expose the patient's neck - loosen their shirt collar
it is necessary to define information relating to the:
site
relation to muscles
relation to trachea
relation to hyoid cartilage
examination of swelling of the neck includes (1)
examination of skin on the head and neck
to look for premalignant or malignant lesions caused by chronic exposure to sun
examination of the anterior and posterior triangles of the neck
to define the site of the lump
palpation of the neck during swallowing
this may identify pathology of the thyroid gland.
otologic examination (1)
to look for a sinus or fistula associated with a branchial anomaly
examination mucosal surfaces ( needs wearing of gloves) (1)
dental appliances like dentures may have to be removed first
pharyngitis suggests reactive adenopathy
in the tonsillar fossa, look for the following features:
ulcerations
submucosal swelling
asymmetry
palpate the tongue and the base of the tongue
examination of the larynx and pharynx (1)
this is done using an indirect or flexible laryngoscopy
References
Pynnonen M et al. Clinical Practice Guideline: Evaluation of the Neck Mass in Adults. Practice Guideline. Otolaryngol Head Neck Surg. 2017 Sep;157(2_suppl):S1-S30.
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