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lymph node enlargment tendes to commonly result from:Infection Immune response Cancer Infected lymph nodes tendes to firm, tender and warm. Overlying skin apper reddned.
Lymph
tender non tender matted fixed Sometime infection of lymph nodes occasionally remain permanently enlarged thought they should be non tender, rubbery consistency. (SHOTTY LYMPH NODES)
PAIN/TENDERNESS:
Presence or absence of tenderness not reliably differentiate benign from malignant nodes.
CONSISTENSY:
Stony hard cancer Rubber nodes lymphoma Softer nodes inflammatory condition
Neck
LEVEL
LEVEL
II- upper jugular lymph node surrounding the internal jugular vein and adjacent spinal accessory nerve
LEVEL IIA:
INFERIORLY: hyoid bone SUPERIORLY: skull base ANTERIORLY: stylohyoid muscle POSTERIORLY: spinal accessory nerve
LEVEL IIB:
INFERIORLY:hyoid bone SUPERIORLY:skullbase ANTERIORLY: spinal acessory nerve. POSTERIORLY: lateral border of SCM.
LEVEL
INFERIORLY: inf.border of cricoid cartilage. SUPERIORLY: inf. Body of hyoid bone ANTERIORLY: lateral border of sternohyoid musculature POSTERIORLY: lateral border of SCM
LEVEL
internal jugular vien) INFERIORLY: clavicle SUPERIORLY: inf. Body of cricoid cartilage ANTERIORLY: lateral border of sternohyoid muscle POSTERIORLY: lateral border of SCM
LEVEL
LEVEL VA:
INFERIORLY: inferior border of cricod cartilage SUPERIORLY: converging of SCM, trapezius. ANTERIORLY: post. Belly of SCM
POSTERIORLY: ant. belly of trapezius
LEVEL VB:
INFERIORLY:clavical SUPERIORLY:lower border of hyoid bone ANTERIORLY:post.belly of SCM
POSTERIORLY: ant.belly of trapezius M.
LEVEL
prelaryngeal. INFERIORLY: suprasternal notch SUPERIORLY: hyoid bone LATERALLY: common carotid arteries (ANTERIOR COMPARTMENT)
PALPATION:
in the case of cervical lymph nodes enlargment palpation has low sensitivity and specificity 60-70% ULTRASONOGRAPHY: grey scale and power doppler sonographic feature are useful to identify the cause of cervical lymphadenopathy. GREY SCALE FEATURE: include size, shape , micro nodular, intranodal necrosis. POWER DOPPLER FEATURE : vascular pattern , displacement of vascularity.
CT
SCAN: CT scan can detect the presence of enlarged cervical lymph node with a short axis diameter.
ULTRASONOGRAPHY
CT- SCAN