The neck is made up of different regions , but the more important this time is the midline of the neck structure , focusing on the thyroid gland. The midline of de neck is composed by the mobile hyoid bone just below the mandible, the thyroid cartilage, readily identified by the notch on its superior edge, the cricoid cartilage, the tracheal rings and the thyroid gland, Is located above the suprasternal notch . The thyroid isthmus spans the second , third , and fourth tracheal rings just below the cricoid cartilage. the lateral lobes of the thyroid curve posteriorly around the sides of the trachea and the esophagus; each is about 4 cm to 5 cm in length. Except in the midline, the thyroid gland is covered by thin straplike muscles anchored to the hyoid bone and more laterally, by the sternomastoids; only the sternomastoids are visible.
Nodes are normally round or ovoid, smooth, and smaller than this gland. The gland is larger and has a lobulated, slightly irregular surface.
Note that the tonsillar, submandibular, and submental nodes drain portions of the mouth and throat as well as the face. Knowledge of the lymphatic system is important. When you detec a malignant or inflammantory lesion, look for enlargement of the regional lymph nodes that drain it when a node is enlarged or tender, look for a source such as infection in its nearby drainage.
Techniques for reviewing neck are :
- Inspection:
It aims to seek changes in:
The shape of the neck ( lymphadenopathy , goiter , lipomas , cysts or tumors ) . In this case the location of cervical volume increased as we will guide diagnosis is very important. Skin : signs vascular , venous congestion, surgical scars , nevi , melanoma and radiodermitis . You can also see the external opening of fistula .
It should examine the position and mobility of the head for muscle spasms.
- Palpation : Palpation is performed from the front or from behind the patient, it is important that both sides should be palpated and compared. The head should be tilted slightly forward to relax the soft tissues.
Palpation of the thyroid gland is done from behind the patient, affirmed thumbs under the neck and fingers on thyroid region in the front of the neck . It is useful to locate the position of the cricoid cartilage , and immediately below it the thyroid isthmus is . In this position you instruct the patient to swallow while attempting to delineate the thyroid lobes . The gland amounts with swallowing movements .
Finally it should permeate the trachea , assess mobility laterally and its location on the median line ( rule displacements) .
- Auscultation : You should accompany the carotid body tumor , vascular aneurysms, carotid stenosis or hyperthyroid goiter is suspected.