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Clinical examination of neck swellings

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • 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


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