W2L7 Neck Lumps Flashcards
What is the lumps and bumps mnemonic?
She Cuts The Fish PERfectly
What are the 3 Ss of neck lumps?
Site - describe location briefly
Size - use your hand and fingers to estimate if you do not have a ruler with you
Surface/overlying skin
What are the 3 Cs of neck lumps?
Colour
Contour - is the lump well-defined or irregular
Consistency - ?soft/firm/hard
What are the 3 Ts of neck lumps?
Tenderness
Temperature - Is it hot/inflamed?
Transilluminable
What are the 3 Fs of neck lumps?
Fluctuance - ?fluid-filled cyst Fixation - ?is it fixed to the underlying tissue or to the overlying skin
Fields - draining lymph glands in the area
What does PER stand for?
Pulsatile (Is it an aneurysm?)
Expansile (Is it an aneurysm?)
Reducible (Is it a hernia?)
What are the structures in Level 1 of the neck?
submandibular salivary glands, myohyoid and digastric muscles, nubmandibular LNs, vessels and nerves
What are the structures in Level 2, 3, 4 of the neck?
internal and external carotids and carotid bodies, CNX in carotid sheath, IJV, LNs.
What are the structures in Level 5 of the neck?
CNXI, LNs, brachial plexus
What are the structures in Level 6 of the neck?
thyroid, hyoid, trachea, oesophagus, larynx, anterior jugular veins
Top 3 neck lumps in a toddler?
INFECTION, congenital, neoplasm
What does lymphadenitis look like?
Big red, inflamed lump in a sick child (acute process)
What is scofula?
Mycobacterial cervical lymphadenitis, refers to a lymphadenitis of the cervical lymph nodes associated with non tuberculous (atypical) mycobacteria. Chronic process, so not febrile.
Top 3 neck lumps in a young adult?
Infectious/ inflammatory, neoplastic, congenital
What kind of neck lumps can acne/ scalp acne give you?
Reactive LNs
What are the characteristics of a thyroglossal duct cyst?
Presentation is typically either as a painless rounded midline anterior neck swelling or, if infected, as a red warm painful lump. It may move with swallowing and classically elevates on tongue protrusion.
Top 3 neck lumps in middle age?
Infection
Neoplasia
Thyroid
How does a thyroid mass present?
Midline mass which moves on swallowing (in pretracheal fascia)
How does a metastatic lymphadenopathy feel
“craggy”
Where is virchow’s node and what is it’s significance?
Virchow’s node is a lymph node in the left supraclavicular fossa. It takes its supply from lymph vessels in the abdominal cavity–> thoracic duct. The finding of an enlarged, hard node (also referred to as Troisier’s sign) is indicative of the presence of cancer in the abdomen, specifically gastric cancer.
What is the likely cause of a neck lump with erythematous, ulcerating skin and a suppurative exudate in an adult?
Infective lymphadenitis due to mycobacteria–> TB (particularly in an HIV patient)
What is the first line imaging of a neck lump?
US
What are the 4 kinds of biopsy?
FNA, incisional (eg core, wide needle), excisional, wide local excision.
