Swelling And Ulcer Case Discussion Flashcards
If there is no impulse seen in pt while coughing
It suggest
Cough impulse absent means Intracranial extension not there
Transillumination in a scalp swelling will suggest
Cystic swelling
Meningocele
If skin over swelling cannot be pinched it implies
That the swelling arises from skin
If pt has swelling on scalp, why is it necessary to rule out swelling over rest of the body
Neurofibromatosis
Lipoma
D/D of swelling on scalp can be
Sebaceous cyst Basal cell carcinoma Meningocele Lipoma Neurofibromatosis
What is sebaceous cyst
It is a blocked hair follicle duct which can give rise to cyst
How to confirm diagnosis of swelling on scalp
FNAC
Xray skull to rule out Intracranial extension
Classical feature of sebaceous cyst
Punctum present
Fluctuation
Overlying skin cannot be pinched
Sebaceous cyst cannot occur in
Palm and sole
Dermoid cyst occurs when and usual sites?
Epithelial element get entrapped along lines of embryonic fusion
Site outer canthus of eye, post auricular
Mgt of dermoid cyst
Excision only if no Intracranial extension
Lymphangioma is aka
Cystic hygroma
What is cystic hygroma
Sequestered lymphatic tissue during development
Most common site of cystic hygroma
Posterior triangle of neck
Clinical feature of cystic hygroma
Fluctuant
Brilliantly transilluminant
Partly compressible
Overlying skin can be pinched
Mgt of lymphangioma
Complication of surgery
Aspiration and sclerotherapy (picibanil)
Definitive tt surgery
11 CN INJURY
What is ranula
Mucus extravasation cyst involving sublingual gland
Examination finding and mgt of ranula
Fluctuant
Brilliant transilluminant
Mgt excision of cyst and sublingual gland
Marsupialisation
Surgical contraindication in ranula
Incision and drainage
Most common nerve injured during ranula surgery
Lingual nerve
Most common str injured during ranula surgery
Submandibular duct
Plunging ranula is
Clinical presentation
Mucus retention cyst involving sublingual and submandibular gland
Swelling in neck and oral cavity
How to differentiate between submandibular gland swelling and lymph node
Submandibular gland is bimanually palpable
and lymph node is not
Hallmark feature of parotid swelling
How to know if deep lobe of parotid is involved
Swelling lifts ear lobule
Tonsillar fossa is pushed medially
Thyroglossal cyst is a remnant of
Mc location of thyroglossal cyst
thyroglossal tract
Sub hyoid in midline
Clinical diagnosis of thyroglossal cyst
It moves with deglutition and protrusion of tongue
Sistrunk surgery is done for
Procedure?
Removal of
cyst
Tract till base of tongue and part of hyoid
Long standing thyroglossal cyst can lead to which cancer
Papillary thyroid cancer
Difference between branchial cyst and fistula
Branchial cyst is persistent cervical sinus
Branchial fistula occurs when there is non fusion of 2nd arch with 6th
Location of branchial cyst and fistula
Cyst- ant border of sternocleiodomastoid junction of upper and middle one third
Fistula ant border of scm, at junction of middle and lower 1/3
Most common cause of cervical lymphadenopathy in India
Tuberculosis
In tb cervical lymphadenopathy which lymph node is involved most common
Level 2
Upper jugular LN
To prevent formation of fistula in TB lymph node how to aspirate
Anti gravity aspiration from above should be done
What is matting of lymph node
After caseous necrosis, inflammation of surrounding wall of lymph node i e periadenitis
This leads to sticking of lymph node to each other
What is collar stud abscess where is it seen
Abscess cavity below and above fistula with opening in fascia
Seen in neck, it is a cold abscess
