Final Part Flashcards
glands involved in sialothiasis
submandibular, sublingual, parotid
-submandibular is the most common bc the gland is long and the flow of the saliva
sialolithiasis presentation
pain and swelling but can be painless
-pain with eating
-stone can be seen at the opening of the affected gland and can also be palpates along the course of the duct
when to be concerned about malignancy for sialolithiasis
-solid lesion on imaging
-cystic/ soft on palpation would be benign
acute bacterial sialadenitis
suppurative sialadenitis that is most common at parrots gland and by s.aur
acute bacterial sialadenitis s+s
-pain and swelling with meals
-tenderness and erythema of duct opening
*pus
how ever will we treat acute bacterial sialadenitis
incision and antibiotics
salivary gland tumor locations
parotid gland MC
pleomorphic adenoma
benign salivary tumor
mucoepidermoid carcinoma and adenoid cystic carcinoma
malignant salivary gland tumor
viruses that give u risk of salivary gland tumor oh no
EBV, HIV, HPV
criteria for abnormal lymph node
bigger than 1.5 cm with decreased motility with a firm rubber feel
-can be parotid or thyroid gland tumor
age above 40
more likely that a neck mass would be malignant not inflammatory
what if you have a mass chilling for years not changing
benign, watch for the fast changing ones
what if the mass fluctuates a lot
congenital that fluctuates with infections
ddx for a nodal neck mass in adults
nodal metastasis from HPV thAT is causing oropharyngeal squamous cell carcinoma
what causes pain from neck mass
the growth of the mass or neural invasion
night sweats and fever
lymphoma
spiking fever alone
acute infection
other causes of neck masses
hematoma, av fistula, pseudo aneurysm
what to look for when pt has a neck lump
skin lesions that could indicate squamous cell carcinoma/ malignant melanoma orrr kitty cat scratch disease
red flag of a neck lump
facial nerve weakness bc that could be a parotid gland tumor
-this is an aggressive cancer
-check forehead, cheek and chin trigeminal nerves
characteristics of an infected lump
warm, tender, erythematous
what is the mass moves from side to side NOT arriba y abajo
it has invaded the carotid sheath
-this can be carotid body tumor or vagal schwannoma
what is the lump moves with swallowing
thyroglossal duct cyst or thyroid tumor
where will lateral neck masses be and what are they
on the sternocleidomastoid muscle
-could be cyst, sinus or fistula
-can be brachial anomaly (congenital)
-they are soft, painless and slow to grow
MC causes of infectious neck masses
-mumps, toxoplasmosis, coccidiodymcosis
Lyme s+S
facial paralysis, synesthesias, dyspepsia cranial neuropathy
-cervial lymphadenopathy, headache, pain
kitty cat scratch pathogen
rochalimaea henselae (gram neg rod)
cat presentation
local papule, pustule, vesicle on top scratch
cat tests
skin test with antigen (hanger-rose), anti-bartonella henselae ism titler, biopsy for pleomorphic intracellular rods and warthog starry silver impregnation stain
cat complications and tx
-rare: near, liver, spleen, bone, skin
-spontaneously resolves
thyroglossal duct cyst cause
due to the remnants of the epithelial thyroglossal tract bc it did not close/ develop in feet
-at midline of neck @ thyroid
types of congenital masses
-thyroglossal cyst, brachial cleft or fistula, dermoid cyst, lymphangioma, congenital toricollis (rare), teratoma (rare), thymic mass (rare)
how to see thyroglossal duct cyst
-mri or ct or us
-dye the track with fitulography
lymphangioma
malformation of the lymph system that needs surgery, sclerotherapy, laser therapy or retreofrequency ablation
toricollis
postural neck deformity that causes lateral neck flexion and neck rotation, the chin is pointed to the other side
que is the result of thymic tissue implantation during the embryologic descent
thyme mass
-normally midline
types of metabolic masses
gout, sarcoidosis, Kimora disease (chronic inflammation involving subcutaneous tissue) and castleman disease (lymphoproliferative disorder)
teratoma
-from pluropotential cells and involves all 3 germ layers encapsulated with a cyst component
*this is a malignancy
brachial cleft cysts
congenital epithelial cyst at the lateral part of the neck due to a failure to obliterate the second brachial cleft during development or trauma
brachial cleft cysts s+s
anterior and upper neck swelling to sternocleidomastoid
-can have a fistula that is open to the skin
-surgery has risks
dermoid cyst caused
by entrapment of the epithelium in deeper tissue during development or trauma
-nontender, midline
hodge lymphoma
younger 15 ot 24, neck, axilla, chest MC, reed sterner cell, one of the most treatable cancers
nonhodhge lymphoma
60s and up, lymph nodes throughout the body, dx typically at later stage
lymphoma s+s
painless lymph node swelling at armpit, groin
-fever, fatigue, sob, weight loss
viral sialadenitis
-mc: mumps, can also be abc, coxsackie, influence a, echovirus
viral siadelitithis s+s
acute pain, swelling @ one or both parotid glands with a non specific prodrome
-feverm malaise, headache, anorexia within 48 hours of parotitis)
HIV red flag
can be asymptomatic with non painful swelling if they have viral siadalithesis
tb
chronic contender swelling of one parotid gland or a lump in the gland
-might or might not have tb s+s
sjorn s+s
recurrent or chronic swelling one or both parotid glands with no apparent cause noted
-autoimmune
-discomfort, dry eyes and mouth
central neck masses
mc: thyroglossal duct cyst
-hyoid bone
-cyst and thyroid carcinoma
-thymic rests and dermoids
