Neck Lumps Flashcards
what are the division of the neck
midline, anterior triangle, posterior triangle
what divides the anterior and posterior triangles
the sternocloidomastoid
what are the boundaries of the anterior triangle
bounded by mandible superiorly, midline medially, anterior border SCM laterally
what are the boundaries of the posterior triangle
SCM anteriorly, trapezius laterally, clavicle inferiorly
what can cause a midline swelling
thyroid, thyroglossal cyst, dermoid cyst
what swelling moves when you stick out your tongue
thyroglossal cyst
what can cause anterior triangle swellings
lymph nodes, branchial cyst, salivary glands, carotid body tumours
what can cause posterior triangle swellings
lymph nodes, cystic hygroma
when does thyroid move
when swallowing
what is the most common cause of neck swellings
lymph nodes
what can cause cervical lymphadenopathy
infection, malignant, haematological (leukaemia, lymphoma)
what else should you look for in lymohadenopathy
other nodes, primary sites, hepatosplenomegaly
when does a thyroglossal cyst present usually
in teenage years
what is a dermoid cyst
rare congenital cyst, soft, nonfluctuant
when do dermoid cysts present
in teenage years
what is a branchial cyst
persisting second branchial arch
arises in upper part of anterior triangle
when do branchial cysts present
in teenage years
what is a cystic hygroma
majority present in 1st year of life, lymph filled cystm causes pressure symptoms
what can cause a swelling in the submandibular salivary glands
stone, pleomorphic adenoma
what can cause a swelling in the parotid salivary glands
infective, pleomorphic adenoma, stone
are the majority of solitary thyroid nodules malignant or benign
95% benign
how common are solitary thyroid nodules
5% of women will develop them
when would a history make you worry about a solitary thyroid nodule
FH of thyroid carcinoma
previous neck irradiation
what might suppressed TSH suggest in a solitary thyroid nodule
solitary toxic adenoma
what can classify nodules as to whether they are benign, indeterminate or suspicious
USS (Thy 1 inadquate, 2 benign, 3 suspicious, 4/5 malignant)
what is the treatment for benign solitary thyroid nodules
leave alone
what is the treatment for suspicious/ malignant solitary thyroid nodules
surgery- thyroid lobectomy/ total thyroidectomy
what superficial structures can cause neck lumps
sebaceous cysts
lipoma
neurofibroma
carbuncle (cluster or boils under the skin)
what is a dermoid cyst
abnormal growth containing epidemis, hair follicles, sebaceous glands- derived from residual embryonic cells
what are the three commonest causes of a midline lump
thyroid swelling
thyroglossal cyst
dermoid cyst
what is a cystic hygroma
fluid filled sac resulting from a block in the lymph system
what is the embryological origin layer of:
carbuncles
ectoderm
what is the embryological origin layer of:
cystic hygroma
mesoderm
what is the embryological origin layer of:
dermoid cyst
ectoderm
what is the embryological origin layer of:
brachial cyst
mesoderm
what is the embryological origin layer of:
thryoid
endoderm
what is the embryological origin layer of:
thyroglossal cyst
endoderm
what is the embryological origin layer of:
neurofibroma
ectoderm
what should you note about a neck lump when examining it
position, size, shape, mobility, consistency, associated lymphadenopathy
what is the onset of a mulitnodular goitre
slow- years
what are hormones like in thyroiditis
T4 raised
TSH suppressed
fT3 raised
what are homones like in MNG (non toxic) and idiopathic goitres
neutral
