preauricular node Supraclavicular fossa
Contraindications to treating lymphatics (3)
- Fractures
- Cancer
- Severe infection
(Don’t want to spread it around)
Septal hematoma is a…
Medical emergency
Thyroid cyst vs. nodule
A nodule does not move when the patient sticks out their tongue, but a cyst will.
Which structures in the neck are NOT palpable?
Hyoid bone (not usually palpable midline) Thyroihoid membrane
The first palpable structure on the neck is the
Thyroid cartilage (Adam’s apple)
The small groove below is the thyroid cartilage is
Cricothyroid ligament
The structure below the Cricothyroid ligament
Cricoid cartilage
The _____ below the cricoid cartilage is not always palpable
Thyroid isthmus
When a patient swallows, what happens to the thyroid gland?
The thyroid gland goes up, and if there’s a nodule, it also goes up. If it doesn’t, the nodule is in the subcutaneous tissue.
What to chart with lumps/swelling
Size Position Attachments Consistency Edge Surface and shape Pulsation/Thrills/Bruits Inflammation Transillumination (SPACEPIT)
Malignant masses commonly infiltrate adjacent tissues, causing them to feel
Fixed and immobile.
Unlike a muscle or an artery, you should be able to roll a node
In 2 directions, up/down and side/side
Enlarged or tender lymph nodes call fo
Reexamination of the regions they drain
Tender lymph nodes suggest
Inflammation
Hard/fixed lymph nodes suggest
Malignancy
Elderly population: Lymph nodes
Decrease with age in size and number
In the pediatric population, when do sinuses develop?
7 years old
