Neck lumps Flashcards
anatomy of the neck
QUIZLET
examination of lymph nodes
be systematic along mandible work backwards feel down the anterior SCM feel across the supraclavicular fossa then behind the SCM then back up behind the SCM don't forget some that extend to the edge of the scapula
superficial sebaceous cyst
enlargement of the spacious gland
often follows the hair line
has a punctum (where the hair would insert in the middle)
often symmetrical
ovoid, smooth
attached to the skin- embedded, cannot move separate to the skin
can become infected- tender, swollen, hot
dermoid cyst
benign and do not change over life
deeper- connective tissue and adipose tissue
lipoma
benign overgrowth of the lipid tissue.
malignant- liposarcoma (rare)
can be big, multiple
supraclavicular fossa, trunk, legs, around the back
thyroglossal cyst
can have active thyroid tissue in them
usually at the level of the hyoid
protrudes with swallowing and tongue protrusion (fixed to thyroid and tongue)
if swallowing only- goitre (thyroid and not tongue)
branchial cyst
outpouching
classically in the midline of the SCM
can become infected
low grade lymphoma
tend to present in multiple lymph nodes
slow and indolent
rubbery
branchial cyst
outpouching
classically in the midline of the SCM
can become infected
congenital- arising from the branchial cleft
soft and fluctuant
usually presents between the age of 20-40 y/o
salivary gland
submental area
submandibular area
parotid gland
salivary gland
submental area
submandibular area
parotid gland
inflammation- mumps, HIV
obstruction- calculi ,stricture
neoplasia
facial nerve branches
*
pharyngeal pouches
similar congenital defect
diverticulum- pouching of the pharyngeal mucosa
out-touching
dysphagia, emesis of undigested food with acid/bile. extreme halitosis
smooth, soft, deeply attached
sternocleidomastoid tumor
rhabdomyosarcoma (rare)
not a tumor:
‘twisted neck’ torcicolli
results from trauma during birth and resolves spontaneously with growth
cystic hygroma
deficiency of the drainer of the lymphatic systems
(rare)
palpate and feels like surgical emphysema
lumpy mass
tx: surgical
carotid body tumour
distinct tumors
sit at the carotid bifurcation level III
slow growing
pulsatile*
*hoarse voice after op
cervical rib
around the posterior triangle
supernummery rib abnormally located above the first normal rib
congenital
supraclavicular region
bony and hard
- upper limb thrombosis
- subclavian vein thrombosis- rib can interfere with the flow through the subclavian vein
tx: anticoagulant and remove the rib
most common oral cancer
mucous lining of the oral cavity / lip
squamous cell carcinoma
signs and symptoms of oral cancer
indolent ulcer on the lateral border of the tongue
most common
doesn’t resolve in 2-6 weeks
ulcers- bleed/painless (rolled edge) leukoplakia erythroplakia speckled leukoplakia dysphagia and odynophagia lymphadenopathy
risk factors for oral cancer
smoking (20 day)
heavy alcohol
HPV16 infection
sunlight
investigations for oral cancer
biopsy
FNA
R/G to see if bone involvement
CT if site is deep
lymphoma
core biopsy with USS
?
lymphoma
core biopsy with USS
LDH- shows the proliferation of cells (increases when there is increased destruction of cells and when there is proliferation of white cells)
describing a lump
INSPECT neumonic
INSPECT
Shape, Size (fruit, veg, nuts), Site
Palpation - pulse
Erythema
Contour lines (borders), Consistency (rubbery/firm), Content, Colour, Compressibility, Cough impulse (groins)
Tender, temperature (use back of hand over lump) tethering, transilumination
