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ABSITE > head and neck > Flashcards

head and neck Flashcards

1
Q

Freys syndrome

A

gustatory sweating; after parotidectomy (injury to auriculotemporl N that cross innervates sympathetics)
causes aberrant regeneration of parasympathetics

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2
Q

ant to post thoracic outlet

A

SCV > phrenic > ant scalene > SCA > brachial plexus > middle scalene

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3
Q

how does phrenic N run over anterior scalene?

A

lateral to medial

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4
Q

thyrocervical trunk STAT

A

suprascapular aa, transverse cervical aa, ascending cervical aa, inferior thyroid aa

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5
Q

congenital bony mass on upper and lingual mouth

A

upper palate: torus palatini (mgmt: nothing)
lingual mandible: torus mandibular (mgmt nothing)

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6
Q

modified radical neck dissection vs radical neck dissection

A

modified: omohyoid, submandibular gland, sensory nerves C2-C5, cervical branch of CN VII facial, and ipsilateral throid lobe

radical that plus CN XI accessory, SCM, and iJ

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7
Q

general w/u of primary HNSCC without known organ?

A
  1. exam with fiberoptic exam
  2. FNA or excisional node bx
  3. DL + EGD + Ipsilateral tonsillectomy
  4. if can’t find primary, do ipsilateral MRND and bilateral XRT
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8
Q

SCC chemotherapeutic

A

5FU and cisplatin

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9
Q

HNSCC

A

5th MC; M>F; EtOH and tobacco is SYNERGISTIC

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10
Q

HNSCC mgmt

A

wide resection 1 cm (.5-1 for all other)
modified radical neck if >4 cm, clinical nodes, bone invasion
adjuvant radiation for >4cm, positive mrgins, node positive

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11
Q

syndrome ass’d HNSCC ORAL

A

plummer vinson syndrome; glossitis, cervical dysphagia, esophageal web, spoon fingers, Fe def anemia

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12
Q

lip flaps required if?

A

> 1/3 lip resected, btk’24 says 1/2

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13
Q

nasopharyngeal SCC

A

EBV, Chinese,
goes to POSTERIOR cervical neck nodes
mgmt: chemoRADIATION**

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14
Q

oropharyngeal SCC

A

mgmt: <4cm: radiate
>4cm: reect, RMND and radiation
goes to POSTERIOR NODES

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15
Q

hypopharyngeal SCC

A

to ANERIOR cervical ndoes; same mgmt as oropharyngeal

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16
Q

nasopharyngeal angiofibroma

A

BENIGN.
M<20 YO, very vasculr
mgmt: embolize (internal maxillary aa) then resect

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17
Q

laryngeal ca

A

sx: hoarse, dysphagia, aspiration
PRESERVE LARYNX
mgmt: XRT if vocal cord only, add chemo if beyond vocal cordsali

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18
Q

salivary gland tumor

A

smaller = more malignant

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19
Q

MC salivary gland tumor location

A

PAROTID GLAND

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20
Q

tx mucoepidermoid cancer

A

resect with MRND +/- postop XRT
preserve CN VII if parotidectomy

21
Q

tx adenoid cystic cancer

A

(watch out: invades NERVES)
resect + MRND +/- postop XRT…. VERY SENSITIVE TO XRT

22
Q

preauricular tumor

A

must rule out parotid tumor but don’t want to enucleate…

so diagnostic SUPERFICIAL PAROTIDECTOMY

23
Q

MC malignant tumor of salivary glands

A

mucoepidermoid

24
Q

MC tumor overall of salivaries

A

pleomorphic adenoma
mgmt; superficial partoidectomy

25
Q

MC injury during parotid surgery

A

greater auricular nerve

26
Q

MC injury during submandibular gland surgery

A

marignal mandivular nerve (drooop in corner)

27
Q

cholesteatoma

A

epidermal inclusion cyst of ear… erode and present with conductive hearing loss and clear drainage from ear

28
Q

mgmt cholesteatoma

A

resect possibly also mastoidectomy

29
Q

chemodectomya

A

vascular tumor of mdidel ear
resect

30
Q

bleeding from posterior nose

A

internal maxillary aa or ehtmoid artery

31
Q

peritonsillar abscess mgmt

A

no airway issues…
needle aspirate and if still bad, drain into mouth (tonsillar bed)

32
Q

retropharyngeal abscess patient

A

<10 yearsor Pott’s disease older

33
Q

retropharyngeal abscess mgmt

A

AIRWAY (may need intubation) , drain through posterior pharyngeal wall

34
Q

parapharyneal abscess

A

mediastinal spread via prevertebral and retropharyngeal spaces

drain through lateral neck to avoid carotid and IJ

35
Q

ludwig angina

A

floor of mouth infection involving mylohyoid

36
Q

neck mass

A

FNA > panednoscopy > CT scan> excisioanl bx +/- ipsi MRND and tonsillectomy followed by radiation

37
Q

warthin tumor

A

benign partoid tumor (smokers, old people) b/l usually
FNA: cyst fluid
mgmt: watchful waiting vs superifial parotidectomy/WLE (not full thing

38
Q

intraop facial nerve monitoring

A

helps with decreased transient nerve paralysis; but no change in permanent paralysis

39
Q

anterior triangle boundaries

A

SCM, mandible, midline; has carotid sheath

40
Q

posterior triangle boundaries

A

SCM, trap, 2nd third of clavicle; has CN XI

41
Q

RLN function

A

motor of LARYNX except cricothyroid (SLN)

42
Q

RLN course

A

R: ant to SCA loops behind and travels in TE groove
L: ant to aortic arch between Left common carotid and SCA and loops behind arch up in TE groove

43
Q

H&N melanoma dx

A

FULL THICKNESS (no shave) bx

44
Q

mgmt melanoma H&N

A

resect with same margins as other sites 1 - <1mm, 2 - >2 mm

45
Q

how do melanomas drain in face

A

tragus line -
anterior: superfiical partoidectomy (drains to parotid) + selective ant neck dissection

posterior: selective posterior neck dissection without parotidectomy

46
Q

vocal cord disruption after emergent intubation?

A

thyroid cartilage fracture

47
Q

optimal trach placement? to avoid TIF

A

between 2nd and 3rd cartilage

48
Q

when to operate on facial N?

A

within 72 hours… if lateral to lateral canthus
otherwise nonop if medial

49
Q
A

ABSITE (37 decks)

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