ABSITE Review - Head and Neck Flashcards
Which structures form the anterior neck triangle?
SCM, sternal notch, inferior border of digastric muscle; contains the carotid sheath
Which structures form the posterior neck triangle?
post border of SCM, trapezius muscle, and clavicle; contains the spinal accessory nerve and brachial plexus
Where is the phrenic nerve in respect to the scalene muscles?
In top of the anterior scalene muscle
What are the branches of the facial nerve?
Temporal, zygomatic, buccal, marginal mandibular and cervical branches
What is innervated by hypoglossal nerve?
Motor to all of tongue except palatoglossus; tongue deviates to side of injury.
What is innervated by recurrent laryngeal nerve?
Innervates all of larynx except cricothyroid muscle
What is innervated by superior laryngeal nerve?
Motor to the cricothyroid muscle
What is Frey’s syndrome?
Occurs after a parathyroidectomy; injury of auriculotemporal nerve that then cross-innervates with sympathetic fibers to sweat glands of skin
Symptoms - gustatory sweating
What is the 1st branch of the external carotid artery?
Superior thyroid artery
What are the branches of the thyrocervical trunk?
STAT - Suprascapular artery, Transverse cervical artery, Ascending cervical artery, Inferior thyroid artery
What is a radical neck dissection?
Takes accesory nerve, SCM, IJ, omohyoid, submandibular gland, sensory nerves C2-C5, cervical branch of facial nerve, and ipsilateral thyroid
What is a modified radical neck dissection?
Takes omohyoid, submandibular gland, sensory nerves C2-C5, cervical branch of facial nerve, and ipsilateral thyroid
Whaat is the MC cancer of the oral cavity, pharynx and larynx?
Squamous cell cancer
What is more premalignant erythroplakia or leukoplakia?
Erythroplakia
What is the MC site of oral cavity cancer?
Lower lip
What is the recommended treatment for oral cavity cancers?
need WLE of tumor with 1-2cm margins
>2cm or if clinically + nodes –> MRND
When is potop XRT required in oral cavity cancers?
> 2cm, positive margins, nerve/vascular/lymphatic invasion
What is the #1 tumor of the nasopharynx in children?
Lymphoma
What is the MC benign neoplasm of the nose/paranasal sinuses?
Papilloma
A mass in a LARGE salivary gland is most likely…
BENIGN
A mass in a SMALL salivary gland is most likely…
MALIGNANT
What is the #1 MALIGNANT tumor of the salivary glands?
Mucoepidermoid carcinoma
What is the #2 MALIGNANT tumor of the salivary glands?
Adenoid cystic carcinoma
What is the #1 MALIGNANT tumor of the MINOR salivary glands?
Adenoid cystic carcinoma
When should the facial nerve be sacrificed?
Only for direct tumor invasion or for preexisting facial paralyses.
What is the #1 BENIGN tumor of the salivary glands?
Pleomorphic adenoma
What is the #2 BENIGN tumor of the salivary glands?
Warthin’s tumor, bilateral in 10%
What is the MC injured nerve with parotid surgery?
Greater auricular Nerve - numbness over the lower portion of auricle
During a submandibular gland resection, which 3 structures are important to find?
Madibular branch of facial nerve
Lingual nerve
Hypoglossal nerve
What is the MC salivary gland tumor in children?
Hemangioma
What is the MC site for epistaxis? What is the treatment?
90% anterior and can controlled with packing
Consider internal maxillary artery or ethmoid artery ligation for persistent posterior bleeding
What is an ameloblastoma?
Slow-growing malignancy of the neck and jaw; soap bubble appereance on x-ray.
What is the nerve damage if lip numbness is present?
Inferior alveolar nerve
Which type of oral abscess is an airway emergency?
Retropharyngeal abscess
Tx - intubate the patient; drain through posterior pharyngeal wall
What is Ludwig’s angina?
Acute infection of the floor of the mouth, involves mylohyoid muscle
What is the 80% rule of parotid tumors?
80% of all salivary tumors are in parotid
80% of parotid tumors are benign
80% of benign parotid tumors are pleomorphic adenomas
What are the benefits of a tracheostomy?
Decreases secretions, provides easier ventilation, decreases pneumonia risk
How can you prevent a tracheo-innominate fistula?
By keeping the tracheostomy above the 3rd tracheal ring
When do you repair a cleft lip?
Repair at 10 weeks, 10lbs, Hgb 10. May be associated with poor feeding
When do you repair a cleft palate?
May affect speech and swallowing if not closed soon enough; may affect maxillofacial growth if closed to early –> repair at 12 months
What is the MC neoplasm in patients with AIDS?
Kaposi Sarcoma
