Chapter 119 Neck Dissection Flashcards
Boundaries of submental triangle
Anterior belly of digastric muscles.
Hyoid bone.
Boundaries of submental triangle
Anterior belly of digastric muscles.
Hyoid bone.
Boundaries of submandibular triangle.
Anterior and Posterior Belly of Digastric.
Body of Mandible.
Primary sites from which metastatic disease may originate if level I lymph nodes are involved:
lip
buccal mucosa
anterior nasal cavity
soft tissue of the cheek
Proposed Radiologic landmark for medial boundary of Level II lymph nodes.
perpendicular plane defined by the posterior aspect of the submandibular gland.
Boundaries of level II LNs:
Superior: skull base
Inferior: inferior border of hyoid bone
Anterior (medial)l:
- clinical - stylohyoid muscles
radiologic - vertical plane defined by posterior surface of the submandibular gland.
Posterior (lateral))
Sublevel II A vs. II B: how to differentiate
vertical plane defined by the spinal accessory nerve.
Boundaries of submandibular triangle.
Anterior and Posterior Belly of Digastric.
Body of Mandible.
Corresponding areas which may harbor metastasis: Level IA
Floor of mouth
Anterior oral tongue
Anterior mandibular alveolar ridge
Lower lip
Corresponding areas which may harbor metastasis: Level IB
Oral cavity
Anterior nasal cavity
Soft tissue structures of midface
Submandibular gland
Boundaries of level II LNs:
Superior: skull base
Inferior: inferior border of hyoid bone
Anterior (medial)l:
- clinical - stylohyoid muscles
radiologic - vertical plane defined by posterior surface of the submandibular gland.
Posterior (lateral))
Sublevel II A vs. II B: how to differentiate
vertical plane defined by the spinal accessory nerve.
Boundaries of level III:
SUPERIOR:
Inferior aspect of the hyoid bone (clinical and radiologic); surgical landmark - carotid bifurcation
INFERIOR:
lower border of cricoid cartilage; surgical landmark - junction of omohyoid muscle with he IJV
LATERAL: posterior border of SCM
MEDIAL:
lateral border of the sternohyoid; (radiologic) - lateral borded of common carotid artery
Corresponding areas which may harbor metastasis: Level V
Nasopharynx, oropharynx
Cutaneous structures of scalp and neck
Corresponding areas which may harbor metastasis: Level IA
Floor of mouth
Anterior Oral tongue
Anterior mandibular alveolar ridge
Lower lip
Corresponding areas which may harbor metastasis: Level IA
Oral cavity
Anterior nasal cavity
Soft tissue structures of midface
Submandibular gland
Corresponding areas which may harbor metastasis: Level II A and II B
nasal cavity
nasopharynx,
oral cavity
oropharynx, hypopharynx, larynx
parotid
Corresponding areas which may harbor metastasis: Level III
oral cavity
oropharynx, nasopharynx, hypopharynx, larynx
Corresponding areas which may harbor metastasis: Level IV
Larynx
Hypopharynx
Esophagus
Thyroid
Corresponding areas which may harbor metastasis: Level V
Nasopharynx, oropharynx
Cutaneous structures of scalp and neck
Boundaries of level V:
What separates VA and VB?
SUPERIOR: Apex formed by the convergence of the SCM and Trapezius Muscles
INFERIOR: CLAVICLE
ANTERIOR:
Posterior border of the SCM
POSTERIOR: Anterior border of the trapezius
Boundaries of level VI:
SUPERIOR: Hyoid bone
INFERIOR: Suprasternal notch
LATERAL: Common carotid arteries
Corresponding areas which may harbor metastasis: Level V
Apex of pyriform sinus
Glottic, subglottic larynx
cervical esophagus
Thyroid gland
