11. =Cervical Lymphnodes.= Note _number_, _size_, _color_,
_consistence_, _character of cut-surface_, etc. The most important
pathologic conditions are: tuberculosis, secondary carcinoma,
Hodgkin’s disease, lymphosarcoma (leukæmic and aleukæmic), various
forms of inflammation, dermoid and epidermoid cysts, cystic
lymphangioma (congenital cystic tumor of the neck), branchiogenic
carcinoma, and hyperplasia in syphilis, rachitis and status
lymphaticus. In acute inflammation the lymphnodes are red and soft;
in chronic inflammation they are usually grayish-white and firm.
12. =Salivary Glands.= The _parotid_, _submaxillary_ and other
_salivary glands_ are examined as to _size_, _color_, _consistence_
and _character of cut-surface_. The most important conditions are:
parotitis (epidemic and secondary), chronic inflammation, calculi,
cystic dilatation of ducts [ranula], Ludwig’s angina, salivary
fistula, granulomata (tuberculosis, syphilis and actinomycosis),
neoplasms (most common forms are the mixed tumors containing
cartilage, fibrous connective-tissue and myxomatous tissue and cords
or rows of cells regarded by some observers as endothelial, by
others as epithelial; other less common tumors are adenoma, fibroma,
carcinoma and sarcoma). Symmetrical enlargement of the salivary
and lachrymal glands occurs as the result of aleukæmic or leukæmic
lymphocytoma (“Mikulicz’s disease”).
13. =Cervical Vessels and Nerves.= Examine the arteries and
veins, noting contents, thickness and character of walls, size of
lumen, changes in the intima, sclerosis, atheroma, calcification,
thrombosis, embolism, etc. In death from strangulation or hanging the
intima of the carotids may be torn. The _aorta_ is usually examined
after the section of the neck-organs. Note size of lumen. In the
adult it usually admits the index-finger or thumb. The circumference
of the thoracic aorta is 4.5-6 cm.; that of the abdominal aorta
is 3.5-4.5 cm. Note its elasticity, contents, thickness of wall,
changes in intima, etc. Fatty degeneration of the intima, sclerosis,
atheromatous plaques and ulcers, calcification and thrombosis are
the most common conditions. Syphilis is a very common cause of
mesaortitis, shown by linear or radiating depressions of the intima.
The _carotid gland_ (paraganglion intercaroticum) at or near the
division of the carotids should be noted. It is about the size of
a rice-grain, oval, vascular and of firm consistence, resembling
very much the superior cervical ganglion. Alveolar tumors apparently
primary in this gland have been observed by a number of writers. Its
epithelial nature is denied by some observers who class it with the
sympathetic system. The _nerves_ and _ganglia_ should be examined
and any change from the normal noted, such as atrophy, effects of
pressure, involvement in scar-tissue, hæmorrhage, inflammatory
processes, neoplasms, etc.
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