THE NECK

Question 1

What are the boundaries of the Anterior Triangle??

Answer 1

• Inferior border of Mandible
• Anterior border of Sternocleidomastoid
• Sagittal line down midline of neck

Question 2

What are the borders of the Posterior Triangle??

Answer 2

• Posterior border of sternocleidomastoid.
• Anterior border of trapezius
• Middle 1/3 of the clavicle

Question 3

Name 5 characteristics of Neck Swelling??

Answer 3

S
site, size, shape, surface
C
colour, consistency, compressible
T
trans-illuminable, tender, temperature, tethered

Question 4

Where is Virchow’s node and what does it signify??

Answer 4

Left sided Supraclavicular Node

Drains lymph of abdomen
Sign of Gastric cancers, gonadal & kidney.

Question 5

Name 4 causes of enlarged cervical nodes?

Answer 5

Haematological/Metastatic Cancers
Viral/Bacterial Infection
Tuberculosis
Lymphomas

Question 6

Tonsilitis

Answer 6

Streptococcal infection
Fever
Exudate tonsils
Cervical lymphadenopathy
Penicillin V 10 days

Question 7

What is Quinsy??

Answer 7

Build up of of pus due to infection (abscess) behind tonsil
Fever, Throat pain, pain opening mouth
Pain worse one side, Uvula deviation
Antibiotics/Surgical Drainage

Question 8

What is Impetigo?

Answer 8

Staphylococcal skin infection
‘GOLDEN CRUST’
Antibiotic Cream
Oral Antibiotics
Very infectious

Question 9

Features of Hypothyroidism?

Answer 9

Dry skin, coarse hair
Lateral eyebrow loss
Periorbital oedema
Reduced Reflexes

Question 10

What is Goitre?

Answer 10

Swelling of enlarged thyroid gland
Moves when swallowing
IF BREATHLESS URGENR REFERALL

Question 11

Causes of Goitre

Answer 11

• Hyper/Hypothyroidism
• Hormone change puberty, pregnancy, menopause
• Iodine deficiency
• Thyroiditis
  -Thyroid cancer

Question 12

Retrosternal Goitre

Answer 12

Dullness to percussion upper sternum
Pemberton’s sign- venous obstruction in patients. Sign is positive when bilateral arm elevation causes facial reddening .

Question 13

Dangers of Thyroid Surgery

Answer 13

Recurrent laryngeal nerve injury(voice change)
Hypocalcaemia
Infection

Question 14

Signs of Horner’s Syndrome

Answer 14

Ptosis- Upper eyelid drooping
Miosis- constriction of pupil
Anhidrosis- decreased sweating

Question 15

What is Torticollis?

Answer 15

Spasm of Sternocleidomastoid
Head pulled to one side-unable to turn

Question 16

What is a Thyroglossal cyst??

Answer 16

Neck mass developed from leftover cells from thyroid formation
Moves when tongue protrudes

Question 17

What location is common for food to become lodged??

Answer 17

Piriform recess
Lies either side of epiglottis

Question 18

Herniated Disc

Answer 18

Where soft cushion of tissue between the bones in your spine pushes out of place (prolapse)
Can cause nerve compression

Question 19

Transient Ischaemic Attack (TIA)

Answer 19

Temporary blockage of internal carotids
Brain blood supply interrupted
Causes neurological symptoms
Precursor to Stroke

Question 20

Management of TIA

Answer 20

Review within 24hrs to specialist
300mg Aspirin daily
Offer secondary prevention once confirmed

Question 21

Investigations for TIA

Answer 21

FBC Chest Xray
ESR/CRP ECG for arrhythmia
Platelets Carotid Angiography
Urea Carotid Imaging
Blood Glucose

Question 22

What is Jugular Venous Pressure (JVP)

Answer 22

Internal jugular vein (IJV)
Between Sternal and Clavicular heads of Sternocleidomastoid
No valves between IJV and Right Atrium
Reflects pressure of heart