A: When a lymph node notices something harmful in the body, it uses its resources to try to destroy it. Inside the lymph nodes are blood cells that fight infection and disease. When the lymph nodes start using them, the gland gets bigger. Colds, sore throats and ear infections all lead to swollen lymph nodes. We treat the infection, it goes away, and the lymph node shrinks.
Location matters: The glands under your jawline are rarely a problem. Swollen glands. Check if your glands are swollen Swollen glands feel like tender, painful lumps: on each side of the neck under the chin in the armpits around the groin Glands known as lymph glands or lymph nodes swell near an infection to help your body fight it.
Sometimes a gland on just one side of the body swells. You might also have other symptoms, such as a sore throat, cough or high temperature. Considering only the neck dissection, there usually will be drains placed under the skin at the time of surgery to collect any serous fluid or blood that accumulates at the operative site. These drains will be removed after a couple days. Once they are out, and if the incision looks to be healing well, the patient can usually go home. It is not unusual to develop some numbness in the neck skin and ear after a neck dissection.
Much of the numbness goes away after several months, but some may be permanent. The nerve supplying sensation to the ear often must be cut during the surgery, and some of this sensation never returns. If you live in a cold climate, you will have to be careful since a numb ear can develop frostbite without first feeling cold or painful.
The remaining numbness can be bothersome but seldom causes any major problems. As mentioned above, one or more of these structures may need to be removed in a neck dissection. Removal of one jugular vein usually causes minimal or no problems. There are many other veins in the neck and the blood can flow back through them.
There may be some temporary swelling, but this usually decreases after a couple weeks. If a neck dissection is being done on both sides of the neck, the surgeon will try to save at least one jugular vein. Both veins can be removed at the same time, but the consequences of the swelling can be quite severe. Removal of the spinal accessory nerve limits the upward movement of the shoulder.
In particular, it will be more difficult to move the arm from the horizontal position to directly overhead. There also may be some shoulder droop on the side of surgery, and there can be some mild pain due inflammation at the shoulder joint.
If the spinal nerve is removed, post-operative physical therapy will be crucial to maintain good shoulder function. Removal of one sternocleidomastoid muscle generally causes no problems. The neck may look a little sunken due to its removal. In normal health, these sinuses cannot be appreciated on examination and cause no symptoms.
Inflammatory states, in particular those caused by allergy or infection, produce symptoms and findings that may be detected during examination. Symptoms associated with sinusitis include: nasal congestion, nasal discharge, facial pain, fever, and pain on palpation of the maxillary teeth.
The frontal and maxillary sinuses are the two that can be indirectly examined. Examination for sinusitis should include the following:. NIH Tooth Site. Prior to palpation, look at the thyroid region.
If the gland is quite enlarged, you may actually notice it protruding underneath the skin. To find the thyroid gland, first locate the thyroid cartilage a. It's particularly prominent in thin males, sits atop the tracheal rings, and can be seen best when the patient tilts their head backwards. Deviation to one side or the other is usually associated with intra-thoracic pathology. For example, air trapped in one pleural space known as a pneumothorax can generate enough pressure so that it collapses the lung on that side, causing mediastinal structures, along with the trachea, to be pushed towards the opposite chest.
This deviation may be visible on inspection and can be accentuated by gently placing your finger in the top of the thyroid cartilage and noting its position relative to the midline.
The thyroid gland lies approximately cm below the thyroid cartilage, on either side of the tracheal rings, which may or may not be apparent on visual inspection. If you're unsure, give the patient a glass of water and have them swallow as you watch this region.
Thyroid tissue, along with all of the adjacent structures, will move up and down with swallowing. The normal thyroid is not visible, so it's not worth going through this swallowing exercise if you don't see anything on gross inspection. Palpation: The thyroid can be examined while you stand in front of or behind the patient. Exam from behind the patient is described below:. Palpating Anterior Cervical Lymph Nodes.
Anterior Cervical both superficial and deep : Nodes that lie both on top of and beneath the sternocleidomastoid muscles SCM on either side of the neck, from the angle of the jaw to the top of the clavicle.
This muscle allows the head to turn to the right and left. The right SCM turns the head to the left and vice versa. They can be easily identified by asking the patient to turn their head into your hand while you provide resistance. Drainage: The internal structures of the throat as well as part of the posterior pharynx, tonsils, and thyroid gland. Lymph nodes of the head and neck.
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