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;
21 Cards in this Set
- Front
- Back
|
what is the major DDx of a pediatric neck mass?
|
thyroglossal duct cyst (midline), branchial cleft cyst (lateral), lymphadenopathy, abscess, cystic hygroma, hemangioma, teratoma/dermoid cyst, thyroid nodule, lymphoma/leukemia. (also parathyroid tumors, neuroblastoma, histiocytosis X, rhabdomyosarcoma, salivary gland tumors, neurofibroma)
|
|
|
what is a thyroglossal duct cyst?
|
remnant of the diverticulum formed by migration of thyroid tissue; normal development involves migration of thyroid tissue from the foramen cecum at the base of the tongue through the hyoid bone to its final position around the tracheal cartilage
|
|
|
what is the average age at dx of thyroglossal duct cyst?
|
usually presents ~5 yrs
|
|
|
how is the dx of thyroglossal duct cyst made?
|
ultrasound
|
|
|
what are the complications of thyroglossal duct cyst?
|
enlargement, infection, and fistula formation b/w oropharynx or salivary gland; aberrant thyroid tissue may masquerade as thyroglossal duct cyst, and if it is not cystic, deserves a thyroid scan
|
|
|
what is the anatomic location of thyroglossal duct cyst?
|
almost always MIDLINE
|
|
|
what is the tx for thyroglossal duct cyst?
|
antibiotics if infection is present, then excision, which must include the midportion of the hyoid bone and entire tract to foramen cecum (sistrunk procedure)
|
|
|
what is the common presentation of a branchial cleft cyst?
|
infection b/c of communication b/w pharyns and external ear canal
|
|
|
what is a branchial cleft cyst?
|
remnant of the primitive branchial clefts in which epithelium forms a sinus tract b/w the pharynx (2nd cleft) or the external auditory canal (1st cleft), and the skin of the anterior neck; if the sinus ends blindly, a cyst may form
|
|
|
what is the anatomic position of a branchial cleft anomaly?
|
2nd cleft: lateral to the midline along anterior border of SCM, anywhere from angle of jaw to clavicle. 1st cleft anomaly: less common than 2nd cleft, tend to be located higher under the mandible.
|
|
|
what is the most common cleft remnant?
|
2nd; thus these are found most often laterally (v thyroglossal cysts, which are found centrally)
|
|
|
what is the treatment for branchial cleft anomalies?
|
antibiotics if infection is present, then surgical excision of cyst and tract once inflammation is resolved
|
|
|
what is stridor? what are the signs/sx?
|
stridor: harsh, high-pitched sound hear on breathing caused by obstruction of the trachea or larynx. signs/sx: dyspnea, cyanosis, difficulty w/feedings
|
|
|
what is the DDx of stridor?
|
laryngomalacia (leading cause of stridor in infants; results from inadequate devt of supporting laryngeal structures; usually self-limited, tx is expectant unless resp compromise is present), tracheobronchomalacia (similar to laryngomalacia but involves the entire trachea), vascular rings and slings (abnormal dvt/placement of thoracic large vessels, resulting in obstruction of trachea/bronchus)
|
|
|
what are the symptoms of vascular rings?
|
stridor, dyspnea on exertion, or dysphagia
|
|
|
how is the dx of vascular rings made?
|
barium swallow revealing typical configuration of esophageal compression, echo/arteriogram
|
|
|
what is the tx of vascular rings?
|
surgical division of the ring, if the patient is symptomatic
|
|
|
what is cystic hygroma?
|
congenital abnormality of lymph sac resulting in lymphangioma
|
|
|
what is the anatomic location of cystic hygroma?
|
occurs in sites of primitive lymphatic lakes and can occur virtually anywhere in the body, most commonly in the floor of the mouth, under the jaw, or in the neck, axillar, or thorax
|
|
|
what is the tx of cystic hygroma?
|
early total surgical removal b/c they tend to enlarge; sclerosis may be needed if the lesion is unresectable
|
|
|
what are the possible complications of cystic hygroma?
|
enlargement in the critical regions, such as the floor of the mouth or paratracheal region, may cause airway obstruction; also, they tend to insinuate onto major structures (although not malignant), making excision difficult and hazardous
|
