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Oral Disease - Soft tissue > Neck lumps > Flashcards

Neck lumps Flashcards

1
Q

What are the borders of the anterior neck triangle?

A

Superior = inferior border of the mandible
Lateral - anterior border of SCM
Medial - sagittal down the midline

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2
Q

List the subdivisions of the anterior neck triangle

A
  • Carotid triangle
  • Submental triangle
  • Submandibular triangle
  • Muscular triangle
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3
Q

What are the borders of the carotid triangle?

A

Superior - posterior belly of digastric
Lateral - medial border of SCM
Inferior - superior belly of omohyoid

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4
Q

What are the major components of the carotid triangle?

A
  • Common carotid artery (it bifurcates here)
  • Internal jugular vein
  • Hypoglossal and vagus nerves
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5
Q

What are the borders of the submental triangle?

A

(Found under the chin)
Inferior - hyoid bone
Medial - midline
Lateral - anterior belly of digastric

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6
Q

What are the main components of the submental triangle?

A

Submental lymph nodes

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7
Q

What are the borders of the submandibular triangle?

A

Superior - body of mandible
Anterior - anterior belly of digastric
Posterior border - posterior belly of digastric

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8
Q

What are the main components of the submandibular triangle

A
  • Submandibular gland and lymph nodes

- Facial artery and vein passes through

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9
Q

What are the borders of the muscular triangle?

A

Superior - hyoid bone
Medial - midline of the neck
Superolateral - superior belly of omohyoid
Inferolateral - inferior portion of SCM

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10
Q

What are the main components of the muscular triangle?

A
  • Muscles and organs including: infrahyoid muscles, pharynx, thyroid and parathyroid gland
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11
Q

What are the borders of the posterior neck triangle?

A

Anterior - posterior border of SCM
Posterior - anterior border of trapezius
Inferior - middle 1/3 of the clavicle

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12
Q

What are the subdivisions of the posterior neck triangle?

A
  • Occipital triangle

- Subclavian triangle

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13
Q

What structure splits up the posterior neck triangle into the subdivisions?

A

The omohyoid muscle (specifically the inferior belly)

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14
Q

Which posterior neck triangle is larger and positioned superiorly?

A

Occipital triangle

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15
Q

What are the muscular components of the posterior neck triangle?

A
  • Omohyoid muscle
  • Splenius cpitus
  • Levator scapule
  • Scalanes (anterior, middle and posterior)
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16
Q

What are the vascular components of the posterior neck triangle?

A
  • External jugular vein
  • Subclavian vein
  • Transverse cervical and supracapsular
17
Q

What are the nervous components of the posterior neck triangle?

A
  • Accessory nerve
  • Cervical plexus (phrenic plexus)
  • Branchial plexus
18
Q

What is the role of the lymphatic system

A

Drainage of tissue fluid, plasma proteins and cellular debris, along with immune functioning

19
Q

What are the divisions of the lymphatic system

A
  • Superficial vessels

- Deep vessels

20
Q

What is the function of the superficial lymphatic vessels?

A

Drainage from the scalp, face and neck to pass it on to deep lymphatic vessels

21
Q

What are the divisions of the deep lymphatic vessels?

A

Left jugular lymphatic trunk

Right jugular lymphatic trunk

22
Q

Where do the deep lymphatic vessels direct lymph to?

A

The associated subclavian vein (left and right depending on the jugular lymphatic trunk)

23
Q

List the superficial lymph nodes

A 
Occipital 
Mastoid 
Preauricular 
Parotid 
Submental 
Submandibular 
Facial 
Superficial cervical
24
Q

What is the function of the deep lymph nodes?

A
  • Recieve all the lymph from the head and neck either directly or via the superficial lymph nodes
25
Q

Differential diagnosis for a superficial neck lump located at any aspect of the neck

A
  • Skin abscess
  • Lipoma
  • Dermoid cyst
26
Q

Differential diagnosis for a midline lump

A
  • Thyroglossal cyst
  • Thyroid swelling (goitre)
  • Submental lymph nodes
  • Sublingual dermoid cyst
27
Q

Differential diagnosis for a lump in the anterior triangle

A
  • Lymphadenopathy affecting submandibular nodes (infection, neoplasm)
  • Submandibular gland pathology
  • Tail of parotid gland swelling
  • Branchial and lymphoepithalial cysts
  • Thyroid lobe swelling
28
Q

Differential diagnosis for a lump in the posterior triangle

A
  • Lymphadenopathy - due to infections or neoplasms (primary or secondary)
  • Carotid body tumour
  • Lipoma
  • Subclavian artery aneurysm
  • Pharyngeal pouch
29
Q

List bacterial infectious aetiology for cervical lymphadenopathy

A
  • Dental abscess, cellulitis, periodontitis or pericoronitis
  • Tonsil, face or scalp infections
  • TB or syphilis
  • Cat scratch disease
30
Q

List viral infectious aetiology for cervical lymphadenopathy

A

Herpetic stomatitis
Infectious mononucleosis
HIV

31
Q

List neoplastic aetiology for cervical lymphadenopathy

A
  • Primary neoplasms - hodgkins and non hodgkins lymphoma or leukemia, skin neoplasms
  • Secondary - carcinoma (oral, salivary gland, thyroid), malignant melanoma, metastases from gastric of abdominal cancer
32
Q

Important history on examination for neck lumps

A
  • History of systemic illness or infectious disease e.g. HIV or syphillis
  • History of animal scratch
  • Signs of systemic symptoms - fever, sweats, anaemia
  • Signs of nasal, sinus or nasopharyngeal symptoms
  • History of drugs (phenytoin)
  • Onset and changes to the lump over time
33
Q

Special ix for neck lumps

A
  • Blood
  • CXR
  • Serology
  • FNA
  • Ultrasound (thyroid)
  • Biopsy
  • Others:: matoux test, thyroid function and ACE and calcium levels
34
Q

Important signs upon inspection of a neck lump

A
  • Changes to voice - weak, hoarse
  • SOB or stridor
  • Scars on the neck - previous surgery
  • Obvious neck massess
35
Q

What type of neck lymps will rise on swallowing?

A

Thyroid mass

Thyroglossal cyst

36
Q

What type of neck lumps will move on protrusion of the tongue?

A

Thyroglossal cyst

37
Q

What are the things we look for when assessing and presenting a neck lump?

A
  • Size
  • Site
  • Shape
  • Skin (overlying)
  • Texture
  • Temperature
  • Mobility
  • Fluctuant
  • Pulsatility
  • Ausculation

Oral Disease - Soft tissue (12 decks)

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