H&N Week 7

Question 1

aetiology for omf surgery

Answer 1

assault
fall
sports
rta
industrial
self harm

Question 2

scope of omf surgery

Answer 2

dentoalveolar
trauma hard and soft tissue
craniofacial surgery
cleft lip and palate surgery
salivary gland surgery
TMJ disorders
facial pain

Question 3

midface trauma

Answer 3

zygoma
maxilla
naso/orbital/ethmoidal

Question 4

orofacial swelling

Answer 4

usually odontogenic infection
threat to airway

Question 5

oral malignancy

Answer 5

“head and neck cancer”
>90% squamous cell carcinoma

Question 6

5 year survival rates by stage

Answer 6

stage I - 86%
stage II - 76%
stage III - 44%
stage IV - 20%

Question 7

worrying signs

Answer 7

area of redness
combined (speckled) white/red lesion
indurated area of ulceration
area of ulceration which has been present for 3wks or more should be viewed as sus
a new area of melanin pigmentation should also be regarded as sus

Question 8

management of oral malignancy

Answer 8

MDT management
MF surgeon/ENT surgeon
oncologist
restorative specialist
specialist nurses
speech and language therapist
physio

Question 9

oral mucosa

Answer 9

mucous membrane that covers all structures inside the oral cavity except teeth
varies in colour from pink to brownish purple depending on an individual’s skin colour

Question 10

what do you find on floor of mouth

Answer 10

lingual frenulum
sublingual folds

Question 11

where do sublingual folds end

Answer 11

sublingual papillae at the base of the lingual frenulum

Question 12

what opens into the sublingual papilla

Answer 12

duct for submandibular gland - Wharton’s duct

Question 13

what is the submandibular gland duct called

Answer 13

Wharton’s duct

Question 14

healthy tongue

Answer 14

flexible muscular organ
rough texture is produced by tiny papillae - filliform, fungiform, foliate, circumvallate
sensory nerves - lingual
taste - chorda tympani
motor nerve - hypoglossal

Question 15

what nerve is tongue innervated by

Answer 15

hypoglossal

Question 16

candidiasis

Answer 16

overgrowth of candida albicans

Question 17

oral thrush

Answer 17

acute fungal infection
white patches that can be easily removed to reveal underlying red areas of inflammation (not AIDS) (pseudomembrane)
may be painful

Question 18

other candida assoc lesions

Answer 18

chronic hyperplastic candidiasis
commissure
smokers
may see dysplasia
anti-fungals can help but try and stop smoking

Question 19

minor ulcers

Answer 19

affect non-keratinised sites usually cheek floor of mouth and labial mucosa 1-5 ulcers (2-4mm) at any one time
heal in 2 weeks

Question 20

major ulcers

Answer 20

typically affect posterior part of mouth, up to 1cm in diameter prolonged healing (several weeks)
may scar

Question 21

contributory factors to ulcers

Answer 21

haematinic deficiencies
stress
trauma to oral mucosa
menstruation
hereditary

Question 22

treatment of ulcers

Answer 22

symptomatic
antiseptic mouthwash
tetracycline mouthwashes
topical steroid prep

Question 23

prognosis of ulcers

Answer 23

recurrent condition

Question 24

xerostomia

Answer 24

dry mouth
due to reduced or absent saliva flow
symptom of certain med conditions
side effect of a radiation to the H&N
side effect of a variety of meds

Question 25

clinical features of xerostomia

Answer 25

severe tooth destruction (decay and erosion)
dry atrophic and fissured tongue
mucosal soreness and infections
no salivary pool
parotid gland enlargement
inflam and fissuring of lips (cheilitis)
oral candidiasis
salivary gland infection

Question 26

cause of herpes labialis

Answer 26

reactivation of herpes simplex virus from trigeminal ganglion

Question 27

clinical features of herpes labialis

Answer 27

vesicular, ulcerated or crusting lesion which typically affects mucocutaneous junction of lip
often preceded by prickling sensation

Question 28

white patch

Answer 28

leukoplakia

Question 29

red patch

Answer 29

erythroplakia

Question 30

videofluroscopy

Answer 30

functional v mechanical
speech therapist in attendance
diff consistencies of barium
Blom-Singer valve assessment

Question 31

ultrasound

Answer 31

solid v cystic
vascularity (Doppler)
US guidance guided FNA

Question 32

characterising lymph nodes

Answer 32

features of benign of lymph nodes
cystic nodes
microcalcification in thyroid mets