PHYSICAL SIGNS OF THE NECK. Triangles of the neck. The neck is divided by the sterno-mastoid muscles into: anterior and posterior triangles. Anterior triangle of the neck. The anterior triangle is bounded: laterally by the SCM muscle, medially by the midline,
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The neck is divided by the sterno-mastoid muscles into:
anterior and posterior triangles.
Marked out by a line joining the sterno-clavicular joint to a point midway between the tip of the mastoid process and the angle of the mandible.
At the upper border of the thyroid cartilage, CCA bifurcates into the internal and external branches.
The pulsations can be felt at this level.
Common carotid artery: external carotid artery, internal carotid artery Branches of ECA: superior thyroid artery , superior laryngeal artery, lingual artery, facial artery.
1. Lymph nodes- lymphadenopathies:
2. Tumors- cystic or solid
3. Thyroid gland- Goiter- diffuse or nodular
VS: T 39.5 C, pulse rate108/min, RR 24/minm, BP=100/60 mmHg., BW 20 Kg
GA: looked sick, but fully concious
Skin: faint maculopapular rashes were observed over arms and thighs .
An ulcer with black crust on erythematous base was seen over her right shoulder region . Its size was approximately 8.0 mm in diameter. The lesion was not tender.
All nodes were soft, not-tender, movable and smooth surface
1. Prolonged fever for 10 days
2. Nonspecific systemic complaints: faintings, nausea, abdominal pain, diarrhea, sore throat, cough, headache, poor appetite
3. Generalized maculopapular rash
4. Cervical and supraclavicular lymphadenopathy
5. Injected and enlarged tonsils with hyperemic soft palate
6. A black crusted ulcer at the right shoulder
Laboratory investigations:CBC: Hb 6.1 g/dl, Hct 18%, WBC 3,600/mm3 (N=74%, L=22%, M=16%) CD4 T-cell count: 4% (20 cells/mm3) Tuberculin skin test : Negative
CXR: Cardiomegaly, generalized reticulo-nodular infiltration both lungs suggesting miliary tuberculosis.
Echocardiogram: Generalized cardiac dilatation, particularly left size was larger than right side. Mild depressed LV systolic function. Small amount of pericardial effusion. Most likely, the lesions are caused by tuberculous myopathy.
Site, shape, size, surface, tenderness, composition, relation