1 / 16

How to Manage a SWELLING IN THE NECK

How to Manage a SWELLING IN THE NECK . Zaid Awad. History 1. General Age, Sex, Race Malaise, weight loss Fever, Rigors, Itching Loss of appetite Contact; TB, URTI Cough, SOB Smoking, Alcohol, Occupation, Travel. History 2. Swelling Duration Onset Progression Pain

bernad
Télécharger la présentation

How to Manage a SWELLING IN THE NECK

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. How to Manage aSWELLING IN THE NECK Zaid Awad

  2. History 1 • General • Age, Sex, Race • Malaise, weight loss • Fever, Rigors, Itching • Loss of appetite • Contact; TB, URTI • Cough, SOB • Smoking, Alcohol, • Occupation, Travel

  3. History 2 • Swelling • Duration • Onset • Progression • Pain • Aggravating/Remitting factors • Overlying skin • Other swellings

  4. History 3 Head & Neck • Pain • Dysphagia /odynophagia • Voice change; • hoarseness/weakness • Discharge • Colour, Odour, Duration, Consistency • Bleeding • Epistaxis, Haemoptysis, Petechiae, Ecchymoses

  5. General Examination GENERAL • Skin Pallor/Cyanosis/Erythema /Jaundice • Dyspnoea • Nutritional Status BMI/muscle wasting • Distended Veins • Tremor • Pulse (rate, rhythm)

  6. Triangles of the Neck

  7. Examination INSPECT • Site • Size • Shape • Overlying Skin PALPATE • Consistency • Pulsation • Relation to muscle (contract/relax) • Other lumps

  8. Examination Movement • With swallowing • With protruding the tongue • By hand - two dimensions Auscultate • Bruit • Venous hum

  9. System Examination • Chest • Inspect Symmetry/Movement/respiratory muscle • Palpate Trachea/Chest Expansion/Apex beat • Auscultate Breath Sounds/Additional Sounds • Abdomen & Pelvis • Inspect Distension Veins Shape • Palpate Ascitis Masses Liver/Spleen/Kidney • Auscultate • Cardiovascular System • Pulse/Pressure

  10. Investigation • Blood Tests: • FBC, U&E, LFT, • If required: TFT, Calcium, Calcitonin • Microbiology & Immunology • Thyroid Antibodies, Swabs, Cultures • Radiology • CT/MR/US/Radio-isotope scan • Cytohisopathology • FNAC/Biopsy

  11. Radiology GENERAL • CXR • CT Chest, Abdomen & Pelvis • Liver USS Swelling • MRI • Ultrasound Scan +/- FNAC

  12. Cyto/Histopathology • FNAC • True Cut/Wide Bore • Tissue Biopsy • Incisional • Excisional

  13. Origin • Lymphadenopathy • Thyroid/Parathyroid gland • Salivary Gland (parotid, submandibular…) • Thyro-glossal Cyst • Branchial Cyst • Carotid Body Tumour • Cystic Hygromata • Pharyngeal Pouch • Sterno-mastoid Tumour • Cervical Rib

  14. Common Sites

  15. LYMPHADENOPATHY INFLAMMATORY NEOPLASTIC BENIGN ACUTE Viral, Bacterial, Fungal.. MALIGNANT CHRONIC PRIMARY (Lymphoma Sarcoma..) NON-INFECTIVE (Sarcoid/ Rheumatoid) SECONDARY H&N and visceral cancer INFECTIVE (TB/Syphilis)

  16. Thank You

More Related