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Surgery M4 part 1 > Neck swellings > Flashcards

Neck swellings Flashcards

1
Q

What are the congenital neck swellings?

A
  • cystic hygroma
  • branchial cyst
  • thyroglossal cyst
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2
Q

a neonate presented with a large translucent cystic mass on the side of his neck, what is the reason behind this condition?

A

coarse lymphangioma
congenital dilation of neck lymphatics
CYSTIC HYGROMA

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3
Q

How should cystic hygroma be treated?

A

injection of sclerosing agent

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4
Q

failure of obliteration of 2nd branchial cleft will lead to?

A

cystic mass under the cover of sternomastoid

BRANCHIAL CYST

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5
Q

What are the complications of a branchial cyst & how is it treated?

A 
fistula formation (acquired)
 surgical excision
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6
Q

failure of thyroglossal trunk obliteration will lead to?

A

THYROGLOSSAL CYST

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7
Q

Where does a thyroglossal cyst commonly occur?

A

subhyoid area

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8
Q

What sign will be seen with a thyroglossal cyst?

A

moves up & down with deglutition & TONGUE PROTRUSION

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9
Q

what are the complications of a thyroglossal cyst?

A

infection

fistula formation

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10
Q

What are the investigations performed incase of a thyroglossal cyst & what is its treatment?

A
  • ultrasound neck
  • radioisotopic scanning
  • SISTRUNK operation
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11
Q

What is your diagnosis if a patient presents to u with a pulsatile swelling under sternomastoid & what investigation will you use to reach it?

A
  • CAROTID ARTERY ANEURYSM

- CT angiography will show abnormal permanent dilation of artery

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12
Q

a patient presents to your clinic with a tense soft swelling attached to the skin with a puntum, what is your diagnosis?

A

sebaceous cyst caused by retention

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13
Q

How is a sebaceous cyst treated?

A

surgical excision through elliptical incision

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14
Q

a patient presents with a soft swelling with a slippery edge & not attached to the skin, what might be your diagnosis & treatment?

A

LIPOMA
subcutaneous benign tumor of adipose tissue
surgical enucleation

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15
Q

a patient presents with a hot red tender swelling that’s fluctuant, what is your diagnosis & treatment?

A

ABSCESS
acute localized suppurative infection
incision & drainage

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16
Q

What may cause a lymph node swelling?

A

inflammation (lymphadenitis)
malignancy (lymphoma or malignant metastasis)

CERVICAL LYMPHADENOPATHY most common

17
Q

How can a lymph node swelling be identified?

A

anatomical sites
multiple & rolling

DIAGNOSE BY FNAC

18
Q

How can you differentiate between an inflamed LN & a metastatic LN?

A

INFLAMED METASTATIC

  • tender - not tender
  • mobile - fixed
  • firm or rubbery - hard
  • discrete - amalgamated
19
Q

a baby with a history of birth trauma presented to your clinic with a unilateral sternomastoid hard mass & head tilt on the same side, what could be your diagnosis and how do u confirm it?

A

STERNOMASTOID TUMOR Congenital torticollis

- diagnosed by neck US

20
Q

What is the management of a sternomastoid tumor?

A

may resolve spontaneously but needs physiotherapy or surgical division of sternal head of muscle

21
Q

a patient presents with a butterfly shaped swelling infront of the neck that moves up & down with deglutition, what is your diagnosis?

A

GOITER

22
Q

what is the herniation of pharyngeal mucosa through Killian’s triangle named?

A

Zenker’s diverticulum

23
Q

What is the cause of Zenker’s diverticulum?

A

spasm of cricopharyngeus muscle –> increase intrapharyngeal pressure –> herniation through weak point

24
Q

What are the signs & symptom’s of Zenker’s diverticulum?

A
  • progressive dysphagia
  • regurgitation of undigested food
  • +/- swelling on LEFT side of the neck that increases with eating
  • soft & compressible with gurgling sensation
25
Q

What is the method of investigation used in Zenker’s diverticulum?

A

Barium swallow –> flask shaped pouch

endoscopy DANGEROUS

26
Q

How can we differentiate a parotid swelling?

A

elevation of ear lobule

diagnose by neck US & CT

27
Q

What complications could a parotid swelling cause?

A

facial nerve palsy

28
Q

How can we differentiate a submandibular swelling?

A
  • no rolling during palpation
  • only 1 swelling
  • palpated by manually (from floor of the mouth)
  • NECK US
29
Q

How should a submandibular swelling be treated?

A

submandibular sialoadenectomy

30
Q

a large mucus retention cyst in the floor of the mouth is called?

A

A Ranula

31
Q

Who is most affected by Ranulas?

A

children & young adults

32
Q

What are the distinguishing factors of a Ranula?

A
  • ruptures & refills usually
  • bluish & translucent
  • smooth & covered with tortous veins
33
Q

How is a ranula treated?

A

Marsupialization

34
Q

a tumor in the chemoreceptors in the carotid body is called?

A

Potato tumor

35
Q

How can a potato tumor be distinguished?

A
  • solid & hard
  • pulsate (transmission from carotid artery)
  • CT ANGIOGRAPHY of neck
36
Q

What is the treatment of a carotid body tumor?

A

surgical excision +/- reconstruction of carotid vessels

Surgery M4 part 1 (47 decks)

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