Specialist ENT oral cavity

CAUSES OF CERVICAL LYMPHADENOPATHY

Specialist ENT Screenshot 2020 12 03 ORAL CAVITY AND PHARYNX SEMIFINAL BS

Acute:

  1. Acute bacterial lymph node inflammation.
  2. Acute lymphatic leukemia.
  3. Acute infectious mononucleosis – Epstein Barr Virus.

Chronic:

I. Inflammatory:

  1. Nonspecific chronic pyogenic lymphadenitis.
  2. Specific
    1. Tuberculosis.
    2. Syphilis.
    3. Sarcoidosis.
    4. Brucellosis.
    5. Fungal disease.

II. Neoplastic:

  1. Primary Lymphoma.
  2. Lymphosarcoma.
  3. Reticulum cell sarcoma.
  4. Chronic lymphatic leukemia.
  5. Burkitt’s lymphoma.
  6. Metastasis from neoplastic lesions from oral cavity and larynx.

III. Autoimmune:

  1. Systemic lupus erythromatosis.
  2. Juvenile rheumatoid arthritis.
Generalised: 1.Inflammatory:

    a) Acute
    -Septicemia
    -Infectious Mononucleosis

    b) Chronic
    -Tuberculosis
    -Syphilis

2) Reticulosis:

    a) Hodgkin’s disease.

    b) Lymphosarcoma.

    c) Lymphatic leukemia.

3) Sarcoidosis.

Diagnosis:

  1. Routine blood and X ray tests.
  2. Fine Needle Aspiration Cytology.
  3. Excision Biopsy of the swelling if required.
  4. CT scan to show the extent and consistency of the lymphadenopathy.
Specialist ENT Screenshot 2020 12 03 ORAL CAVITY AND PHARYNX SEMIFINAL BS

Levels of Cervical lymph node

Level

Lymph nodes

Boundaries

I

A

Submental nodes

Bilaterally: Anterior belly of digastric
Inferiorly: Hyoid bone

B

Submandibular nodes

Superiorly: Mandible
Posteroinferiorly: Posterior belly of digastric
Anteroinferiorly: Anterior belly of digastric

II

A (Anterior to the vertical line in relation to spinal accessory nerve)

Upper internal jugular (deep cervical) nodes

Superiorly: Skull base
Inferiorly: Inferior border of hyoid bone and carotid bifurcation
Posteriorly: Posterior border of sternocleidomastoid (SCM)
Anteriorly: Lateral border of sternohyoid and stylohyoid

B (Posterior to the vertical line in relation to spinal accessory nerve)

III

Mid internal jugular (deep cervical) nodes

Superiorly: Inferior border of hyoid bone and carotid bifurcation
Inferiorly: Inferior border of cricoid cartilage and junction of omohyoid muscle and IJV
Posteriorly: Posterior border of SCM
Anteriorly: Lateral border of sternohyoid

IV

Lower internal jugular (deep cervical nodes)

Superiorly: Inferior border of cricoid cartilage and Junction of omohyoid and IJV
Inferiorly: Clavicle
Posteriorly: Posterior border of SCM
Anteriorly: Lateral border of sternohyoid

V

A (Above the horizontal plane marking the inferior border of arch of cricoid cartilage)

Posterior triangle (spinal accessory) nodes

Superiorly: Convergence of SCM and trapezius
Inferiorly: Clavicle
Posteriorly: Anterior border of trapezius
Anteriorly: Posterior border of SCM

B (Below the horizontal plane marking the inferior border of arch of cricoid cartilage)

VI (Prelaryngeal or Delphian, Pretracheal, Paratracheal, Prethyroidal)

Anterior compartment (midline) nodes

Superiorly: Hyoid bone 

Inferiorly: Suprasternal notch 

Bilaterally: Carotid arteries

VII

Upper mediastinal nodes

Below suprasternal notch

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