Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
23 Cards in this Set
- Front
- Back
|
What characteristics of lymph nodes should be assessed by palpation?
|
SIZE
>1 cm possibly pathologic >5 usually neoplastic (also path: <1 cm in preauricular) (IV users often have big lymph nodes) CONSISTENCY -Rock-hard usually neoplasic (Hodgkin's nodeas usually rubbery) - Fluctuant nodes usually necrosis or bilateral lymphadenitis MATTING - when individual nodes fuse into larger conglomerates - usually malignancy - possibly inflammation - chronic infections or sarcoidosis *Notice whether stuck to overlying skin, subjacent tissue, both TENDERNESS - usually suggest inflammation - possibly malignancy |
|
|
Describe:
- Benign Nodes - Cancerous Nodes - Inflammatory Nodes |
BENIGN NODES
small, soft, nontender, well-demarcated CANCEROUS NODES large, rock-hard, nontender, matted INFLAMMATORY NODES tender, firm (but not rock-hard), occasionally fluctuant, often matted |
|
|
Generalized v. Localized Lymphadenopathy - suggests...?
|
GENERALIZED
1. disseminated malignacy (esp hematologic) 2. collagen vascular disease, including sarcoidosis 3. infectious process (e.g., mono, syph, AIDS, TB) 4. reaction to drugs/IV drug use LOCALIZED 1. local infection 2. neoplasm |
|
|
Locations to palpate lymph nodes
|
- cervical/neck
- delphian (theyrohyoid mem) - surpaclavicular - axilla - epitrochlear - inguinal and femoral - popliteal - paraumbilical - hilar |
|
|
Significance of enlarged occipital lymph nodes
|
- common in childhood infections
- rare in adults (unless clear scalp infection); thus usually reflect generalized lymphadenopathy (HIV?) |
|
|
Significance of enlarged posterior cervical lymph nodes
|
Usually the result of dandruff
|
|
|
Significance of enlarged preauricular lymph nodes
|
- Lymphoma
- Ipsilateral conjunctivitis (Parinaud's Sign) |
|
|
Significance of scattered Submandibular/Submental lymph nodes
|
- Usually localized pathology - e.g., dental
|
|
|
Significance of enlarged, rock-hard high post cervical lymph nodes
|
nasopharyngeal tumor
|
|
|
Significance of enlarged, rock-hard submental/submandibular lymph nodes
|
Cancer of nose, lip, ant tongue, ant floor of mouth
|
|
|
Significance of enlarged, rock-hard midjugular lymph nodes
|
cancer of base of tongue, larynx
|
|
|
Significance of enlarged, rock-hard lower jugular lymph nodes
|
Cancer of thyroid, cervical esophagus
|
|
|
What is "Scrofula"?
|
Old term for cervical lympadenitis due to TB --> patient's neck appeared as large as pig's neck (scrofula = sow in Latin)
Often spread by unpasteurized milk from infected cows |
|
|
What are "shotty" lymph nodes in head and neck?
|
= small, pea-sized, nontender, mobile, discrete lymph nodes
- common, esp in kids - usually reflect preexisting inf - may outlast by several weeks - ANT CERVICAL - URI, inflammation of ant mouth - POST CERVICAL - otitis media, scalp infections |
|
|
What are Delphian Nodes and what are their significance?
|
= small, midline prelaryngeal lymph nodes
- located on thyrohyoid membrane - when enlarged, often signify thyroid disease: - subacute throiditis - Hashimoto's Disease - thyroid carcinoma - Could also signify tracheal cancer |
|
|
Significance of palpable supraclavicular lymph node
|
Metastatic involvement from Breast or Lung
- RIGHT - ipsilateral breast of lung; contralateral lower lobe of lung - LEFT - ipsilateral breast or lung; extrathoracic tumors(intraabdominal or intrapelvic) |
|
|
What are the names for a Large, Palpable Left Supraclavicular Node?
Why? Where exactly is it located? |
= Sentinel Node
= Troisier's Node = Virchow's Node (when gastric carcinoma) Very pathologic - either metastasis from ipsilateral breast or lung; esophageal tumor; or extrathoracic -- stomach, intestine, liver, pancreas, testicles, endometrium Palpable behind clavicular head of SCM |
|
|
What is the best way to palpate a supraclavicular node?
|
- patient sitting upright with head forward and arms down - palpate from BEHIND
- when patient in supine position, palpate from FRONT - Valsalva maneuver or coughing may "pop" out a deeply seated node |
|
|
What is the significance of an enlarged epitrochlear node?
|
- Inflammatory process of hand/forearm
- IV drug user - Systemic illness - sarcoidosis, syphilis |
|
|
What is the best way to palpate an epitrochlear node?
|
Shake patient's Right hand with your Right hand; use your Left hand fingertips to search for nodes in the epitrochlear region
|
|
|
What is the significance of an enlarged Inguinal/Femoral node?
What is the difference in their locations? |
Inguinal - more lateral in groin
Femoral - more medial, nearer to genitals Enlarged femoral usually much less significant - often just dermatophytosis of foot Enlarged inguinal might be malignant |
|
|
What is the significance of an enlarged popliteal node?
|
Questionable...... often very hard to palpate bc so deep
|
|
|
What is Sister Mary Joseph's Nodule?
|
= periumbilical nodule/hard mass
- detectable by palpation of navel - Represents metastatic involvement of paraumbilical nodes from intrapelvic or intraabdominal malignancies - often GASTRIC or OVARIAN |
