H&N: Cancers Flashcards
What are the common risk factors of head and neck cancers?
- Heavy alcohol use
- Heavy tobacco use
- Age
- Dental hygiene
- Males more than women
- EBV infection
- Chewing betel quid (Paan)
- Occupational/Environemntal exposure to certain inhalants
- Long term exposure to sunlight or sunbeams (lip)
- HPV
What is the common malignancy seen in head and neck cancers?
Squamous cell carcinomas
What is the general presentation of head and neck cancers?
- Unexplained painful and/or mucosal ulceration or lesion within the oral cavity (leukoplakia, eythroplakia, lump)
- Unexplained hoarseness of voice
- Dysphagia or Odynophagia
- Otalgia
- Cervical lymphadenopathy
What are the the typical investigations required to determine diagnosis and severe of HNC or thyroid cancer?
- Clinical examination
- Biopsy
- Imaging
- Endoscopic investigation
What are common causes of neck lumps?
- Thyroid cancer
- Hyperthyroidism
- Hypothyroidism
How is the severity of the HNC determined?
-TMN staging used (stage 1-4)
What is contained in the superficial cervical fascia?
Loose connective tissue containing
- Adipose tissue
- External jugular vein
- Cutaneous nerves
- Superficial lymph nodes
- Platysma muscle
Which structures are contained within the pretracheal fascia?
- Infrahyoid muscles
- Thyroid gland
- Trachea
- Oesophagus
What strutures are invested by the buccopharyngeal fascia?
- Muscles of pharynx
- Muscles of oesophagus
Which structures are found within the carotid sheath?
- Common carotid artery
- Internal jugular vein
- Vagus nerve
Which structures are enclosed by the prevertebral fascia?
- Axillary vessels
- Brachial plexus of nerves
What are the advantages provided by the deep cervical fascia?
- Allow structures to move and pass over one another with ease
- Allow separation of tissues during surgery
- Determine the direction and extent to which any infection occurring within the neck may spread
What are symptoms of a retropharyngeal abscess?
- Visible bulge in the oropharynx
- Sore throat
- Difficulty swallowing
- Stridor
- Reluctance to move neck
- High temperature
Why does the thyroid goitre move upon swallowing?
- Enclosed by pre-tracheal fascia which is attached to hyoid bone
- Hyoid bone and pharynx rise on swallowing so therefore any pathology swelling involving the thyroid moves with the space
What can retrosternal extension thyroid goitre lead to ?
- Compression of the structures running through the root of the neck such as the trachea and venous blood vessels
- Can lead to symptoms of stridor and breathlessness
