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Principles and Procedures > H+N pt. 1 > Flashcards

H+N pt. 1 Flashcards

1
Q

What portion of head and neck cancer patients present with early-stage disease?

A

1/3

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2
Q

2/3 of oral/pharynx present with locally advanced disease at what sites? What are the most common stages of these occurrences?

A

Primary Site and Cervical Node, Stage III and IV

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3
Q

What are the common site of metastasis for head and neck cancers? (5 answers)

A

Lung is the most common, Mediastinal Nodes, Liver, Brain, and Bone

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4
Q

In what specific cancers is distant metastasis a common occurrence? (2 answers)

A

Hypo and Nasopharynx

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5
Q

What is the path of spread for head and neck cancers? (1 answer)

A

Nerves

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6
Q

What is the treatment standard for H&N patients that have inoperable or unresectable tumors/ Stage III and IV?

A

Chemotherapy and Radiation Therapy

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7
Q

What is the definition of cancerization?

A

The prevalence of a second cancer resulting from treatment in the area of the original disease

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8
Q

What percentage of H&N Patients have a risk of developing second cancer after being cured of their first cancer?

A

Greater than 20%

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9
Q

What is the leading cause of death in patients with early H&N tumors?

A

Second Primary Tumor

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10
Q

What is the five-year survival rate of H&N Cancer?

A

60%

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11
Q

What age groups does oral cancer commonly affect?

A

55-64 YO

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12
Q

What age groups does laryngeal cancer commonly affect?

A

65-74 YO

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13
Q

What is the cause of the higher prevalence of nasopharynx cancer in Asian nations? (2 answers)

A

Diet with high salt and Tobacco use

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14
Q

What is the cause of the higher prevalence of Oral cancer in Indian nations? (1 answers)

A

Betel Nut Chewing

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15
Q

What are the etiologic factors of H&N Cancer? (3 answers)

A

Smoking, Alcohol, and Tobacco use

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16
Q

What can smokeless tobacco cause besides malignancy?

A

Pre-malignant lesions known as Leukoplakia, which are white patches

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17
Q

What are the environmental etiologic factors of H&N Cancer? (4 answers)

A

Outdoor occupations, Furniture working, fumes, formaldehyde

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18
Q

What are the radiation etiologic factors of H&N Cancer?

A

Exposure at a young age affecting the thyroid and salivary gland

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19
Q

What are the virus etiological factors of H&N Cancer? (3 answers)

A

Epstein Barr Virus (EBV), Herpes Simplex 1, HPV

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20
Q

What is the pattern of prognosis from the lips to hypopharynx?

A

decreases as you go backwards

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21
Q

In what situations is prognosis unfavorable for those having Head and Neck cancer? (4 answers)

A

Disease that: Cross the midline, exhibit endophytic growth, are poorly differentiated, present as Non-squamous Cell carcinomas

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22
Q

For advance H&N cases, what best describes their LN, tumor and invasion behavior? (3 answers)

A

Fixed Lymph Nodes, Fixed Lesion or Fixed cranial nerve involvement

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23
Q

What is special about the organ and structure included in the H&N region? (2 answers)

A

Serve dual purpose in the respiratory and digestive systems

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24
Q

What is the staging of H&N cancer based on? (1 answer)

A

involvement of adjacent structure

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25
Q

What is the circular region located between the nasal cavity, nasopharynx and oropharynx?

A

Waldeyers region

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26
Q

What is the significance of tumor development within the lower nasopharynx to the upper oropharynx region?

A

Tumors can interfere with the natural response of the soft palate to keep food from entering the nasal passage and also restrict air passages

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27
Q

Describe tonsils and their purpose.

A

Tonsils are a band of lymphoid tissue, they provide protection against airway infection and form a barrier between the aerodigestive tract

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28
Q

What is the vertebral level of the inferior margin of the nasopharynx?

A

C1

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29
Q

What is the vertebral level of the Oropharnyx?

A

C2-C3

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30
Q

What is the vertebral level of the Epiglottis?

A

C3

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31
Q

What is the vertebral level of the true vocal cord?

A

C4

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32
Q

What are some effects of salivary gland tumors? (3 answers)

A

facial paralysis, neuropathy, and interruption of blood supply

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33
Q

What is Cranial Nerve I

A

Olfactory Nerve

34
Q

What is Cranial Nerve II

A

Optic Nerve

35
Q

What is Cranial Nerve III

A

Oculomotor Nerve

36
Q

What is Cranial Nerve IV

A

Trochlear Nerve

37
Q

What is Cranial Nerve V?

A

Trigeminal Nerve

38
Q

What is Cranial Nerve VI?

A

Abducens Nerve

39
Q

What is Cranial Nerve VII?

A

Facial Nerve

40
Q

What is Cranial Nerve VIII?

A

Vestibulocochlear Nerve

41
Q

What is Cranial Nerve IX?

A

Glossopharyngeal Nerve

42
Q

What is Cranial Nerve X?

A

Vagus Nerve

43
Q

What is Cranial Nerve XI?

A

Accessory Nerve

44
Q

What is Cranial Nerve XII?

A

Hypoglossal Nerve

45
Q

What portion of the body’s lymphatics are located in the head and neck region?

A

nearly 1/3

46
Q

What pattern does lymphatics of the head and neck drain, ipsilateral or bilateral?

A

Mainly Ipsilateral

47
Q

How many regions are the head and neck lymphatics divided into?

48
Q

What head and neck lymphatics are included in the first region? (2 answers)

A

Submental and Submandibular

49
Q

What head and neck lymphatics are included in the second region? (3 answers)

A

Superior Jugular, Superior spinal accessory, Jugulodigastric

50
Q

What head and neck lymphatics are included in the third region? (1 answer)

A

Midjugular

51
Q

What head and neck lymphatics are included in the fourth region? (2 answers)

A

Inferior Jugular and Jugulo-omohyoid

52
Q

What head and neck lymphatics are included in the fifth region? (2 answers)

A

Inferior Spinal Accessory and Transverse Cervical

53
Q

What head and neck lymphatics are included in the sixth region? (2 answers)

A

Paratracheal and Pre-tracheal

54
Q

What is the other name for the jugulodigastric node?

A

Subdigastric node

55
Q

What is the other name for the node of rouviere?

A

Lateral Retropharyngeal node

56
Q

What is the other name for the Spinal Accessory chain?

A

Posterior Cervical Lymph chain

57
Q

What is the other name for the Mastoid Node?

A

Retroauricular

58
Q

What dictates the size of radiation portal and treatment plan for H&N patients? (1 answers)

A

Degree of nodal involvement

59
Q

What is the H&N node to which most of the drainage flows through?

A

Jugulodigastric

60
Q

Most H&N cancers are ___ lesions found in the _____ lining.

A

Infiltrative and Epithelial

61
Q

What is the definition of indurated?

A

Endophytic, more aggressive, harder to control

62
Q

What is the definition of exophytic?

A

Noninvasive neoplasm with raised, elevated borders

63
Q

what percentage of patients present with otalgia?

64
Q

How can you manually detect H&N cancers? (3 answers)

A

Palpation, Direct Inspection, Biopsy

65
Q

What are some examinations used to diagnose H&N cancers? (2 answers)

A

Indirect laryngoscopy and Fiber Optic Endoscopy

66
Q

What is the advantage of using PET for H&N cancers? (2 answers)

A

High sensitivity and specificity, helpful for locally advanced disease

67
Q

What is the primary histology of H&N cancers?

A

Squamous Cell Carcinomas

68
Q

What is the primary histology of salivary gland cancer?

A

Adenocarcinoma

69
Q

What are the four types of squamous cell carcinomas presented in H&N cancer?

A

Lymphoepithelioma, spindle cell carcinoma, Verrucous Carcinoma, Undifferentiated carcinoma

70
Q

What factors are used in the staging of H&N cancers? (3 answers)

A

Size, Extent, and Positive Nodes

71
Q

Prior to IMRT, large ports were used to treat H&N cancer due to the risk of nodal spread. True or False?

72
Q

What are the two main options of treatment for H&N cancers?

A

Radiotherapy and Surgery

73
Q

What are the three goals when considering treatment options for H&N cancers?

A

Eradicate disease, maintain function and preserve cosmesis

74
Q

What are the factors that are involved when determining treatment? (6 answers)

A

Age, General Condition, Comorbidity factors, habits and lifestyle, occupation, desires

75
Q

What is the importance of surgery during the staging process for H&N Cancers?

A

crucial to understanding the microscopic extent of the disease

76
Q

Surgical resection and reconstruction has shown to have not the best outcomes with early stage diseases. True or False?

A

False, it shows good outcome

77
Q

What is the name of the removal of the larynx and reconstruction of the trachea?

A

Laryngectomy and Tracheostomy

78
Q

What is the gold standard treatment for neck disease?

A

Radical Neck Dissection

79
Q

What is the issue with giving radiotherapy after surgery in H&N patients? (2 answers)

A

difficulty healing wounds as decreased blood flow, impaired cellular composition (collagen and leukocytes)

80
Q

What are the most utilized techniques for H&N Cancers?

A

3DCRT and IMRT

81
Q

What are some crucial requirements during patient positioning for H&N therapy? (3 answers)

A

Bringing the shoulders down and out of the field, maintain the head and body in the same position everyday, moving certain structures out of the field such as tongue, jaw and etc.

Principles and Procedures (27 decks)

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