Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ECU Dysphagia > 4.2 - Dysphagia in Head + Neck Cancers > Flashcards

4.2 - Dysphagia in Head + Neck Cancers Flashcards

1
Q

What are the Risk Factors for head and neck cancers?

7

A

Tobacco

Alcohol

HPV in oropharyngeal cancers

Epstein-Barr virus in nasopharyngeal cancers

Poor oral hygiene

Poor nutrition especially Vitamin A and B deficiency

GERD in pharyngeal cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In TNM Cancer Classification, what do the numbers 0-4 mean?

A

The extent of spreading.

0=more localized, 4=diffuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In TNM Cancer Classification, what does the letter “T” mean?

A

Tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In TNM Cancer Classification, what does the letter “N” mean?

A

Lymph Node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

In TNM Cancer Classification, what does the letter “M” mean?

A

Metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is M1 basically equivalent to?

A

T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What was the trend in cancer treatment prior to 1990?

A

Surgery usually followed by XRT.

XRT = Radiation therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the goal in current cancer treatment?

A

Organ preservation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the current trend in cancer treatment?

3

A

Using chemoradiation therapy to try to shrink the tumor.

Surgical removal of the tumor

Radiation therapy to address remaining cancer cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the three general guidelines to head and neck cancer assessment?

A

Preoperative conference

Preoperative clinical swallow evaluation

Preoperative videofluoroscopic swallow evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the goal of a Preoperative Conference for patients with head and neck cancer?

A

To discuss outcome options.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is performed in a Preoperative Conference for patients with head and neck cancer?

(2)

A

Discussion of what the patient should expect

PEG placed pre, peri or post op?
PEG = Percutaneous Endoscopic Gastrostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why do we hold a Preoperative Clinical Swallow Evaluation for patients with head and neck cancer?

A

Patients are probably already experiencing changes in swallowing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is performed in a Preoperative Clinical Swallow Evaluation for patients with head and neck cancer?

(2)

A

Clinical swallow

Objective swallow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a Clinical swallow?

3

A

Done on first visit

Non-instrumental exam

Patient questions and trial swallows

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is an Objective swallow?

A

Evaluation using objective measurements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is a Preoperative Videofluoroscopic Swallow Evaluation performed for patients with head and neck cancer?

A

With or without postural or compensatory techniques.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is done in Surgical Removal of cancer?

2

A

Removal of cancerous structures.

Primary tumor surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the risks of Surgical Removal of cancer?

5

A

Decreased movement.

Scar tissue formation.

Wound dehiscence.

Decreased sensation at suture/graft site.

Presence of tracheotomy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Dehiscence?

A

Wound ruptures along a surgical incision.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What kinds of surgeries are seen in head and neck cancer?

8

A

Mandibulectomy/Mandibulotomy (Lower jaw)

Matxillectomy (Upper jaw)

Laser

Laryngectomy

Tracheostomy

Gastrotomy

Neck dissection

Reconstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is used in Post Radiation Therapy?

A

Use of X Ray beams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How does Post Radiation Therapy change the patient’s Anatomy?

(2)

A

Changes the nature of the tissues by reducing blood supply

This damages small nerve endings in the region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the major negative effects of Post Radiation Therapy?

(6)

A

Nausea

Fibrosis (hardening of muscle tissue)

Irritation to skin

Damages the salivary glands causing xerostomia (dry mouth)

Peripheral neuropathies

Necrosis (death) of tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the major negative effects of Chemotherapy?

6

A

Nausea (poor tolerance to food)

Loss of appetite

Infections of oral cavity

Occasional mucositis (inflammation, very painful)

Hair loss

Xerostomia (dry mouth)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the major negative effects of Chemoradiation Therapy in regards to swallowing?

(4)

A

Reduced strength and coordination of the anterior tongue.

Reduced posterior movement of the base of tongue (to the posterior pharyngeal wall)

Reduced laryngeal elevation

Reduced airway closure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the cancers of the Oral Cavity?

4

A

Lip

Floor of the Mouth

Tongue

Retro-Molar Trigone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

In what population does Lip Cancer most often occur?

A

Men- 55 to 65 years old.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the primary risk factors for Lip Cancer?

3

A

Alcohol

Tobacco

Poor oral and dental hygiene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How does Lip Cancer usually present initially?

What happens in more advanced stages?

A

Non-healing ulcers

Pain in advanced stages.`

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How is Lip Cancer usually treated in the initial stage?

A

Radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How is Lip Cancer usually treated in Carcinoma In-Situ?

A

Lesions of the lip may also be surgically removed

33
Q

What does “Carcinoma In-Situ” mean?

A

Within a particular structure/area

34
Q

What kind of Dysphagia is seen in patients with Lip Cancer?

2

A

Mostly oral stage deficits – Labial seal, oral bolus control.

May affect other structures because of radiation effects.

35
Q

Where are cancers of the Floor of the Mouth seen?

2

A

Anterior surface on either side of the midline.

They can spread to bone and tongue

36
Q

Approximately ___% of Floor of the Mouth Cancers involve the sub-maxillary nodes.

A

30%

37
Q

What kind of Dysphagia is seen in patients who have Cancer in the Floor of the Mouth?

(3)

A

Mostly oral stage deficits – Oral bolus control.

Can affect other physiological processes – hyoid excursion and UES opening.

May affect other structures because of radiation effects.

38
Q 
If Tongue Cancer affects the 
anterior section (initial 2/3rds), we say it affects the \_\_\_\_\_\_\_.
If Tongue Cancer affects the 
posterior section (latter 1/3rd), we say it affects the \_\_\_\_\_\_\_.
A

Oral Cavity

Oropharynx

39
Q

What happens if the lesions in Tongue Cancer are at the base and posterior 1/3 of the tongue?

(2)

A

It can invade the tonsils

It is usually advanced.

40
Q

How do we treat Tongue Cancer?

2

A

Radiation

Glossectomy

41
Q

What sort of Dysphagia is seen in Tongue Cancer?

A

Mostly oral stage deficits.

42
Q

What sort of Dysphagia is seen in Partial Glossectomies?

2

A

Bolus prep

Holding bolus.

43
Q

What sort of Dysphagia is seen in Total Glossectomies?

A

Posterior propulsion of bolus.

44
Q

What sort of Dysphagia is seen in Removal of Base of the Tongue?

(2)

A

Pharyngeal stripping affected

Could affect hyoid excursion as well.

45
Q

What can also create Dysphagia in patients with Tongue Cancer?

What might also be affected?

A

Effects of radiation.

In cases of velar resection – Velopharyngeal Closure (VPC) is affected as well.

46
Q

What is the Retro-Molar Trigone?

A

Triangular space behind the last molar tooth

47
Q

How common is Cancer in the Retro-Molar Trigone?

A

Rare

48
Q

What are symptoms of Cancer in the Retro-Molar Trigone?

3

A

Tongue pain

Ear canal pain

Truisms (spasm of jaw muscle)

49
Q

How is Cancer in the Retro-Molar Trigone treated?

A

Radiation therapy

50
Q

What sort of Dysphagia is seen in Cancer in the Retro-Molar Trigone?

(3)

A

Poor mastication

Poor oral control

Poor posterior propulsion of bolus into the oropharynx.

51
Q

What creates the Dysphagia seen in Cancer in the Retro-Molar Trigone?

A

Side effects of surgery or radiation.

52
Q

What are the cancers of the Pharynx?

3

A

Oropharynx

Nasopharynx

Hypopharynx/Laryngopharynx

53
Q

What structures are affected in Cancer of the Oropharynx?

5

A

Base of the tongue

Tonsils

Soft palate

Uvula

Lateral-posterior pharyngeal walls

54
Q

What structures are affected in Cancer of the Nasopharynx?

4

A

Postero-superior pharyngeal wall

Lateral pharyngeal wall,

Eustachian tube orifice

Adenoids

55
Q

What structures are affected in Cancer of the Hypopharynx/Laryngopharynx?

(3)

A

Pyriform sinuses

Post-cricoid

Lower posterior pharyngeal walls.

56
Q

What are common surgeries used for Pharyngeal Cancer?

3

A

Palatal resection

Pharyngeal resection.

Laryngo-pharyngectomy (if laryngeal involvement)

57
Q

What sort of Dysphagia is is seen in Pharyngeal Cancers?

6

A

Pharyngeal stripping

Velopharyngeal Closure (VPC)

Base of the Tonge to Posterior Pharyngeal Wall (BOT to PPW) retraction

UES opening

Hyoid excursion may be affected.

Poor mastication due to Truisms (jaw muscle spasms)

58
Q

What are the Cancers of the Larynx?

3

A

Supraglottis

Glottis

Subglottis

59
Q

What is the Supraglottis?

A

The area above the vocal folds.

60
Q

What is the Glottis?

A

The area around the vocal folds.

61
Q

What is the Subglottis?

A

The area below the vocal folds.

62
Q

What is the main cause of Laryngeal Cancer?

A

Smoking

63
Q

Are Glottic Cancers life threatening?

2

A

No

Removal of larynx will cause loss of voice but life is saved

64
Q

Supraglottic lesions are usually ______. These lesions usually spread superiorly to the ______.

A

Large

Epiglottis

65
Q

Lymph nodes are usually involved in ___% - ___% of patients with Glottic Cancer.

A

40%-50%

66
Q

What is the major risk of Subglottic Cancers?

How are they usually treated?

A

Airway obstruction.

Total laryngectomy in most cases.

67
Q

What sort of Dysphagia is seen in Laryngeal Cancers?

A

Laryngeal penetration/Aspiration

68
Q

What usually causes the dysphagia in patients with Laryngeal Cancers?

(3)

A

Changes due to radiation.

TEP (tracheoesophageal puncture) and tracheostomy influences.

Can influence physiological abnormality of hyoid excursion + UES opening.

69
Q

What is a Hemilaryngectomy?

A

A surgical procedure that removes part of the front of the larynx

70
Q

What are the risks of Hemilaryngectomy?

2

A

Airway protection compromised

Unilateral weakness in the pharyngeal areas.

71
Q

What is a Supraglottic Laryngectomy?

A

Only the portion of your larynx above the vocal cords is removed

72
Q

What are the risks of Supraglottic Laryngectomy?

2

A

Pharyngeal propulsion impaired

Airway compromise.

73
Q

What is a Total Laryngectomy?

A

The entire larynx is removed

74
Q

What are the risks of Total Laryngectomy?

2

A

Airway compromise

Pressure issues for bolus flow.

75
Q

What is always affected in Oral, Laryngeal, + Pharyngeal Cancers?

A

Anatomy

76
Q

What Oral, Laryngeal, + Pharyngeal Cancers treatments and intervention will significantly affect swallowing?

(3)

A

Radiation

Chemo

Surgery

77
Q

What is commonly seen in Oral, Laryngeal, + Pharyngeal Cancers?

A

Aspiration

78
Q

What physiological components are affected in Oral, Laryngeal, + Pharyngeal Cancers?

A

Based on the site of the tumor.

ECU Dysphagia (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions