Examination of the Neck

A. Kategile

Examination of the Neck

History
P/E
D/D
History
commonest cause Lymphydenspathy
Age
Cystic hyrma Children Upper/1/3
Branchrol cyst Children centrally + Fistula
stornmastoral tumor children while carcinomaous
Adult

History (Cont.)
Swelling
commoniest symptom
mode of onset suddest or insiolous
duration short or long
pain
- Painfull or painless

P/E or Local Examination

Neck divided into Anterior and posterior triangles

sternsclesclostoid in muscles
Inspection Epsed level nipple
Swelling-? Nature node
- gland thyroid
aster, postical
Site
Size
Shape
Skin
Sinus
Fistula
Ulceration Mali samary
Scar - Surgery

P/E or Local Examination (Cont.)

Palpation
Size
Shape-Oval, Vecturgular, Irregular
Surface Smooth, rough
Margin Defined ill defined
Coustistincy crystic, soft, firm hard
Thunder, tendor
Mobility fixed or mobile
- Surrounding structums

P/E or Local Examination (Cont.)

Pulsation Expensile bencoth major

vessel
- Pulsative Vscular in nature eg.
Anerysm
Movement with
(-) gloltatron horter
Protrusion glossiphthargeal tumour
Auscultation Bruit ? Anuseurysm

Lymph Nodes
Groups
1. Submental
2. Sub mandibulai
3. Sterns cleodomistorel muscle
4. Pre-and post auricular
5. Intral supraclanicular

Lymph Nodes (Cont.)

Actiuloegy
Inframmatory Pharyngitis, Dental, Iinsillitis etc.
Malignancy eg. Thyroid, wassphangod tumour
etc
Hymphoma
Reactiona - HIV

Lymph Nodes (Cont.)

Inspection
Site eg. Virdours node, between heads of
sternocleod mastoid
Submental chin, Lip floor mouth tongue
Submandibular As above
Sternocleodmastoid thyroid
Sypra and introclancular Breast
Shape- Ovel, Irregular etc.

Lymph Nodes (Cont.)

Indication
Size
Constinstancy
Surface
Margin
Instility
Painful or painless
Pulsation Epcusile
- Pulsatile
Ausculatation ?

D/D of the Neck

(-) Midline screlling 4 Units novas with
slottation goits
Thyroghssol cyst Muves with tongue
protrusion
Lughrigs, Angica
Lipoma
Branchil Gyst Festula
Permiscal cyst

D/D of the Neck

(Cont.)
Lateral swellilngs
Submandibullar triangle
Nodes
Cerotid bidy tumoour
Aneurysum of Carotid cartomy
Branchia cyst

D/D of the Neck (Cont.)

Posterior triangle
Nodes
Cystic ygroma in children
Sternomastoid tumour
Carvical ribs
Lipoma

D/D of the Neck (Cont.)

N/B Examination of thyroids follows the same
pattern as any neck swelling
NOTE Hard fixed Goiter with ceria by
mphhyaclonopathy is highly suspicious of
malignancy.