The document discusses the lymphatic system of the head and neck. It describes the anatomy and physiology of lymphatics, including the mechanisms of lymph flow. It details the lymph nodes of the head and neck region, organized by groups. These include the superficial and deep cervical lymph nodes. The document discusses clinical examination of the lymphatic system and conditions that cause lymph node enlargement in the head and neck region.
Pain is the common symptom in many chronic conditions such as cancers, neuropathies, and chronic disease. It is also experienced in trauma varying from mild to severe based on the location and degree of trauma. This presentation is a brief outline on types of pain, classification of pain, pain pathways and management of pain
Pain is defined as an “unpleasant emotional experience usually initiated by a noxious stimulus and transmitted over a specialized neural network to the central nervous system where it is interpreted as such”.
Free nerve endings – responsible for carrying noxious stimulus from both superficial as well as deep somatic and visceral pain sensations therefore reffered as nociceptors
According to type of impulses they carry second order neuron can be classified as –
LOW THRESHOLD MECHANOSENSORY( ligth touch, pressure and Proprioception)
NOCIOCEPTIVE SPECIFIC ( Noxious stimulation)
WIDE DYNAMIC RANGE ( wide range of stimulus intensities from nonnoxious to noxious.
SILENT NOCICEPTORS (It is an afferent neuron that appear to remain or silent to any mechanical stimulation .These neuron become active with tissue injury and add to the nociceptive input entering the CNS.
Pain is the common symptom in many chronic conditions such as cancers, neuropathies, and chronic disease. It is also experienced in trauma varying from mild to severe based on the location and degree of trauma. This presentation is a brief outline on types of pain, classification of pain, pain pathways and management of pain
Pain is defined as an “unpleasant emotional experience usually initiated by a noxious stimulus and transmitted over a specialized neural network to the central nervous system where it is interpreted as such”.
Free nerve endings – responsible for carrying noxious stimulus from both superficial as well as deep somatic and visceral pain sensations therefore reffered as nociceptors
According to type of impulses they carry second order neuron can be classified as –
LOW THRESHOLD MECHANOSENSORY( ligth touch, pressure and Proprioception)
NOCIOCEPTIVE SPECIFIC ( Noxious stimulation)
WIDE DYNAMIC RANGE ( wide range of stimulus intensities from nonnoxious to noxious.
SILENT NOCICEPTORS (It is an afferent neuron that appear to remain or silent to any mechanical stimulation .These neuron become active with tissue injury and add to the nociceptive input entering the CNS.
INTRODUCTION
HISTORY
EPIDEMIOLOGY
DEFINITIONS OF PAIN
BENEFITS OF PAIN
NOCICEPTION
PAIN RECEPTORS
THEORIES OF PAIN
CHARACTERISTICS OF PAIN
PAIN PATHWAY
MECHANISM OF PAIN
PAIN ASSESSMENT
APPLIED ASPECTS
CONCLUSION
REFERENCES
Pain definition, Pain pathways, pain modulation, the endorphin system, Types of Pain, current trend of Drugs used for pain management. New Drugs for pain
INTRODUCTION
HISTORY
EPIDEMIOLOGY
DEFINITIONS OF PAIN
BENEFITS OF PAIN
NOCICEPTION
PAIN RECEPTORS
THEORIES OF PAIN
CHARACTERISTICS OF PAIN
PAIN PATHWAY
MECHANISM OF PAIN
PAIN ASSESSMENT
APPLIED ASPECTS
CONCLUSION
REFERENCES
Pain definition, Pain pathways, pain modulation, the endorphin system, Types of Pain, current trend of Drugs used for pain management. New Drugs for pain
The framework of the nose consists of bone and cartilage. Two small nasal bones and extensions of the maxillae form the bridge of the nose, which is the bony portion. The remainder of the framework is cartilage and is the flexible portion. Connective tissue and skin cover the framework.
Air enters the nasal cavity from the outside through two openings: the nostrils or external nares. The openings from the nasal cavity into the pharynx are the internal nares. Nose hairs at the entrance to the nose trap large inhaled particles.
Paranasal sinuses are air-filled cavities in the frontal, maxilae, ethmoid, and sphenoid bones. These sinuses, which have the same names as the bones in which they are located, surround the nasal cavity and open into it. They function to reduce the weight of the skull, to produce mucus, and to influence voice quality by acting as resonating chambers.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
2. INTRODUCTION
• The lymphatic system represents an
accessory route through which fluid
flows from the interstitial spaces into
blood.
3. PHYSIOLOGYANDANATOMYOFLYMPHATICS
• The lymphatic system consists of :
1. Fluid, known as lymph
2. Vessels that transport lymph
3. Organs that contain lymphoid tissue
(eg, lymph nodes, spleen, and
thymus)
4.
5. Mechanism of lymphatic flow:-
•Lymph flows under forces similar to those that
govern venous return
•Lymph flows at even lower pressure and speed
than venous blood; it is moved primarily by
rhythmic contractions of the lymphatic vessels
themselves, which contract when stretched by
lymph.
6. • Since lymphatic vessels are often wrapped with an artery in
a common sheath, arterial pulsation may also rhythmically
squeeze the lymphatic vessels and contribute to lymph flow.
• Finally, at the point where the collecting ducts join the
subclavian veins, the rapidly flowing bloodstream draws the
lymph into it.
• Considering these mechanisms of lymph flow, it should be
apparent that physical exercise significantly increases
the rate of lymphatic return.
7. Lymphatics ultimately deliver lymph into 2
main channels
Right lymphatic
duct
•Drains right side of
head & neck, right
arm, right thorax
•Empties into the
right subclavian
vein
Thoracic duct
•Drains the rest of
the body
•Empties into the
left subclavian
vein
8.
9.
10. Only 2 areas in head and neck have no direct
lymphatics:
a)orbit- is virtually devoid of lymphatics.
b) muscles- do not have lymphatics
Their lymph drains in fascial planes between
muscles and around the blood vessels that
supply them.
11. LYMPH NODES OF HEAD &
NECK
SUPERFICIAL/Terminal/
Peripheral
groups/Regional
Outer
circle
Inner
circle
DEEP/Outl
ying
groups
Deep cervical
lymph nodes
13. Submental lymph nodes
•chin & hyoid bone
•anterior bellies of
digastric muscles in
submental triangles.
Recieves lymph from
A. Tip of tongue
B. Floor beneath tongue
C. Lower incisors
D. Central part of lower
lip
E. Skin over chin
14. Submandibular lymph nodes
• Situated on
a)superficial surface of
submandibular salivary
gland.
b)Beneath investing layer of
deep cervical facia.
• They are divided into:
• Anterior group :submental vein close to
chin.
• Middle group : around facial vein&
facial artery above submandibular
salivary gland.
• Posterior group : behind facial vein.
15. Recieves lymph from:
•Front of scalp.
•Anterior part of nasal cavity,
palate & adjacent cheek.
•Upper & lower lip except
central part.
•Frontal, maxillary, ethmoidal
air sinuses.
•Upper& lower teeth except
lower incisors.
•Anterior 2/3rd of tongue.
•Floor of mouth, vestibule.
16. Buccal lymph nodes
• Situated over buccinator
muscle close to facial vein.
• Recieves lymph from
Eyelids, cheek, mid portion of
face
17. OCCIPITAL NODES
• Situated at the apex of
posterior triangle of neck
• Recieves lymph from back of
scalp
• Drains into deep cervical
lymph nodes
18. MASTOID / RETROAURICULAR
LYMPH
NODES
•Situated over lateral
surface of mastoid
process of temporal
bone
•Recieves lymph from
a) Strip of scalp
above auricle.
b) Posterior wall of
external auditory
meatus
Drains into
deep cervical lymph
19. PAROTID LYMPH NODES
• Situated on/ within parotid
gland.
• Receives lymph from:
a) Scalp above parotid
salivary gland.
B)lateral surface of
auricle.
C)anterior wall of external
auditory meatus
D) lateral wall of
external auditory
meatus.
E)lateral wall of eyelid
20. Retropharyngeal lymph nodes
•Situated in retropharyngeal space between
pharyngeal wall & prevertebral fascia .
•Receives lymph from: soft palate, nasal part of
pharynx, auditory tube, upper part of cervical
vertebral column.
•Drains into deep cervical lymph nodes.
21. Laryngeal lymph
nodes
•Situated in front of
larynx on cricothyroid
ligament.
•Recieves lymph from
larynx, trachea, isthmus
of thyroid.
•Drains into deep
cervical lymph
nodes.
22. Tracheal lymph nodes
•Situated
Pretracheal in front
of trachea.
Paratracheal lateral
to trachea.
•Recieves lymph :
Oesophagus, trachea,
larynx.
•Drains into deep
cervical lymph
nodes
23. CLINICALSIGNIFICANCE
• The most common area that drains into these nodes is
skin, and thus the most common tumors to
metastasize to them are melanoma and squamous cell
carcinoma.
24. Cervical lymph
nodes
• Distributed along the internal & external jugular
veins.
• Acc. To their relation to deep fascia of neck,
they are divided into superficial & deep
groups
• Superficial nodes restricted to upper region of
neck& found in angle between mandibular ramus
& SCM muscle.
• Receive lymph from
• Ear lobe
• Adjacent part of skin
• Secondary to preauricular & postauricular
25. • Deep cervical nodes divided into superior & inferior group
• It follows the internal jugular vein so called as JUGULAR
CHAIN
26. Jugulo digastric lymph nodes
• Situated at the level of greator horn of hyoid bone.
• Recieves lymph from tonsil and tongue.
Juglo-omohyoid nodes
• Situated related to the intermediate tendon of omohyoid muscle.
• Recieves lymph from posterior 1/3rd of tongue.
• In general deep cervical nodes receive lymph from regional lymph
nodes and drain into jugular lymph trunk
27. SUPERIOR DEEP CERVICAL NODES
INFERIOR DEEP CERVICAL/ SUPRACLAVICULAR
NODES.
THORACIC DUCT(Left
side) LYMPHATIC DUCT
(Right Side)
VENOUS ANGLE (on either side), where internal
jugular & subclavian veins unite.
Thus the lymph enters the system of superior vena
cava
28. WALDEYERRING
• Waldeyer's tonsillar ring (or pharyngeal lymphoid
ring) is an anatomical term describing the Lymphoid
tissue ring located in the pharynx and to the back of the
oral cavity.
29.
30. •Waldeyer’s outer ring comprises of lymph
nodes in neck and cervical lymph nodes(
occipital, post auricular, pre auricular, parotid,
facial, lingual, submental and sub mandibular)
31. Adenoids
• Enlarge during 3-4 years(
respiratory infection _
bacterial)
• Contribute to recurrent sinusitis
and middle ear infection
• Nasal obstruction , snoring,
loss of sleep, change in voice,
adenoid faces( elongated
face,pinched nostrils, open
mouth, high arch palate,
shortened upper lip)Narrowing
of naso pharyngeal airway
34. Submandibular-1b
• Anterior belly of
the
digastric anteriorly
• Posterior belly of
digastric posteriorly
• Body of
mandible
superiorly
35. Upper jugular group level2A/2b
• Along the upper 1/3 of the
internal jugular vein and
upper
½ of the spinal accessory N
• Skull base superiorly
• Carotid bifurcation below
/ hyoid bone
• Posterior border of
SCM laterally
• Posterior belly of
digastric medially
36. Level3 middle jugular group-jugulo
omohyoid
• Around the middle third of
the IJV
• Carotid bifurcation
superiorly
• Posterior border of Scm
laterally
• Lateral border of
sternohyoid medially
37. Level4-lower jugular
• Around the lower third of
the IJV
• Omohyoid –surgical land
mark
• Cricoid arch clinical
landmark
• Clavicle inferiorly
• Posterior border of the
SCM posteriorly
• Lateral border of
the sternohyoid
medially
38. Level5 A/5b
• Lymph nodes of the
posterior triangle
• Anterior border of
the trapezius
laterally
• Posterior border of
scm medially
• Clavicle inferiorly
39. • Sub-divided into level 5a
and 5b by the horizontal
plane marking the inferior
border of the cricoid arch
• 5a-spinal accessory nodes
• 5b-nodes accompanying
the transverse cervical
vessels
40. Level6-central compartment
• Nodes that surround the
midline
visceral structures
• Hyoid bone superiorly
• Suprasternal notch inferiorly
• CCA laterally
• This level includes
pretracheal,
paratracheal, prelaryngeal
43. EXAMINATION OF LYMPH
NODES
1. Lymph nodes should be examined from patient’s behind.
2. Examination is done by asking patient to flex his neck
slightly to reduce tension of muscles
3. To palpate, use the pads of all four fingertips.
4. Examine both sides of head simultaneously while applying
steady gentle pressure.
44. Palpation
1. Rise in local temperature
2. Tenderness
3. Situation and extent
4. Size and shape
5. Surface
6. Margin
7. Consistency (Soft, elastic and rubbery, firm, hard and stony
hard)
8. Nodes separate or matted together
9. Fixity to surrounding structures(skin,
muscle,nerve,vessel,bone or any viscus)
45. ANTERIOR/POSTERIOR CERVICAL
LYMPH NODES
• They lie anterior & posterior to sternomastoid muscle.
• Tip of fingers are used to palpate anterior nodes, medial
to sternomastoid muscle and posterior nodes behind the
muscle while patient’s head tipped slightly forwards.
51. Supraclavicular lymph
nodes
• While patient’s head is tipped
forward, the index finger of
the examiner is placed in
the triangle and the area is
palpated with a rotary
motion.
52. PALPATI
ON
• Soft and
fluctuating
• Firm ,discrete
• Stony hard
• Matted
CONDITIO
NS
Hodgkins
lymphoma
Syphili
s
Secondary carcinoma
TB , Acute
lymphadenitis,
metastatic carcinoma
54. CYSTICHYGROMA
.
• A cystic hygroma/cystic lymphangioma, is an often congenital
multiloculated lymphatic lesion that can arise anywhere, but is
classically found in the left posterior triangle of the neck and
armpits. This is the most common form of lymphangioma .
• Cystic hygromas are benign, but can be disfiguring. It is a
condition which usually affects children
56. PERITONSILLARABCESS
• Acutely infected tonsil may undergo abscess formation ,mass in
lateral pharynx, interfering with swallowing and breathing. Shows
symptoms of fever pain and trismus.
• Treatment surgical drainage of abscess with or without
tonsillectomy and iv antibiotics
57. CAUSES OF LYMPH NODE
ENLARGEMENT
Sub mandibular Nodes
• Sinusitis
• Tonsillitis
• Conjunctivitis
• Pharyngitis
Sub mental Nodes
• Periodontitis
• Mononucleosis
(Epstein-Barr Virus)
• Cytomegalovirus
• Toxoplasmosis
58. Deep cervical nodes
• Pharyngitis
• Rubella
• Tuberculosis
• Lymphoma
• Head and neck cancer
Occipital nodes
• Local infection
• Secondary Syphillis
• Neoplasm
Postauricular nodes
• Otitis Externa
• Secondary Syphilis
• Rubella
63. CHARACTERS OF L.N. ENLARGEMENT IN SOME DISEASES
1 Streptococcal infection of tonsils:
Uni or Bilateral *
Tender & unmatted
Usually submandibular but may extend to lower cervical group.
2 Scarlet Fever
Sore Throat
Marked enlargement of submandibular L.N.
Other cervical L.N. (bilateral, tender, discrete, suppuration is common
3-Diphtheria
Enlarged submandibular L.N. usually bilateral,
tender, not matted.
64. 4-German Measle:
•OccipitaI L.N.
always present
enlargement are nearly
infectious
•Closely resembles that of
mononucleosis
5-Infectious Mononucleosis:
Bilateral L.N. enlargement, firm, discrete, mobile.
Appear first in posterior cervical area, adjacent to cervical spines later ,
submandibular L.N. will be enlarged
65. 6- T.B.:
* The chiefly affected group is upper cervical group
• Generalized L.N. enlargement is exceptional.
* Unilateral or Bilateral.
* Often firm, matted, painful,
• May become adherent to skin or deep structures.
66. 7.Syphilis:
Primary
L.N draining a chancre - Rocky
hard, uni Or bilateral, not tender.
Secondary
•Generalized L.N.
enlargement
•Especially posterior triangle
of the neck
•(shotty, discrete, painless).
67. 8.Hodgkins Disease.:
* lower cervical group then later on generalized L.N.
enlargement.
•Glands are:
a. moderately enlarged, not tender.
b. Firm, rubbery in consistency.
c. Discrete, mobile however as a result of later
extension outside the capsule glands become matted or
fixed.
Non Hodgkins Lymphoma:
*Also the cervical group is firstly affected
*Hard in consistency
•Tend to become fused and fixed to deep
structures
•May give pressure manifestations.
68. 10- CARCINOMATOUS L.N.:
*Firm, but some times hard.
*A stoney hard nodes fixed to underlying tissues are nearly
always neoplastic in nature
*Carcinomatous L.N. may be freely mobile
69. LYMPHANGITIS
• Acute inflammation elicited when bacterial infections spread into
and through the lymphatics
• Most common agents are group A β-hemolytic streptococci
• Affected lymphatics are dilated
• Filled with an exudate of neutrophils and monocytes
• Infiltrates can extend through the vessel wall into the
perilymphatic tissues
• In severe cases, produce cellulitis or focal abscesses.
70. Clinicall
y, • Red, painful subcutaneous streaks (the inflamed lymphatics)
• Painful enlargement of the draining lymph nodes (acute
lymphadenitis).
• If bacteria are not contained within the lymph nodes, subsequent
passage into the venous circulation can result in bacteremia or
sepsis.
71. Lymphoma
• Cancer of the lymphatic system
• Lymphoma is differentiated by
the type of cell that multiplies
and how the cancer presents
itself
• Two main groups:
• Hodkgin’s lymphoma
• Non Hodgkins lymphoma
72. LYMPHOEDEMA
• Condition in which swelling of
tissue in the extremities occurs
due to obstruction of the
lymphatics & accumulation of
lymph.
• Etiology
• Primary lymphoedema
• Secondary lymphoedema
74. Secondary or obstructive lymphedema
• Represents the accumulation of interstitial fluid
behind a blockage of a previously normal lymphatic
• Can result from Malignant tumors obstructing either
the
lymphatic channels or the regional lymph nodes
• Surgical procedures that remove regional
groups of lymph nodes (e.g., axillary lymph
nodes in radical mastectomy) Postirradiation
fibrosis, Filariasis, Post inflammatory
thrombosis and scarring
75. Symptom
s:
• Feeling of tightness in the
extremity
• Swollen extremity
• Visible skin changes (tautness,
pitting)
76. L
Y
MPHANGIOMA
• Benign hamartomatous tumor of lymphatic channels
• With a marked predilection for the head and neck
region, at submandibular and parotid area .
77. NODEMETASTASIS
Whytumour cellentermorereadilythanvascular system?
• Lymphatic system arises by budding from the
venous system.
• Blood capillaries have narrow endothelial
junction
and do not resorb larger molecules and cells.
• Lymphatic capillaries have relatively open
endothelial junction that permits larger
molecules and cells to be absorbed and
passed.
80. Selective NeckDissection
• Cervical lymphadenectomy with preservation of one
or more lymph node groups
• Four common subtypes:
• Supraomohyoid neck dissection
• Posterolateral neck dissection
• Lateral neck dissection
• Anterior neck dissection
81. TNM classification
NX- Regional lymph node that
can not be assessed
N0 -No regional lymph node
metastasis.
N1-Metastasis in single
ipsilateral lymph node 3 cm or
less in greatest dimension.
N2-Metastasis in single
ipsilateral lymph node more
then 3 cm but not more then
6cm in gretest dimension
N2a-Metastasis in single ipsilateral
lymph node more then 3cm but not
more then 6cm in greatest
dimension.
N2b –Metastasis in multiple
ipsilateral lymph node less then 6
cm in greatest dimension .
N2c-Metastasis in bilateral or
contra lateral lymph node less
then 6cm in greatest dimension N3- more than 6cm