Swelling of the Head and Neck

Question 1

What are the 2 triangles of the neck called?

Answer 1

• Anterior triangle

- Posterior triangle

Question 2

Anatomically where is the anterior triangle of the neck located?

Answer 2

Below digastric, in front of

sternomastoid

Question 3

Anatomically where is the posterior triangle of the neck located?

Answer 3

Behind sternomastoid, in front of trapezius, above clavicle

Question 4

What are the two classifications of head and neck swelling?

Answer 4

• Acquired

- Developmental

Question 5

What are the different types of acquired HN swelling? (4)

Answer 5

• Trauma
• Infection
• Immunological
• Neoplastic
  (Malignant/Benign)

Question 6

Name some conditions that are classified as developmental HN swelling (7)

Answer 6

• Branchial cyst
• Thyroglossal cyst
• Dermoid cyst
• Epidermal cyst
• Cystic hygroma
• Fibrous dysplasia
• Cervical rib

Question 7

When examining a lump what things do you need to look out for? (10)

Answer 7

• Site
• Size
• Shape
• Surface
• Texture
• Temperature
• Tenderness
• Surrounding tissue
• Mobility
• Drainage lymph nodes

Question 8

What is a branchial cyst?

Answer 8

Proliferation of epithelial remnants from second

branchial cleft within lymph nodes

Question 9

Which age group is most affected by a branchial cyst?

Answer 9

Children and adolescents

Question 10

Describe the texture and nature of a branchial cyst

Answer 10

• Fluid filled
• Soft
• Smooth
• Globular

Question 11

Where is a branchial cyst located?

Answer 11

Upper part of the lateral neck beneath anterior border of sternocleidomastoid

Question 12

What is the most common developmental cyst of the neck?

Answer 12

Thyroglossal Cyst

Question 13

What is a Thyroglossal Cyst?

Answer 13

Failure of complete descent of thyroid tissue from

foramen caecum with subsequent cystification

Question 14

Which age group is most affected by a Thyroglossal cyst?

Answer 14

Common in children and young adults

Question 15

Where is a Thyroglossal cyst located?

Answer 15

Midline swelling in neck above level of thyroid

Question 16

Describe the movement of a thyroglossal cyst

Answer 16

Swelling often moves on swallowing or tongue protrusion

Question 17

What is a Dermoid cyst?

Answer 17

Proliferation of epithelial rests

Question 18

Which age group is most affected by a dermoid cyst?

Answer 18

Young adults

Question 19

Where is a dermoid cyst located?

Answer 19

Lateral neck swelling, floor of mouth above mylohoid muscle

Question 20

Describe the texture and nature of a dermoid cyst

Answer 20

• Fluid filled
• Soft
• Smooth
• Globular

Question 21

What is cystic hygroma?

Answer 21

Proliferation of sequestrated lymphatic endothelium of

the jugular sac

Question 22

When does cystic hygroma present itself?

Answer 22

Presents at birth or manifests during infancy/

childhood

Question 23

Where is a cystic hygroma located?

Answer 23

Lower third of neck

Question 24

Describe the texture and nature of a cystic hygroma

Answer 24

• Spongy
• Soft
• Translucent

Question 25

Why do lymph nodes enlarge? (2)

Answer 25

- Increase in the number of cells | - Infiltration of nodes with cells

Question 26

At what age does lymphadenopathy becomes worrying (malignancy)?

Answer 26

Patients over the age of 50 only 40% are benign

Question 27

Name some systemic bacterial infections that can cause cervical lymphadenopathy (2)

Answer 27

- TB | - Syphillis

Question 28

Name some systemic viral infections that can cause cervical lymphadenopathy (2)

Answer 28

- Infectious mononucleosis - Cytomegalovirus - HIV infection

Question 29

What is Pyogenic Lymphadenopathy

Answer 29

Oral inflammatory conditions (ie dental | abscess)

Question 30

Describe the consistency of Pyogenic Lymphadenopathy

Answer 30

- Soft when acute | - Not fixed to surrounding tissue

Question 31

What causes infectious mononucleosis?

Answer 31

Epstein-Barr Virus

Question 32

Who is most affected by Viral Lymphadenopathy?

Answer 32

Young adults

Question 33

What are some clinical features of Viral Lymphadenopathy? (3)

Answer 33

- Fever - Malaise - Sore throat

Question 34

Describe the nature of the lymph nodes during Viral Lymphadenopathy

Answer 34

- Firm - Discrete - Tender - Mobile

Question 35

What is Tuberculous lymphadenopathy?

Answer 35

Mycobacterium tuberculosis transmitted by sputum droplets from infected patients

Question 36

What are some clinical features of Tuberculous lymphadenopathy? (6)

Answer 36

- Fever - Malaise - Night sweats - Weight loss - Persistent cough - Shortness of breath

Question 37

Which lymphadenopathy causes ulcer formation on dorsum of tongue?

Answer 37

Tuberculous lymphadenopathy

Question 38

Who is most affected by malignant Lymphadenopathy?

Answer 38

Arise in middle-aged & elderly

Question 39

What type of Malignant Lymphadenopathy arises in children and young adults?

Answer 39

Burkitt's Lymphoma

Question 40

What are some clinical features of Malignant lymphadenopathy? (4)

Answer 40

- Fever - Malaise - Night sweats - Weight loss

Question 41

Who is most affected by Metastatic carcinoma?

Answer 41

Seen in middle-aged & elderly

Question 42

Describe the nature of a Metastatic carcinoma

Answer 42

- Indurated mass - Fixed to surrounding tissue - Rocky hard - Painless

Question 43

What is a Cervical rib?

Answer 43

Congenital condition where you are born with an extra rib which arises from the 7th cervical vertebra

Question 44

What are some neurological symptoms of someone with a cervical rib? (3)

Answer 44

- Pain - Paraesthesia - Anaesthesia of forearm and hands

Question 45

What is a lipoma?

Answer 45

Benign tumor made of fat tissue

Question 46

Where is a lipoma predominantly found?

Answer 46

Posterior neck space is the most common site