Neck swellings Flashcards

1
Q

Where is the anterior triangle?

A

Lateral border SCM

Medial is midline

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2
Q

Where is the posterior triangle?

A

Clavicle inferiorly
Lateral - anterior border of trapezius
Medial - lateral border of SCM

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3
Q

Which swellings are found superficially?

A

Sebaceous cysts
Lipomas
Neurofibromas

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4
Q

Which swellings are found in the midline?

A

Thyroid
Thyroglossal cyst
Dermoid cyst

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5
Q

What swellings could be present in the anterior triangle?

A

Salivary glands
Lymph nodes
Branchial cyst
Carotid body tumour

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6
Q

What swellings are present in the posterior triangle?

A

Lymph nodes

Cystic hygroma

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7
Q

Which points in a Hx are important if symptom is cervical lymphadenopathy?

A

Fever, weight loss
Hoarseness, dyspnoea
melena, recent immigrant

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8
Q

What investigations are needed if cervical lymphadenopathy?

A
CXR
Fine needle aspiration
Mantoux test or ZN stain
Check hepatospenomegaly
Check other nodes
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9
Q

What is evident in examination of a thyroglossal cyst?

A

Moves with the tongue
Below hyoid
Presents in teenage years

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10
Q

What is the treatment for a thyroglossal cyst?

A

Excision

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11
Q

What are the features of a dermoid cyst?

A
Presents in youth
Soft
Non-fluctant 
In midline
Also found lateral to eye
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12
Q

What is a branchial cyst?

A

Persistent part of 2nd branchial arch.
Teenage years
Half filled water bottle

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13
Q

What may be contained in a branchial cyst?

A

Cholesterol crystals

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14
Q

What is a caution with branchial cysts?

A

May fistulate to skin and leak saliva

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15
Q

Where do cystic hygromas present?

A

Posterior triangle

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16
Q

In whom do cystic hygromas present?

17
Q

What are the features of cystic hygromas?

A

Lymph filled.
Transilluminable
Pressure symptoms

18
Q

What is the treatment for cystic hygromas?

A

Will shrink over time so just leave it

19
Q

Which cancer is most likely to appear on the ectopic thyroid tissue?

20
Q

If the swelling moves on swallowing where it is likely to be?

21
Q

If the swelling move on sticking the tongue out what is not likely to be?

A

Dermoid cyst

22
Q

What is a chemodactoma?

A

Carotid body tumour

23
Q

If a swelling is soft, is it likely to be benign or malignant?

24
Q

What is Trosier’s sign?

A

Presence of Virchow’s node

25
What is the structure called in the mouth which contains all the tonsils?
Waldeyer's tonsillar ring
26
Histologically, what kind of cancer is likely to be found in the oesophagus?
Squamous epithelial
27
Where else can cystic hygromas present?
Axilla
28
What parts of the history are particularly important in thyroid swellings?
FHx | Previous neck irradiation
29
True or False | Hoarseness could be either benign or malignant
False. | Mostly malignant.
30
Which nerve infiltration causes hoarseness?
recurrent laryngeal
31
Which investigations should be done in a thyroid swelling?
TSH | USS-FNA
32
What are the 5 responses of FNA?
Thy1- inadequate Thy2- benign Thy 3- suspicious Thy4/5 malignant
33
What further investigation is carried out in Thy3?
Thyroid lobectomy