BTK_ Head/Neck

Question 1

Structures in a subclavian central line placement (Anterior to Posterior )

Answer 1

Subclavian vein –> Phrenic Nerve –> Anterior Scalene –> Subclavian Artery –> Middle Scalene

Question 2

Anterior Neck Triangle (Boundaries and Content)

Answer 2

Anterior = midline of neck
Posterior = SCM
Inferior/Apex = Sternal notch
Superior/Base = lower border of body of mandible

Content = carotid sheath

Question 3

Posterior Neck Triangle (Boundaries and Content)

Answer 3

Anterior = Posterior border of SCM
Posterior = Trapezius muscle
Base = middle 3rd of clavicle
Apex = intersection of SCM and Tranpezius

Content = Spinal accessory Nerve

Question 4

Squamous Cell Cancer of the Neck: How common in neck? How common overall? Men vs Women Ratio?

Answer 4

• Most common cancer of the head and neck
• # 5 most common cancer overall
• Men:Women 5:1 ratio

Question 5

Staging for Squamous Cell Cancer of Head/Neck:

Stage 1 and 2? Treatment?

Answer 5

Local disease ( no regional or distant mets)

Tx = surgery or radiation acceptible (depends on location/morbidity of resection)

Question 6

Staging for Squamous Cell Cancer of Head/Neck:

Stage 3 and 4? Treatment?

Answer 6

Locally aggressive or distant mets

Tx = Surgery (WLE + MRND) followed by radiation /- chemotherapy\

Question 7

Oral SCC > 4cm or + nodes/bone invasion treatment?

Answer 7

Resection with MRND followed by Post-Op radiation

Question 8

75 year old smoker with 2cm ulcerated lesion along vermillion border of lower lip. No lymphadenopathy or evidence of metastasis on workup. Diagnosis? Treatment?

Answer 8

Diagnosis: squamous cell cancer (early stage)

Treatment:
- Wide local excision with at least 3mm margin (preferred)
[Radiation not used unless clinically evident neck disease]