Cap. 10 Cabeza y cuello Flashcards by Ocsicnarfjavier SV

Name the 3 auditory ossicle bones:

Malleus (hammer)
incus (anvil)
stapes (stirrup)

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Name the nerve that crosses the internal carotid artery 1 to 2 cm above the carotid bifurcation:

Hypoglossal nerve

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The hypoglossal nerve supplies motor innervation to all of the muscles of the tongue except:

Palatoglossus

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The phrenic nerve lies on top of what muscle?

Anterior scalene

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Name the branches of the facial nerve:

Temporal, zygomatic, buccal, marginal mandibular, cervical branches

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Which branch of the facial nerve is most often injured in carotid surgery?

Marginal mandibular nerve

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Name the branches of the trigeminal nerve:

Opthalmic (V1), maxillary (V2), mandibular (V3)

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What nerve is found within the carotid sheath?

Vagus

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The recurrent laryngeal nerve innervates all of the muscles of the larynx except:

Cricothyroid muscle

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Which nerve is responsible for sensory innervation of the larynx above the level of the vocal folds?

Internal branch of the superior laryngeal nerve

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Which nerve is responsible for sensory innervation of the larynx below the level of the vocal folds?

Recurrent laryngeal nerve

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Name the branches of the thyrocervical trunk:

STAT
Suprascapular artery
Transverse cervical artery
Ascending cervical artery
Inferior thyroid artery

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What is the first branch of the external carotid artery?

Superior thyroid artery

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Name the blood supply to the nose:

Anterior/posterior ethmoidal arteries off the ophthalmic artery
Superior labial artery from the facial artery
Sphenopalatine artery off the internal maxillary artery

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What nerve innervates the strap muscles?

Ansa cervicalis

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Define the regions of the cervical lymph nodes:

Level I: submental and submandibular nodes Level II: upper jugular nodes
Level III: middle jugular nodes
Level IV: lower jugular nodes
Level V: posterior triangle
Level VI: anterior compartment 
Level VII: upper mediastinal nodes

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What structure divides the parotid gland into superficial and deep lobes?

Facial nerve

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What is the name of the duct in the parotid gland?

Stenson duct

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What is the name of the duct in the submandibular gland?

Wharton duct

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What is the most common nerve injured in parotid surgery?

Greater auricular nerve

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What is the most common type of cancer of the oral cavity, pharynx, and larynx?

Squamous cell carcinoma

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What is the biggest risk factor for head and neck cancer?

Tobacco

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What is the most common location for an oral cavity cancer?

Lower lip

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Oral cavity cancer is most likely to spread to which regional lymph nodes?

Submental and submandibular (level I)

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What is the most common benign head and neck tumor in adults?

Hemangioma

What is the most common tumor of the nasopharynx in children?

Lymphoma

What is the most common benign neoplasm of the nose and paranasal sinuses?

Papilloma

What is the most common benign lesion of the larynx?

Papilloma

What is the treatment for an early glottic squamous cell carcinoma?

Primary radiation versus conservative surgical resection—laser versus endoscopic (if recurs perform chordectomy)

What is the treatment for an advanced glottic squamous cell carcinoma?

Laryngectomy, modified radical neck dissection, and postoperative radiation

Where do head and neck tumors most often distantly metastasize?

Lung

Which disorder involves dysphagia, esophagitis, iron deficiency anemia, and an increased incidence of oral cavity cancer?

Plummer-Vinson syndrome

What are the indications for a radical neck dissection?

Clinically positive lymph nodes Fixed cervical mass High rate of suspicion for metastatic disease

In oral cavity cancer, when is a modified radical neck dissection indicated?

Clinically positive nodes Tumor size >2cm

Which structures are taken in a radical neck dissection?

Accessory nerve, cervical branch of the facial nerve, internal jugular vein, ipsilateral thyroid, omohyoid, sternocleidomastoid muscle, submandibular gland, sensory nerves C2-C5

What is spared in a modified radical neck dissection?

Type I: spinal accessory nerve Type II: spinal accessory nerve, internal jugular vein Type III: spinal accessory nerve, internal jugular vein, sternocleidomastoid (SCM)

What percentage of salivary tumors are benign?

80%

What percentage of salivary tumors are in the parotid?

80%

What is the most common benign salivary tumor?

Pleomorphic adenoma

What percentage of pleomorphic adenomas undergo malignant degeneration?

What is the second most common benign tumor of the salivary glands?

Warthin tumor

What percentage of Warthin tumor are bilateral?

10%

What is the most common salivary gland tumor in children?

Hemangioma

What is the most common malignant tumor of the salivary glands?

Mucoepidermoid carcinoma

What is the second most common malignant salivary gland tumor?

Adenoid cystic carcinoma

What is the name of the vascular plexus located in the anterior portion of the nasal septum, which is responsible for 90% of epistaxis?

Kiesselbach plexus

What percentage of epistaxis can be controlled with anterior or combined anterior and posterior nasal packing?

95%

Which arteries can be ligated in order to control epistaxis?

Ethmoid artery, internal maxillary artery

Why does a nasal septal hematoma require emergent treatment?

The accumulation of blood in the nasal septum may deprive the septal cartilage of its blood supply from the perichondrium. It requires immediate incision and drainage, septal splinting, and antibiotics to prevent avascular necrosis of the septal cartilage and subsequent saddle nose deformity.

What is the initial management for a traumatic cerebrospinal fluid (CSF) leak?

- Head elevation - Avoid nose blowing/straining - With/without antibiotics

Which diagnostic test can be used to confirm whether fluid is CSF?

B2-transferrin

What is the treatment for a persistent CSF leak (>4–6 weeks)?

Surgical repair

What is the treatment for a CSF leak associated with meningitis?

Surgical repair

What is the most common cause of laryngeal stenosis?

Trauma

Most common location for an esophageal foreign body:

Upper esophagus at the thoracic inlet

Above what level should a tracheostomy be placed to avoid the complication of a tracheo- innominate fistula?

Above the third tracheal ring

What is the initial treatment for a peritonsillar abscess?

IV antibiotics and needle aspiration

What is the treatment for a retropharyngeal abscess?

IV antibiotics and surgical drainage through the posterior pharynx or neck

What is the treatment for a parapharyngeal abscess?

IV antibiotics, incision and drainage through the lateral neck, and leave a drain in place

What is the initial treatment for acute suppurative parotitis?

Antibiotics, IV fluids, sialogogues, warm compresses

When is it necessary to operate on acute suppurative parotitis?

When there is no clinical improvement after 12 hours of treatment