2.1 Neck lumps

Question 1

roles of lymphatic system

Answer 1

-remove excess fluid from interstitial space
-return small proteins/fluid to venous system
-physical+phagocytic barrier, lymphocytes

Question 2

is pharyngeal tonsil (adenoid) enlargement common in children?

Answer 2

yes

Question 3

symptoms of pharyngeal tonsil enlargement

Answer 3

-snoring
-mouth breathing
-middle ear problems

Question 4

are tonsils lymph nodes? why?

Answer 4

no
don’t have a fibrous capsule around them

Question 5

palpation of reactive cause of enlarged lymph node

Answer 5

(infection)
-tender
-mobile
-recent rapid growth

Question 6

palpation of lymphoma

Answer 6

-rubbery
-painless
-fast growing

Question 7

palpation of malignant lump

Answer 7

-hard
-tethered to tissues
-painless

Question 8

red flags for lymphadenopathy

Answer 8

-hard, fixed, irregular
-weight loss, night sweats, pruritus
-persistent voice hoarseness, difficulty swallowing
-other lymphadenopathy: armpit, groin
-> 6 weeks
-rapid size growth

Question 9

conjunctivitis can affect which facial lymph nodes?

Answer 9

pre auricular

Question 10

name some neck structures which drain directly into deep cervical LNs

Answer 10

thyroid, posterior 1/3 tongue, pharynx, larynx

Question 11

sign of gastric cancer

Answer 11

virchow’s node

Question 12

name some causes of neck lumps

Answer 12

-sebaceuous cyst
-lipoma
-cervical lymphadenopathy (reactive/malignant)
-thyroglossal duct cyst, branchial cyst, dermoid cyst
-grave’s disease
-salivary gland infection
-carotid body tumour/aneurysm

Question 13

sign of carotid body tumour

Answer 13

pulsatile mass can move side to side, not up or down

Question 14

first imaging choice for neck lump

Answer 14

ultrasound, with fine needle aspiration