Neck lumps Flashcards
What are the borders of the anterior triangle?
Superiorly – inferior border of the mandible (jawbone).
Laterally – anterior border of the sternocleidomastoid.
Medially – sagittal line down the midline of the neck.
What are the borders of the poster triangle?
Anterior- posterior border of the sternocleidomastoid.
Posterior-anterior border of the trapezius muscle.
Inferior – middle 1/3 of the clavicle.
What are the key features of Reactive lymphadenopathy?
The most common cause of neck swellings.
History of local infection or a generalized viral illness
What are the key features of Lymphoma
Rubbery, painless lymphadenopathy
pain whilst drinking alcohol (very uncommon)
B symptoms (fever, night sweats, and weight loss) splenomegaly
What are the key features of Thyroid swelling?
Moves upwards on swallowing
Maybe hypo-, eu- or hyperthyroid symptomatically
Define a thyroglossal cyst?
Thyroglossal Duct Cysts are a birth defect. They are a fibrous cyst that forms a persistent thyroglossal duct.
What causes thyroglossal cyst?
During embryonic development, the thyroid gland is being formed, beginning at the base of the tongue and moving towards the neck canal, known as the thyroglossal duct. Once the thyroid reaches its final position in the neck, the duct normally disappears. In some individuals, portions of the duct remain behind, leaving small pockets, known as cysts. During a person’s life, these cyst pockets can fill with fluids and mucus, enlarging when infected, presenting the thyroglossal cyst.
What are the key features of thyroglossal cyst?
irregular neck mass
Usually midline, between the isthmus of the thyroid and the hyoid bone
More common in patients < 20 years old
Usually midline, between the isthmus of the thyroid and the hyoid bone
Moves upwards with protrusion of the tongue
May be painful if infected
What is another name for a Pharyngeal pouch?
Zenker’s diverticular
What are the key features Pharyngeal pouch
More common in older men
Represents a posteromedial herniation between thyropharyngeus and cricopharyngeus muscles
Usually not seen but if large then a midline lump in the neck that gurgles on palpation
Typical symptoms are dysphagia, regurgitation, aspiration, chronic cough, and smelly breath
What is the management of a Pharyngeal pouch?
Diagnosis: barium swallow
Treatment: If small - do nothing
If large - resect the diverticulum and incise the cricopharyngeus muscle.
What is a Pharyngeal pouch?
It is diverticulum of the mucosa of the pharynx, just above the cricopharyngeal muscle (i.e. above the upper sphincter of the esophagus). It is a pseudo diverticulum (not involving all layers of the esophageal wall).
What are the key features of a Cystic hygroma?
A congenital lymphatic lesion (lymphangioma) typically found in the neck, classically on the left side
Most are evident at birth, around 90% present before 2 years of age
What are the key features of Branchial cysts?
An oval, mobile cystic mass that develops between the sternocleidomastoid muscle and the pharynx
Develop due to failure of obliteration of the second branchial cleft in embryonic development
Usually present in early adulthood
What are the key features of a Cervical rib?
More common in adult females
Around 10% develop thoracic outlet syndrome
