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008 Lymph Nodes - Introduction to Clinical Surgery Lectures

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Information about 008 Lymph Nodes - Introduction to Clinical Surgery Lectures

Published on July 1, 2008

Author: memorablemedicine

Source: slideshare.net

Description

Lecture on lymph nodes from a series of lectures on an introduction to clinical surgery. It has been devised with medical students in mind.
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Lymph Nodes Nick Harvey

Lymph Nodes: Causes of Lyphadenopathy Generalised Systemic infections Leukaemia Autoimmune diseases Localised Local infection Metastases Lymphoma

Generalised

Systemic infections

Leukaemia

Autoimmune diseases

Localised

Local infection

Metastases

Lymphoma

Lymph Nodes: History Onset, Course, Duration Painful or painless Other lumps Present or past? Same type or effect Cause Symptoms suggestive of primary tumour in the catchment area Effect on General Condition Fever, weight loss, appetite, bleeding tendency, recurrent infections

Onset, Course, Duration

Painful or painless

Other lumps

Present or past?

Same type or effect

Cause

Symptoms suggestive of primary tumour in the catchment area

Effect on General Condition

Fever, weight loss, appetite, bleeding tendency, recurrent infections

Lymph Nodes: Lymphatic Drainage of the Body Head & Neck Superficial Cervical Lymph Nodes Submental (tongue, mouth, lips) Submandibular (tongue, mouth) Jugulodigastric (tonsils) Pre-auricular (scalp) Post-auricular (scalp) Occipital (scalp) Deep Cervical Lymph Nodes Upper deep cervical Lower deep cervical Thyroid, upper oesophagus, naso- and oropharynx

Superficial Cervical Lymph Nodes

Submental (tongue, mouth, lips)

Submandibular (tongue, mouth)

Jugulodigastric (tonsils)

Pre-auricular (scalp)

Post-auricular (scalp)

Occipital (scalp)

Deep Cervical Lymph Nodes

Upper deep cervical

Lower deep cervical

Thyroid, upper oesophagus, naso- and oropharynx

Lymph Nodes: Lymphatic Drainage of the Body Head & Neck

Lymph Nodes: Examination Cervical Lymph Nodes Start behind the patient Tilt the head to the same side you’re examining Relationship to sternocleidomastoid

Start behind the patient

Tilt the head to the same side you’re examining

Relationship to sternocleidomastoid

Lymph Nodes: Lymphatic Drainage of the Body Head & Neck Lymph Nodes Plan for Examination of Cervical Lymphadenopathy Skin of scalp, ears & neck Nose Mouth: floor, tongue, gums, tonsils Parotid, submandibular & thyroid Arms, chest wall (breasts) Indirect laryngoscopy

Plan for Examination of Cervical Lymphadenopathy

Skin of scalp, ears & neck

Nose

Mouth: floor, tongue, gums, tonsils

Parotid, submandibular & thyroid

Arms, chest wall (breasts)

Indirect laryngoscopy

Lymph Nodes: Lymphatic Drainage of the Body Supraclavicular Lymph Nodes Upper & Lower Deep Cervical Right Upper limb, both sides of the chest & breast Left Upper limb, both sides of the chest & breast Lungs & abdominal viscera including testes

Upper & Lower Deep Cervical

Right

Upper limb, both sides of the chest & breast

Left

Upper limb, both sides of the chest & breast

Lungs & abdominal viscera including testes

Lymph Nodes: Lymphatic Drainage of the Body Axillary Lymph Nodes Anterior group Posterior group Central group Apical group Lateral group Upper limb & trunk above the level of umbilicus

Anterior group

Posterior group

Central group

Apical group

Lateral group

Upper limb & trunk above the level of umbilicus

Lymph Nodes: Lymphatic Drainage of the Body Axillary Lymph Nodes

Lymph Nodes: Lymphatic Drainage of the Body Inguinal Lymph Nodes Trunk below the umbilicus Lower limb External genitalia skin Lower half of anal canal

Trunk below the umbilicus

Lower limb

External genitalia skin

Lower half of anal canal

Lymph Nodes: Lymphatic Drainage of the Body Thoracic Duct Starts at L2 on right side - cisterna chyli Crosses to the left side at T4 Terminates in the left subclavian vein

Starts at L2 on right side - cisterna chyli

Crosses to the left side at T4

Terminates in the left subclavian vein

Lymph Nodes: Examination General Temperature Cachexia/weight loss Anaemia Jaundice Petechial haemorrhage/ecchymoses Local Presenting lymph node (as a swelling) Other lymph nodes Lymphatics Catchment area Liver & spleen

General

Temperature

Cachexia/weight loss

Anaemia

Jaundice

Petechial haemorrhage/ecchymoses

Local

Presenting lymph node (as a swelling)

Other lymph nodes

Lymphatics

Catchment area

Liver & spleen

Lymph Nodes: Investigations FBC, U&Es, LFTs, Clotting CXR, Abdo USS, CT Appropriate investigation to find a primary FNA cytology Biopsy??

FBC, U&Es, LFTs, Clotting

CXR, Abdo USS, CT

Appropriate investigation to find a primary

FNA cytology

Biopsy??

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