Neck lumps Flashcards

(37 cards)

1
Q

What are the borders of the anterior neck triangle?

A

Superior = inferior border of the mandible
Lateral - anterior border of SCM
Medial - sagittal down the midline

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2
Q

List the subdivisions of the anterior neck triangle

A
  • Carotid triangle
  • Submental triangle
  • Submandibular triangle
  • Muscular triangle
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3
Q

What are the borders of the carotid triangle?

A

Superior - posterior belly of digastric
Lateral - medial border of SCM
Inferior - superior belly of omohyoid

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4
Q

What are the major components of the carotid triangle?

A
  • Common carotid artery (it bifurcates here)
  • Internal jugular vein
  • Hypoglossal and vagus nerves
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5
Q

What are the borders of the submental triangle?

A

(Found under the chin)
Inferior - hyoid bone
Medial - midline
Lateral - anterior belly of digastric

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6
Q

What are the main components of the submental triangle?

A

Submental lymph nodes

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7
Q

What are the borders of the submandibular triangle?

A

Superior - body of mandible
Anterior - anterior belly of digastric
Posterior border - posterior belly of digastric

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8
Q

What are the main components of the submandibular triangle

A
  • Submandibular gland and lymph nodes

- Facial artery and vein passes through

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9
Q

What are the borders of the muscular triangle?

A

Superior - hyoid bone
Medial - midline of the neck
Superolateral - superior belly of omohyoid
Inferolateral - inferior portion of SCM

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10
Q

What are the main components of the muscular triangle?

A
  • Muscles and organs including: infrahyoid muscles, pharynx, thyroid and parathyroid gland
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11
Q

What are the borders of the posterior neck triangle?

A

Anterior - posterior border of SCM
Posterior - anterior border of trapezius
Inferior - middle 1/3 of the clavicle

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12
Q

What are the subdivisions of the posterior neck triangle?

A
  • Occipital triangle

- Subclavian triangle

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13
Q

What structure splits up the posterior neck triangle into the subdivisions?

A

The omohyoid muscle (specifically the inferior belly)

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14
Q

Which posterior neck triangle is larger and positioned superiorly?

A

Occipital triangle

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15
Q

What are the muscular components of the posterior neck triangle?

A
  • Omohyoid muscle
  • Splenius cpitus
  • Levator scapule
  • Scalanes (anterior, middle and posterior)
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16
Q

What are the vascular components of the posterior neck triangle?

A
  • External jugular vein
  • Subclavian vein
  • Transverse cervical and supracapsular
17
Q

What are the nervous components of the posterior neck triangle?

A
  • Accessory nerve
  • Cervical plexus (phrenic plexus)
  • Branchial plexus
18
Q

What is the role of the lymphatic system

A

Drainage of tissue fluid, plasma proteins and cellular debris, along with immune functioning

19
Q

What are the divisions of the lymphatic system

A
  • Superficial vessels

- Deep vessels

20
Q

What is the function of the superficial lymphatic vessels?

A

Drainage from the scalp, face and neck to pass it on to deep lymphatic vessels

21
Q

What are the divisions of the deep lymphatic vessels?

A

Left jugular lymphatic trunk

Right jugular lymphatic trunk

22
Q

Where do the deep lymphatic vessels direct lymph to?

A

The associated subclavian vein (left and right depending on the jugular lymphatic trunk)

23
Q

List the superficial lymph nodes

A
Occipital 
Mastoid 
Preauricular 
Parotid 
Submental 
Submandibular 
Facial 
Superficial cervical
24
Q

What is the function of the deep lymph nodes?

A
  • Recieve all the lymph from the head and neck either directly or via the superficial lymph nodes
25
Differential diagnosis for a superficial neck lump located at any aspect of the neck
- Skin abscess - Lipoma - Dermoid cyst
26
Differential diagnosis for a midline lump
- Thyroglossal cyst - Thyroid swelling (goitre) - Submental lymph nodes - Sublingual dermoid cyst
27
Differential diagnosis for a lump in the anterior triangle
- Lymphadenopathy affecting submandibular nodes (infection, neoplasm) - Submandibular gland pathology - Tail of parotid gland swelling - Branchial and lymphoepithalial cysts - Thyroid lobe swelling
28
Differential diagnosis for a lump in the posterior triangle
- Lymphadenopathy - due to infections or neoplasms (primary or secondary) - Carotid body tumour - Lipoma - Subclavian artery aneurysm - Pharyngeal pouch
29
List bacterial infectious aetiology for cervical lymphadenopathy
- Dental abscess, cellulitis, periodontitis or pericoronitis - Tonsil, face or scalp infections - TB or syphilis - Cat scratch disease
30
List viral infectious aetiology for cervical lymphadenopathy
Herpetic stomatitis Infectious mononucleosis HIV
31
List neoplastic aetiology for cervical lymphadenopathy
- Primary neoplasms - hodgkins and non hodgkins lymphoma or leukemia, skin neoplasms - Secondary - carcinoma (oral, salivary gland, thyroid), malignant melanoma, metastases from gastric of abdominal cancer
32
Important history on examination for neck lumps
- History of systemic illness or infectious disease e.g. HIV or syphillis - History of animal scratch - Signs of systemic symptoms - fever, sweats, anaemia - Signs of nasal, sinus or nasopharyngeal symptoms - History of drugs (phenytoin) - Onset and changes to the lump over time
33
Special ix for neck lumps
- Blood - CXR - Serology - FNA - Ultrasound (thyroid) - Biopsy - Others:: matoux test, thyroid function and ACE and calcium levels
34
Important signs upon inspection of a neck lump
- Changes to voice - weak, hoarse - SOB or stridor - Scars on the neck - previous surgery - Obvious neck massess
35
What type of neck lymps will rise on swallowing?
Thyroid mass | Thyroglossal cyst
36
What type of neck lumps will move on protrusion of the tongue?
Thyroglossal cyst
37
What are the things we look for when assessing and presenting a neck lump?
- Size - Site - Shape - Skin (overlying) - Texture - Temperature - Mobility - Fluctuant - Pulsatility - Ausculation