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Flashcards in Neck lumps Deck (36)
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1
Q

Name the boundaries of the anterior triangle in the neck

A

Mandible superiorly
Anterior border of the sternocleidomastoid laterally
Midline medially.

2
Q

Name the boundaries of the posterior triangle

A

Posterior border of the sternocleidomastoid anteriorly
Anterior border of the trapezius laterally.
Clavicle inferiorly

3
Q

Why does your thyroid move when you swallow?

A

Because it is enveloped in pretracheal fascia.

4
Q

Swellings in the anterior triangle could be?

A

Lymph nodes
Branchial cyst
Salivary glands
Carotid body tumor

5
Q

Swellings in the posterior triangle could be?

A

Lymph nodes

Cystic hygroma

6
Q

What would you look for in a neck lump?

A
Position
Movement
Size
Shape
Consistency
7
Q

Most common cause of neck lumps

A

Lymph nodes

8
Q

Cervical lymphadenopathy

A

Enlargement of the cervical lymph nodes

9
Q

Causes of cervical lymphadenopathy

A

Infective
Malignant
Haematological- leukaemia/lymphoma.

10
Q

What should you do if cervical lymphadenopathy is present?

A

Look for other nodes
Look for primary sites
Look for hepatosplenomegaly.

11
Q

Where do thyroglossal cysts occur?

A

In the thyroglossal tract (the path of embryological development of the thyroid gland)
However usually above the hyoid bone.

12
Q

What may become infected in a thyroglossal cyst?

A

Lymphatics within the thyroglossal duct.

13
Q

On examination- what movement will show a thyroglossal cyst?

A

It will move with the tongue.

14
Q

Who will a thyroglossal cyst likely affect?

A

Teenagers.

15
Q

Complications associated with thyroglossal cysts?

A

Sometimes they can fistulate (abnormal connection between two epithelial surfaces) out of the neck.
If big- may cause local effects.

16
Q

Where would you find a dermoid cyst?

A

Presents as a midline swelling

17
Q

What are dermoid cysts?

A

Rare congenital cysts.

18
Q

Who do dermoid cysts usually present in?

A

Teenagers.

19
Q

What is the 2nd most common cause of anterior triangle swellings?

A

Branchial cysts

20
Q

Site of presentation of branchial cysts

A

Usually present in the upper part of the anterior triangle.

21
Q

Consistency of branchial cysts

A

Feels like a half filled hot water bottle.

22
Q

What is a cystic hygroma

A

Lymphatic sac occurs in the posterior neck resulting in a lymphatic fluid accumulation.
Transilluminates and can press on local structures.

23
Q

Where else can cystic hygromas effect?

A

The axilla.

24
Q

What age group do cystic hygromas normally affect?

A

Usually young children- present normally in the first year.

25
Q

Why should you examine the mouth in neck swellings?

A

The cause of the swelling may be a tumour of the salivary glands.

26
Q

Which salivary gland are you most likely to get a stone in and why?

A

Submandibular gland due to it being mucin secreting.

27
Q

Patient is hoarse- likely to be

A

Thyroid carcinoma with invasion of the recurrent pharyngeal nerve.

28
Q

Lump in neck that moves up and down and lump in anterior triangle that doesnt move.

A

Likely to be papillary cancer with lymph node involvement.

29
Q

Investigations into lumps?

A

Fine needle aspiration.

30
Q

Th1 result on FNA

A

inadequate

31
Q

Th2 result on FNA

A

Benign

32
Q

Th3 result on FNA

A

Suspicious (25% malignant)

33
Q

Th4 and Th5 result on FNA

A

Malignant.

34
Q

If you have got back Th1 or Th2 result on FNA, what do you do?

A

Repeat FNA.

35
Q

If you have got back Th3 result on FNA, what do you do?

A

Thyroid lobectomy

36
Q

If you have a Th4 or Th5 result on FNA, what do you do?

A

Total thyroidectomy