DEPT OF SURGERYMEDICAL FACULTY YARSI UNIVERSITY

JAKARTA 2011

Neck Trigonum

AnteriorPosterior

Border : M. Sternocleidomastoideus

M. DigastricusM. OmohyoideusOs HyoidOs Clavicula

A. Cervical Lymph nodesNormal : smooth surface, ellipseSoftVariable size

Cervical Lymph nodes

SubmentalSubmandibularUpper jugular nodesMid jugular nodesLower jugular nodesAccessory nerve nodesSupraclavicular nodes

150 – 250 lnn (30% total lnn)

Disease of the lymph nodes

Inflammation / infectionMetastasesPrimary tumorsLeukemia

Inflammation / infection

1. Acute Lymphadenitis

Source of infection

Lymphatic channel

Lymph node

Abscess

2. Chronic Lymphadenitis

PMN <<<Monocyte, plasma cell >>>Normal structure lnn

3. Tuberculoses Lymphadenitis

High incidenceUsually not from KPVia oropharyngeal mucousMC type Bovinum

Milk Food

Periadenitis Conglomerates

Scropuloderma

B. Branchial CystEmbryological defect

First Branchial arch Parotid

Ext auditory canal

Second Branchial archAnt border of SCMTonsilar fossa

Third Branchial archSimilar with 2nd

Fossa pyriformis

Clinical Signs and Symptoms

Mass, location depend on typePain from secondary infection

Pathology CystSquamous complexFibrous tissueLymphoid tissueCholesterol rich fluid

(Hassal’s body)

Therapy

Excision

C. Cervical Cystic HygromaCystic, multi locusUnclear borderConsistency cystic, softFluctuantAnterior or lateralObstetric : difficult in labour

Therapy

Excision asapRecurrent : high because indefinite

border