Neck swelling - History taking, Causes, Classification

Neck swelling
-History taking
-Common causes
-Classification neck swelling

1. NECK SWELLING History Taking Causes & Classification BY: IZATTY LIM (0308188) BATCH 4

2. BIODATA HISTORY TAKING Age Gender Occupation

3. HOPI NECK SWELLING HISTORY TAKING When do you first notice the lump? Rule of 7: 7 days = inflammatory/infection 7 weeks/months = tumour 7 years = congenital/development What do you think is the cause? History of trauma Previous TB How do you notice it? Noticed accidentally Told by others Painful How does the lump disturbs you? Associated symptoms pain, discharge, dysphagia, dyspnea, cosmetically disfiguring, fear of malignancy Any changes to the lump since you first notice it? Size Has the lump ever disappears before? Lying down supine Any activity Do you ever had any other lumps before this? Multiplicity

4. Systemic Review Head & Neck symptoms Pain in mouth / throat Mouth ulceration Nasal discharge Pain / blockage of airway Voice changes Difficulty breathing Systemic illness Suggestive of malignancy Anorexia, weight loss and symptoms from other systems Suggestive of infection Malaise, fever, rigors, local symptoms HISTORY TAKING

5. PAST MEDICAL HISTORY DRUG & ALLERGY FAMILY HISTORY SOCIAL HISTORY HISTORY TAKING Thyroid cancer & radiation Previous skin cancer / lesion Smoking Chewing tobacco Alcohol Malignancy

6. Causes of Neck Swelling

7. Causes Inflammatory / Infection Lymphadenopathy Bacterial / viral Granulomatous Tuberculous Cat-scratch Fungal Sarcoidosis Sialadenitis Parotid Submaxillary Neoplasia Metastatic Unknown primary Epidermoid carcinoma Primary head & neck Melanoma Primary Adenocarcinoma Thyroid Lymphoma Salivary Lipoma Glomus vagale Carotid body tumor Rhabdomyosarcoma Congenital / Developmental Sebaceous cysts Branchial cleft cysts Thyroglossal cysts Lymphangioma / hemangioma Dermoid cyst Ectopic thyroid tissue Layngocele Thymic cysts

8. SUPERFICIAL Sebaceous cyst Lipoma Dermoid cyst Abscess Lymph nodes CAUSES & CLASSIFICATION DEEP Anterior Triangle Move with swallowing Thyroid Thyroglossal cyst Lymph node Do not move with swallowing Salivary gland Brachial cyst Carotid body tumor Carotid aneurysm Posterior Triangle Cervical rib Subclavian artery aneurysm Pharyngeal pouch Cystic hygroma

9. Miscellaneous cysts Dermoid cyst Thyroglossal duct cyst Brachial clelf cyst Cystic hygroma CAUSES & CLASSIFICATION Midline neck masses Thyroglossal duct remnants (cysts) Dephian lymph nodes Pryramidal lobe of thyroid gland *Mass at sternal notch: tuberculous abscess, dermoid cyst, or a fatty tumor associated with Cushing's syndrome similar to the Dowager's hump. Fullness of the sternal notch can occur in leukemia ( Jaccoud's sign) Lateral neck masses Brachial cysts Carotid body tumors

10. Unilateral Neck swelling Parotid & submandibular glands Bilateral Neck Swelling Mikulicz’s disease Bilateral parotitis Dehydration Drug effect (sulfonamides, iodides, propythiouracil ) Infection ( chriomeningitis or mumps) Malignancy (leukemia, lymphoma) Metabolic disease (alcoholism, malnutrition, vit A deficiency, DM) Autoimmune disease (SLE, sarcoidosis ) CAUSES & CLASSIFICATION

11. Jones N, Hibbert J, Luxon LM. Scott-Brown’s Otorhinolaryngology: Head and Neck Surgery cd-rom (A Hodder Arnold Publication). 7th ed. Gleeson MJ, Clarke RC, Browning GG, editors. London: Oxford University Press, USA; 2008 . Schwetschenau E, Kelley DJ. The Adult Neck Mass [Internet]. 2002 [cited 2015 Sep 14]. Available from: http:// www.aafp.org/afp/2002/0901/p831.html Williams ME. Assessment of the Neck and Lymph Nodes in the Elderly Patient [Internet]. Medscape. 2009 [cited 2015 Sep 14]. Available from: http:// www.medscape.com/viewarticle/712256_5 Neck Lump [Internet]. Fastbleep Biology Notes. [cited 2015 Sep 14]. Available from: http:// www.fastbleep.com/biology-notes/9/11/356 references

12. Thank You For Listening!