Swelling of the Head and Neck Flashcards
What are the 2 triangles of the neck called?
- Anterior triangle
- Posterior triangle
Anatomically where is the anterior triangle of the neck located?
Below digastric, in front of
sternomastoid
Anatomically where is the posterior triangle of the neck located?
Behind sternomastoid, in front of trapezius, above clavicle
What are the two classifications of head and neck swelling?
- Acquired
- Developmental
What are the different types of acquired HN swelling? (4)
- Trauma
- Infection
- Immunological
- Neoplastic
(Malignant/Benign)
Name some conditions that are classified as developmental HN swelling (7)
- Branchial cyst
- Thyroglossal cyst
- Dermoid cyst
- Epidermal cyst
- Cystic hygroma
- Fibrous dysplasia
- Cervical rib
When examining a lump what things do you need to look out for? (10)
- Site
- Size
- Shape
- Surface
- Texture
- Temperature
- Tenderness
- Surrounding tissue
- Mobility
- Drainage lymph nodes
What is a branchial cyst?
Proliferation of epithelial remnants from second
branchial cleft within lymph nodes
Which age group is most affected by a branchial cyst?
Children and adolescents
Describe the texture and nature of a branchial cyst
- Fluid filled
- Soft
- Smooth
- Globular
Where is a branchial cyst located?
Upper part of the lateral neck beneath anterior border of sternocleidomastoid
What is the most common developmental cyst of the neck?
Thyroglossal Cyst
What is a Thyroglossal Cyst?
Failure of complete descent of thyroid tissue from
foramen caecum with subsequent cystification
Which age group is most affected by a Thyroglossal cyst?
Common in children and young adults
Where is a Thyroglossal cyst located?
Midline swelling in neck above level of thyroid
Describe the movement of a thyroglossal cyst
Swelling often moves on swallowing or tongue protrusion
What is a Dermoid cyst?
Proliferation of epithelial rests
Which age group is most affected by a dermoid cyst?
Young adults
Where is a dermoid cyst located?
Lateral neck swelling, floor of mouth above mylohoid muscle
Describe the texture and nature of a dermoid cyst
- Fluid filled
- Soft
- Smooth
- Globular
What is cystic hygroma?
Proliferation of sequestrated lymphatic endothelium of
the jugular sac
When does cystic hygroma present itself?
Presents at birth or manifests during infancy/
childhood
Where is a cystic hygroma located?
Lower third of neck
Describe the texture and nature of a cystic hygroma
- Spongy
- Soft
- Translucent
Why do lymph nodes enlarge? (2)
- Increase in the number of cells
- Infiltration of nodes with cells
At what age does lymphadenopathy becomes worrying (malignancy)?
Patients over the age of 50 only 40% are benign
Name some systemic bacterial infections that can cause cervical lymphadenopathy (2)
- TB
- Syphillis
Name some systemic viral infections that can cause cervical lymphadenopathy (2)
- Infectious mononucleosis
- Cytomegalovirus
- HIV infection
What is Pyogenic Lymphadenopathy
Oral inflammatory conditions (ie dental
abscess)
Describe the consistency of Pyogenic Lymphadenopathy
- Soft when acute
- Not fixed to surrounding tissue
What causes infectious mononucleosis?
Epstein-Barr Virus
Who is most affected by Viral Lymphadenopathy?
Young adults
What are some clinical features of Viral Lymphadenopathy? (3)
- Fever
- Malaise
- Sore throat
Describe the nature of the lymph nodes during Viral Lymphadenopathy
- Firm
- Discrete
- Tender
- Mobile
What is Tuberculous lymphadenopathy?
Mycobacterium tuberculosis transmitted by sputum droplets from infected patients
What are some clinical features of Tuberculous lymphadenopathy? (6)
- Fever
- Malaise
- Night sweats
- Weight loss
- Persistent cough
- Shortness of breath
Which lymphadenopathy causes ulcer formation on dorsum of tongue?
Tuberculous lymphadenopathy
Who is most affected by malignant Lymphadenopathy?
Arise in middle-aged & elderly
What type of Malignant Lymphadenopathy arises in children and young adults?
Burkitt’s Lymphoma
What are some clinical features of Malignant lymphadenopathy? (4)
- Fever
- Malaise
- Night sweats
- Weight loss
Who is most affected by Metastatic carcinoma?
Seen in middle-aged & elderly
Describe the nature of a Metastatic carcinoma
- Indurated mass
- Fixed to surrounding tissue
- Rocky hard
- Painless
What is a Cervical rib?
Congenital condition where you are born with an extra rib which arises from the 7th cervical vertebra
What are some neurological symptoms of someone with a cervical rib? (3)
- Pain
- Paraesthesia
- Anaesthesia of forearm and hands
What is a lipoma?
Benign tumor made of fat tissue
Where is a lipoma predominantly found?
Posterior neck space is the most common site
