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ENT- Neck lumps, thyroid and parathyroid - Coggle Diagram
ENT- Neck lumps, thyroid and parathyroid
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DDx Neck Lump
- Congenital / developmental
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Neck Lump History
- Length of time ⭐- Rule of seven
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- How was it first noticed??
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- What do they think is the reason??
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- Hx thyroid cancer or radiation
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- Head and neck symptoms review
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Physical Exam
- Site
- Size
- Shape
- Consistency
- Mobility
- Surface
- Edges
- Tenderness
- Fluctuations
- Transillumination
- Overlying skin
- Ass lymoh nodes
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Site
Midline lower neck swelling: Thyroid until proven otherwise - get them to swallow
Angle of mandible / earlobe: Parotid till proven otherwise - raised earlobe is pathomneumonic - will be on exam if in hospital ⭐
Facial nerve palsy and parotid swelling: Malignant until proven otherwsie
Neck bruit, thryoid swelling: Grave's pathomneumonic
- Previous neck scar
- Bimanual palpations
- Ausc for bruit - thyrotoxic
- Translumination
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- Laryngoscopy /pharyngoscopy
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- Lymphatics - cervical lymphadenopathy
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Diagnostic Features
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Older > 40y/o
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80% rule
Applies to no-thyroid lateral neck swelling
80% are lymph nodes
of those 80% malignant
of those 80% mets
of those 80% from primary head and neck site
- Anatomical site of neck swelling
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