Term
| what are the common neck masses from age 0-15 in order of prevelence |
|
Definition
inflammatory
congenital
neoplasia: malignant > benign |
|
|
Term
| what are the common neck masses from age 16-40 in order of prevelence |
|
Definition
inflammatory
congenital
neoplasia: benign > malignant |
|
|
Term
| what40+ in order of prevelence |
|
Definition
neoplasia: malignant > benign (cancer until proven otherwise)
inflammatory
congenital |
|
|
Term
| what are the 7 common primary origins of neck masses in order of their prevelence |
|
Definition
tonsil 25%
base of tongue and nasopharynx 20%
hpoppharynx 15%
floor of mouth 10%
pharynx and thyroid 5% |
|
|
Term
| what parts are looked at on the physical exam for a neck mass(10) |
|
Definition
oral cavity, nasopharynx, hypopharynx, larynx, thyroid, salivary glands
skin of scalp, face, ears, neck |
|
|
Term
| what types of radiographic studies can be done for a neck mass (10) |
|
Definition
| chest x-ray, sinus x-ray, ultrasound, MTI, CT, mrA, arteriography, saliography, radionucleotid, endoscopy |
|
|
Term
| what is neck level 6, what is its significance |
|
Definition
paratracheal
dissected in thyroid ectomy for cancer |
|
|
Term
| what is level 2 of the neck |
|
Definition
|
|
Term
| what is level 3 of the neck |
|
Definition
|
|
Term
| what is level 4 of the neck |
|
Definition
|
|
Term
| what is level 5 of the neck |
|
Definition
|
|
Term
| what is level 1 of the neck |
|
Definition
|
|
Term
| why are the levels of the neck important for neck masses |
|
Definition
| they tell you where the primary is at |
|
|
Term
| what biopsies are done for neck masses |
|
Definition
| open or needle aspiration |
|
|
Term
| what areas drain into the posterior triangle |
|
Definition
| aurical and back, scalp, nasopharynx |
|
|
Term
| what areas drain into the submandibular triangle |
|
Definition
|
|
Term
| what areas drain into the preauricular triangle |
|
Definition
|
|
Term
| where are thyroid masses located in the neck, what can the mass be composed of, what should you do when you see one |
|
Definition
midline neck
can be benign, malignant, inflammatory, or infectious
always fine needle aspirate masses and send out specimine |
|
|
Term
| what are 5 studies that can be done on the thyroid, what is a percaution |
|
Definition
thyroid function studies
thyroid scan (99-Tc)
U/S
FNA
CT scan- do thyroid scan first, contrast will mess it up for 6 weeks |
|
|
Term
| what two types of neck masses can be due to carcinomas |
|
Definition
nasopharyngeal
paranasal and sinus |
|
|
Term
| what 4 neck masses are congenital |
|
Definition
branchial cleft cyst
thyroglossal duct cyst
laryngocele
lymphangomia |
|
|
Term
| what neck masses are adenoma / adentitis (6) |
|
Definition
warthin's tmor
pyelomorphic ademona of the salivary glands
Tb adentitis
cat scratch disease
actinomycosis
sialedentitis |
|
|
Term
| what areas metastazise into the upper jugular (1-3) |
|
Definition
| oral pharynx and oral cavity |
|
|
Term
| what areas metastasize into the lower jugular |
|
Definition
|
|
Term
| what areas metastasize into the submantibular triangle |
|
Definition
| oral cavity, nasal, sinus, facial |
|
|
Term
| what 5 neck masses are due to infection |
|
Definition
ludwigs angina
odontogenic abscess
submandibular abscess
midline neck abscess
adentitis |
|
|
Term
| what neck masses can be malignant 4 |
|
Definition
parotid
lymphoma
virchow;s node
glomus tumor |
|
|
Term
| what neck mass is autoimmune |
|
Definition
|
|
Term
| what neck mass is a benign tumor |
|
Definition
|
|
Term
| what neck mass is a sarcoma |
|
Definition
|
|
Term
| what neck mass is induced by trauma |
|
Definition
|
|
Term
| nasopharyngeal carcioma: CC, Dx, complications |
|
Definition
cc: i can't hear
dx: unilateral serious otitis media without history
complications: can invade skull base |
|
|
Term
| who commonly gets nasopharyngeal carcinoma (2), what causes it |
|
Definition
cantonese chinese between 44-55 yo
EBV associated |
|
|
Term
| what are the 3 types of nasopharyngeal carcinoma, which is the most common |
|
Definition
squamous cell
non-keratainizing
undifferentiated - most common |
|
|
Term
| who most commonly gets a paranasal or sinus carcinoma (4) |
|
Definition
males > females
50-79 yo
hardwood and niclel workers |
|
|
Term
| around when is a paranasal or sinus carcinoma diagnosed, why |
|
Definition
| 8 mo delay from symptoms becaise the symptoms are non-specific |
|
|
Term
| what types of carcinoma do hardwood workers get (3) |
|
Definition
| adenocarcinoma, squamous cell, anaplastic paranasal and sinuc carcinomas |
|
|
Term
| what types of carcinomas do nickel workers get (2) |
|
Definition
| squamous cell and anaplastic paranasal and sinus carcinoma |
|
|
Term
| when and how are paranasal and sinus carcinoma treated |
|
Definition
one sinus = send to surgery (espically if bony erosion)
especially if it is a bony erosion |
|
|
Term
| branchial cleft cyst: where is it located, when is it diagnosed |
|
Definition
anterior triangle
usually diagnosed as child or early adult |
|
|
Term
| describe the mass of a branchial cleft cyst (3) |
|
Definition
| non-tender, fluctuant, has abscess that is tender inflammed and painful |
|
|
Term
| what are 5 symptoms of branchial cleft cyst |
|
Definition
| mass, abscess, dysphagia, dyspenia, stridor |
|
|
Term
| first branchial cleft cyst: location |
|
Definition
| behind ear lobule, connects to external canal |
|
|
Term
| what do you do if a branchial cleft cyst develops an abscess |
|
Definition
|
|
Term
| second branchial cleft cyst: location |
|
Definition
| cyst in neck that connects to external canal, most common |
|
|
Term
| fourth branchial cleft cyst: location, sign |
|
Definition
open to skin
between internal and external carotid, over cn12, under aortic arch, up into piriform sinus |
|
|
Term
| what is the difference between a second and third branchial cleft cyst |
|
Definition
second goes over CN 9 and 12
third goes between CN 9 and 12
cant tell the difference until surgery |
|
|
Term
| what branchial cleft cyst is the most common |
|
Definition
|
|
Term
| what is the treatment of a branchial cleft cyst (2) |
|
Definition
surgical excision
use 18 gauge needle to get the thick green goo out |
|
|
Term
| thyroglossal duct cyst: location, complications (2) |
|
Definition
anterior midline neck
may become infected
may have more than one thyroid |
|
|
Term
| thyroglossal duct cyst: how to identify |
|
Definition
| moves with swallowing and potrusion of the tongue |
|
|
Term
| thyroglossal duct cyst: treatment (2) |
|
Definition
operation
thyroid scan before operation |
|
|
Term
| laryngocele: location, cause, who gets it (2) |
|
Definition
most common in 50-60s
more in males
midline neck
dilation of laryngeal ventricle and saccule |
|
|
Term
| laryngocele types and how to identify them |
|
Definition
internal: inside larynx, no neck mass, can cause airway stress
external; outside larynx, neck mass |
|
|
Term
|
Definition
aiways compormise (internal)
laterla neck mass (external)
increase in size with increased pressure
gurgling sensation |
|
|
Term
| lymphangomia: aka, location, cause |
|
Definition
cystic hygroma
posterior triangle
congenital malformation of the lymphatic system |
|
|
Term
| lymphangomia: where is it most commonly located, who is it seen in |
|
Definition
head and nack
usually found <2yo |
|
|
Term
| lymphangomia: symptoms(5) |
|
Definition
painless, soft, ill defined, doughy mass
dysphagia, paiin, stidor, dyspenia |
|
|
Term
|
Definition
| surgical excision (difficult due to finger like projections) |
|
|
Term
| what 4 things do you do when an inflammatory adenopathy is suspected |
|
Definition
observe, put on antibiotics for two weeks, repeat exam
if not better aspirate and send for tests |
|
|
Term
| warthin's tumor: aka, what is it, who gets it, where is it |
|
Definition
papillary cystadenoma lymphomatosum
benign cystic mass
more in men than women
usually in parotid, rarley bilateral |
|
|
Term
|
Definition
slow growing
non tendor
cystic |
|
|
Term
| warthin's tumor: treating |
|
Definition
| none, dont risk life to take it out |
|
|
Term
| pyelomorphic adenoma of the salivary glands: prognosis, treatment |
|
Definition
benign, high reoccurrance
operation: it can convert to cancer and damage to facial or marginal nerve |
|
|
Term
| what is the claim to fame of pyelomorphic adenoma of the alivary glands |
|
Definition
| most common benign salivary tumor |
|
|
Term
| who gets pyelomorphic adenoma of the salivary glands (2) |
|
Definition
|
|
Term
| where is pyelomorphic adenoma of the salivary glands usually |
|
Definition
|
|
Term
| tuberculosis adentitis: what disease category, what location, cause |
|
Definition
granulomatous adenopathy
posterior triangle
atypical mycobacterium (not usually TB)causes node to outgrow blood supply and abscess |
|
|
Term
| tuberculosis adentitis: who gets it (2) where is it located (2) |
|
Definition
| kids (more common) - anterior triangle adults - posterior triangle (may be TB) |
|
|
Term
| tuberculosis adentitis 4 signs |
|
Definition
progressive enlargement
fever, local pain, alaise |
|
|
Term
| cat scratch disease: disease family, location, cause |
|
Definition
granulomatous adenopathy
posterior triangle
regional lymphadentitis due to rochalimaea henselae infection from cat interaction 3 weeks prior |
|
|
Term
| cat scratch disease: who gets it and where |
|
Definition
| kids in periauricular and submandibular areas (posterior triangle says notes in other spot) |
|
|
Term
| cat scratch disease signs (6) |
|
Definition
lymphadenopathy
low grade fever
myalgia
malaise
headache
anorexia |
|
|
Term
| cat scratch disease pathology |
|
Definition
| multiple granulomas with micro abscesses |
|
|
Term
| cat scratch disease: treatment (4) |
|
Definition
resolves in 3 mo
analgesics
warm compress
antibiotics (erythromycin, clythromycin) |
|
|
Term
| actinomycosis: disease family, lcation (3), who gets it |
|
Definition
granulomatous adenopathy
seen in adults
in submandibular and upper jugular (other spot says posterior triangle) |
|
|
Term
| sialdentitis: what is it, what subtype is there |
|
Definition
infection of the slaivary glands
sialyosis: enlarged infected parotid |
|
|
Term
|
Definition
infection, dehydration, chemo, saliolithiasis,
saliosis: DM, alcoholic, vitamin deficiency, sjogerns |
|
|
Term
| sialdentitis treatment (3) |
|
Definition
| hydration, antibiotics, warm compress |
|
|
Term
|
Definition
| infection of the floor of the mouth usually due to dental procedure or treatment |
|
|
Term
| what are the signs of ludwigs angina (4) |
|
Definition
woody induration (not abscess)
submental and submandibular enlargement (fluid in all triangles)
high temperature
tongue displacement |
|
|
Term
| odontogenic abscess: cause, signs (2) |
|
Definition
infection due to dentition
painful swelling trismus
floow or mout elevated pushing tongue posterior |
|
|
Term
| odontogenic abscess treatment (2) |
|
Definition
|
|
Term
| what is the cause of a submandibular abscess, when and how is it treated |
|
Definition
impacted stone in submandibular duct
if swollen for >2 d then start antibiotics |
|
|
Term
| parotid malignancy: ddx, 3 signs, complications |
|
Definition
ddx: bells palsy
parotid mass, CN VII paralysis, pain in 5-7%
20% metastizises to lung and bone |
|
|
Term
| signs a neck mass is lymphoma (6) |
|
Definition
may or may not be symptomatic
soft, smooth, elastic, mobile node
slow growing |
|
|
Term
| how is a neck lymphoma diagnosed (2) |
|
Definition
|
|
Term
| how is a neck lymphoma treated |
|
Definition
| chemotherapy and or radiation |
|
|
Term
| what are the types of virchow;s nodes, where did they come from |
|
Definition
left supraclavicular: comes from anywhere in the body but the right chest
right supraclavicular: comes from the right chest
GI, GI, lung, pancreas |
|
|
Term
| glomus tumor: aka, prognosis, treatment |
|
Definition
chemdectoma
rarley malignant
surgical excision |
|
|
Term
|
Definition
firm round slow growing
on lateral neck |
|
|
Term
| glomus tumor diagnosis (4) |
|
Definition
| angiography, CT, mri, MRA |
|
|
Term
| sjogern's syndrome: aka, 3 signs |
|
Definition
dry eyes and mouth, arthritis
SICCA syndrom |
|
|
Term
| 4 ways to diagnose sjogern's syndrome |
|
Definition
sjogern;s antibody test
biopsy of lower lip
scarred down minor salivary glands
parotid enlargement |
|
|
Term
| hemangioma: location, when does it show up, when does it involution |
|
Definition
anterior triangle
usually evident by 6 mo
spontaneous involution by 7 mo |
|
|
Term
|
Definition
diffuse skin lesions
soft cystic masses |
|
|
Term
|
Definition
conservative therapy - dont operate early it will get smaller
surgery for cosmetic or functional impairment
steroids to slow or stop groath |
|
|
Term
| karposki's sarcoma: aka, who gets it, where is it |
|
Definition
diffuse adenopathy
seen in HIV positive
bilateral parotid masses |
|
|
Term
| acquired laryngocele : how does it happen give examples (4) |
|
Definition
prolonged increased intralaryngeal pressure
cough, straining, glass blowing, wind insturments |
|
|
