Archive for March, 2006
Sore-Stiff Neck. Stiffness in the neck is the usual result of irritation in the muscles, bones and ligaments that make up the spine in the neck region. Sudden soreness or stiffness, of a temporary nature, is often due to the strain of unusual neck-bending activities, such as gardening work and ordinarily a day of rest relieves painful situations as these. Stiffness, or pain in the neck of a recurrent nature, is usually caused by continuing difficulties from sprains, fractures and arthritis or possibly an infection elsewhere in the body, such as, teeth.
The treatment of neck stiffness and soreness depends upon its cause. X-rays may reveal local difficulties in the neck, while examination of the entire body may reveal an infection causing general arthritis or other systemic disease. The only treatment a person should attempt for himself in such matters, is regulation of elimination, diet, proper rest and avoidance of exceptional exercise in the neck region. Continuing soreness and pain in the neck should be investigated by the physician for possible serious underlying disease.
Enlarged Glands in the Neck. Enlarged neck glands commonly follow an infection in the mouth, possibly of the teeth,
Fig. 31. Neck growths and enlargements, present since childhood, often are the result of abnormal development. Fast-growing enlargement at any age is most likely due to infectious processes, but may mean cancerous disease. Goiter moves up and down with the swallowing act and is most often close to the midline.
tongue or pharynx. These enlarged glands, can be felt just below the angle of the jaw, extending straight downward. They are frequently tender to the touch, and if infected, can be painful without being touched at all.
In addition to infection, enlarged neck glands can result from tumor growths in the oral cavity, of the lip, tongue, gum, jaw or tonsil. They may also indicate a cyst within the neck, enlargement of the thyroid gland or systemic lymphoid diseases, such as Hodgkin’s Disease. Any neck enlargement lasting more than a week, may represent serious disease, and the physician should be consulted without delay.
The neck, the support and connection for the head to the body, is also the location of the thyroid gland and many human ills as well.
Examination of the Neck
The neck is examined in a well-lighted position before a close-up wall mirror for clear observation.
1. Note flexibility of the neck. Bend the head slowly frontward and backward, from side to side, and rotate to the right and left. Stiffness or soreness noted in these actions may denote arthritis, irritation of the neck muscles and ligaments, or an infection in the neck.
Fig. 30. The neck contains the body’s important connections for the head and senses. There are many great blood vessels, glands, nerves, breathing tubes, muscles and other structures in this small space. It also may figure prominently as a thing of beauty.
2. Feel for enlarged neck glands. Bend the head back and feel along the sides of the neck muscles, stretching from the breastbone to the mastoid bone. Enlarged glands in this region can be rolled under the fingers, and usually are painful to touch.
3. Feel the region of the thyroid gland. With the thumb and forefinger, press gently on the sides of the windpipe just above the collarbone. Swallow and feel the thyroid gland rise and fall along with the windpipe.
Cancer of the Pharynx. Malignant growth, especially cancer, often occurs in the pharynx, base of the tongue and the vocal cords. Unfortunately this area cannot be seen without the aid of special mirrors and lighting arrangements. The features arousing suspicions of such difficulties are hoarseness of a constant nature, pain, and bleeding, which may occur together or separately and in variable degrees. After fifty years of age, coughing of blood and a soreness in the throat, of more than ten days’ duration, should arouse suspicion. Hoarseness is a very common difficulty at all ages and is no cause for alarm following brief periods of sore throat or upper respiratory infection. However, a persistent hoarseness of several weeks or more in a person of fifty years or older, should prompt suspicion of serious vocal cord disease, including cancer.
There are other growths in this region, such as polyps, cysts and plain irritations, all of which are easily treated by the physician, but the possibility of cancerous disease in the pharynx region, demands early diagnosis, if effective cure is to be expected.
Halitosis (Bad Breath) – This difficulty concerns everyone, and can be very offensive and embarrassing. The problem is exaggerated by widely publicized advertising, but nevertheless, halitosis is a very real problem everywhere.
Prevention of offensive breath is mostly a matter of effective oral hygiene. This includes cleaning the mouth and teeth after each meal, at least to the point of rinsing the mouth well. Unusually persistent cases, however, warrant a physician’s help in determining the cause. Investigation may uncover disease possibilities within the mouth, nose or sinus region, as well as lungs or bronchial tubes.
Coughing. A cough is usually due to irritation of the larynx or vocal cords by colds or infections in this area. The irritation may be described as a tickling, or as a rasping soreness. It may be temporary and respond to various gargles and rest, or the cough may persist for long periods. When copious amounts of sputum are produced with coughing, the most probable site of difficulty is in the lungs, whereas, the cough originating in the larynx is usually described as a dry and hacking cough.
Pharyngitis-A general redness like that of raw hamburger, covered with many small blood vessels, is the appearance of the irritated pharynx-called pharyngitis. Pharyngitis frequently accompanies upper respiratory infections, bronchitis, sinus disease, virus infection and various types of sore throat.
If hoarseness is present, it means that the vocal cords, which cannot be seen easily, are also irritated along with the rest of the pharynx and larynx. Treatment of pharyngitis varies usually with the disease which it accompanies. As a difficulty by itself, it frequently re-responds to gargling with plain water or salt water solution.
Tonsilitis-Infection and inflammation of the tonsils is most frequent in childhood during the formative years. It is not uncommon however, for tonsils to become infected in the senior years of life, or harbor infection through the years, to bring about other bodily disturbances in adult life. Tonsils which might appear to be innocent, may actually harbor and distribute bacteria organisms, sometimes responsible for other diseases such as arthritis, kidney disease and sore throats, among others.
Removal of the tonsils in later years is frequently done. It is slightly more difficult than in childhood, but is often followed by relief from arthritis pains and a host of other diseases, which have been kept alive by long-infected tonsils.
Examination of the Pharynx
The pharynx can be seen partially by forceful traction on the tongue, by the fingers wrapped in a handkerchief. It begins in back of the one-half inch uvula, which hangs down freely from the posterior rim of the palate.
1. Observe the sides of the pharynx where the tongue appears to originate, and note the irregular flesh colored tonsils on each side. When removed, a small cavity remains in their
Fig. 29. The pharynx is the region of the tonsils, back part of the nose and swallowing area. It is probably the most examined of all body regions, and reflects many diseases.
site. Adult tonsils may be atrophied to a pea size or if irritated and infected, be as large as grapes and flecked with pus.
2. With a flashlight, examine the back of the pharynx while attempting to yawn. An all-over redness, with noticeable soreness, usually means pharyngitis as in colds, sore throats, etc.
3. Examine the wall of the pharynx on all sides and the back of the tongue, if possible, for any one particular sore, ulcer or bleeding point, which may mean cancer.
Leukoplakia. A whitish discoloration, as a soft wet crusting on the tongue surface and occasionally on the inner surface of the cheek, is termed leukoplakia. It is the result of chronic irritation, such as over-indulgence in the use of tobacco, but is also thought at times to be related to syphilis or some other systemic diseases. Leukoplakia definitely is a pre-cancerous condition and necessitates immediate expert medical care.
Fig. 28. Leukoplakia on the tongue is a white, leathery, sometimes sore formation, resulting from chronic irritation. Often caused by smoking, it is considered potentially cancerous and should not be ignored.
Cancer of the Tongue. Any ulcer or recent sore irregularity on the tongue might be the beginning of cancer. Three percent of all bodily cancer, and found much more in the male sex, it is often associated with jagged and broken teeth, or other irritations such as leukoplakia, glossitis or syphilis. It is definitely a disease of later years; it was formerly associated with syphilis about fifty percent of the time. Now, however, coincidence with syphilis is very low, and association with heavy smoking is becoming higher and higher. Any sore on the tongue over two weeks in duration demands a physician’s early attention.
Paralysis of the Tongue. The tongue normally has great agility to move in any direction including straight out. When it loses the ability to move, especially to one side, difficulties such as strokes are quickly suspected. Paralysis of the tongue, whether in whole or part, almost always represents difficulty with nerves which bring motion ability to the tongue muscle and the physician’s examination alone can uncover the basic difficulty.
Enlarged Tongue. An enormously enlarged tongue (macro-glossia) sometimes is found in unusual diseases of the body tissues, along with accompanying enlargements of other soft tissue areas of the body, such as the lips, nose and facial features. Diagnosis and treatment for these difficulties becomes considerably involved and the physician’s advice is without equal.