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Applied Anatomy > Neck Conditions > Flashcards

Neck Conditions Flashcards

1
Q

what are the boundaries of the anterior triangle?

A

Sternocleidomastoid

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2
Q

What are the borders of the posterior triangle?

A

Trapezius

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3
Q

5 characteristics of a neck swelling?

A

Size, Shape, Consistency,mobility and tendorness

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4
Q

Where is Virchows’s node located? what might its enlargement signify?

A

Left supraclavicular fossa and malignancy of the Abdomen in GI tract

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5
Q

Name 3 possible causes of enlarged cervical nodes?

A

infection
Malignancy
Autoimmune disorders

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6
Q

What anatomical features mean that voice change and hypocalcaemia are risks of thyroid surgery?

A
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7
Q

What is Horner’s syndrome?

A
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8
Q

Landmarks of the anterior triangle?

A

Superiorly - inferior border of the mandible
Laterally - Anterior border of the Sternocleidomastoid
Medially - Sagittal line down the midline of the neck

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9
Q

Landmarks of the posterior triangle?

A

Anterior - Posterior border of Sternocleidomastoid
Posteriorly- anterior border of trapezius
Inferiorly -middle 1/3 of the clavicle

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10
Q

Midline of the neck

A

Sagittal

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11
Q

Great vessels

A

Thyroid gland
Thyroid cartilage

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12
Q

spinous process

A
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13
Q

Causes of neck swelling and duration

A

In history, ask how long have you had it for.

  • it could be trauma, inflammation, infections - acute few days
  1. This could be bacterial-TB/ staphylococcus, or streptococcus infection, or could be raised because of dental/ impetigo/ tonsilitis/ quinsy ( inflammation of the throat)
  2. Viral - Urti/mumps
  • neoplastic (Tumour) - weeks to months

endocrine- chronic for months
This could be Goitre- Hashmito’s, Grave’s , iodine deficiency

  • congenital ( birth disorders) - Thyroglossal cyst chronic for years
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14
Q

History of the patients ?

A

age - child- cause of infection , young adult -infections or inflammatory mass, adult- goitre,older - neoplasm-beginin or malignant primary or secondary ?

Duration- Acute/subacute/chronic

Symptoms- hyper / hypo

Red flags of malignancy - weight loss, persistant hoarseness, cough, dysphagia

Haematological cancers- night sweats , fever, fatigue

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15
Q

Neck lumps - key points to think in your history and examination?

A
  • Foreign travel - areas of endemic
  • Exposure to animals - cat scratch fever, toxoplasmosis( infection from poo, infected cats) , insect bites
  • risk factors of head and neck
  • past history and family history
  • Occupational exposure - to wood dusts, nickel, asbestos
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16
Q

quinsy or peritonissor abscess

A
  • caused by the build up of pus- due to infection behind the tonsil
  • Symptoms- Fever, throat pain and difficulty opening ypur mouth
  • Pain is worse on the side
    the key feature is deviation of the uvulanon examination
  • Management - antibiotics or surgical drainage
17
Q

Impetigo

A

Staphyloccocus skin infection

18
Q

Impetigo treated with?

A

antibiotic cream (fucidin)
orally ( erythromycin)
it is very infectious and often swollen neighbouring nodes

19
Q

Blocked salivary duct

A
20
Q

Features of Hypothyroidism

A
  • dry hair
  • coarse features - the features of the face is not defined properly, eyebrows are thing from the lateral side
  • puffy dull face with dry skin, periorbital oedema ( fluid build up under the eyes),
21
Q

Features of hypothyroidsim ?

A
  • Bulging of the eyes are called Exopthalamus or proptosis
  • Reness of the eyes
  • eyelids retract
22
Q

What is a Goitre ?

A

Swelling due to an enlarged thyroid gland - could be hyper/hypo

The swelling moves while swallowing and it can extend behind the sternum sometimes and compress the trachea - this is called as retrosternal goiter!

if the patient feels breathless - they need to be referred to the hospital

23
Q

Causes of Goitre

A

Hyper or hypo
Pregnancy
menopause
puberty
idoine dietary deficiency
iatrogenic
Inflammation of the thyroid Gland - Thyroiditis

24
Q

other causes of thyroid masses

A

Thyroid Nodule
Thyroid Carcinoma
Thyroid Cyst
Thyroid Adenoma

25
Q

dangers of thyroid surgery

A
  • bleeding in the neck
  • it affects the recurrent laryngeal nerve
  • Hypocalcemia
    Build of bodily fluids after the surgery
    Infection
26
Q

Drooping of the upper eyelid ?

A

ptosis

27
Q

Constriction of the pupil ( smaller pupil)

A

miosis

28
Q

decreased sweating

A

anhidrosis

29
Q

what is hornors syndrome?

A

interruption of nerve supply from the brain to the face and eye, on one side of the body. This leads to miosis, ptosis and anhydrosis

30
Q

Hornor’s syndrome affects ?

A

sympathetic fibres comes from the hypothalamus and get into the spinal cord

It then exit from T1 and ascend in the cervical sympathetic chain on their way to the eye and the sweat glands of the face.

running close to the lungs and apex subclavian artery

31
Q

TIA?

A

TRANSIENT ISCHAEMIC STROKE - recovery time can take up to 24 hrs

It is caused by a temporary blockage in the internal carotid arteries usually at the place of narrowing.

32
Q

What is the management of TIA?

A

Management -Patients must be seen within 24hrs , offer immediate aspirin 300mg daily unless contradicated

refer them immediately for specialist assessment investigation to be seen with 24hrs of symptoms

offer secondary prevention - on top of aspirin as soon as possible after the diagnosis of TIA is confirmed

33
Q

Investigations of TIA

A

**Blood test **such as FBC, ESR,CRP, Platalets, Urea, Blood glucose, syphilis serology

Chest X ray

monitor ECG for 24 hrs to look for arrythmia

Transesophageal & transthoracic of echocardiography

**Carotid duplex test ** - non-invasive ultrasound which shows how well the blood is flowing through the carotid arteirs - carotid angiography

**Carotid imaging **

34
Q

After a patient gets TIA, they’re more likely to get a stroke ? that’s called secondary prevention which are as follows

A

Antiplatalet tablets
* * Anticoagulant Therapy
* Carotid endarterectomy
Modifying several risk factors for stroke including **HTN, cholestrol and smoking **

35
Q

JVP

A

Jugular Venous Pressure can be observed in the internal jugular vein

It can be seen in between the sternuma and teh clavicle head of the sternocleidomastoid muscle

The pressure reflects on the right atrium, right side of the heart

36
Q

Conditions that cause Raised JVP ?

A
  • Constrictive Pericardities
  • Congestive Cardiac failure
37
Q

Virchow’s Node

A

Enlarged Left supraclavicular node which drains lymph vessels in the abdomen cavity.

Called as ‘Senitol Node’ of cancer in the abdomen.

It is particularly gastric cancer but can also be kidney. testicles and ovarian cancer.

Also, Known as Troisier’s sign

38
Q

Torticollis or wry neck

A

Caused due to the spasm of the sternocleidomastoid muscle.

Commonly present in children where the head is pulled towards one side

This could be a strain or viral but can be self limited

Applied Anatomy (3 decks)

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