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Surgery > Head And Neck > Flashcards

Head And Neck Flashcards

0
Q

Boundaries of anterior triangle

A

Antrior border of scm
Anterior midline of neck
Mandible

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1
Q

Segments of digestive system

A

Pharynx

Esophagus

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2
Q

Contents of anterior triangle

A

Submandibular
Submental
Carotid
Muscular

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3
Q

Content of carotid triangle

A 
Carotid sheath
Common carotid artery
Internal jugular v
Vagus nerve
Carotid sinus and body
Bifurcation
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4
Q

Contents of muscular triangle

A

Infrahyoid
Thyroid
Parathyroid

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5
Q

Parts of posterior triangle

A

Occipital

Supraclavicular

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6
Q

Occipital triangle contains what nerve?

A

CN 11 or spinal accessory n

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7
Q

Most common head and neck malignancy

A

Squamous cell CA

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8
Q

Regardless of the disease, what will be the approach?

A

Diagnostic and therapeutic approach is the same

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9
Q

Approach is the same, what will vary based on the disease?

A

Evaluation of the site of lesion (local, regional, distant spread)

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10
Q

Most common cause of death in ds of head and neck

A

Layngeal CA

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11
Q

9 etiology of ds of head and neck

A

TUPP BITCH

  • tobacco and alcohol
  • betel nut and quid chewer
  • UV light
  • HPV
  • pipesmoking
  • thermal injury
  • plummer vinson syndrome
  • chronic infection
  • immunosuppression
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12
Q

Synergistic rather than additive

A

Tobacco and alcohol

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13
Q

Most common preventable risk factors in the ds of head and nexk

A

Tobacco and alcohol

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14
Q

Smokeless tobacco has 4x increased risk of developing

A

Oral cavity Ca

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15
Q

Induction of _____ mutations with upper aerodigestive tract tumors in px w hx of tobacco use

A

P53

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16
Q

Long term use of betel nut quid is destructive to ____ and highly Cagenic

A

Oral mucosa

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17
Q

This etiology is related to devlt of LIP CA

A

UV light

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18
Q

40% of toncillar ca exhibits evidence of

A

HPV 16 and 18

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19
Q

Presents as a triad of dysphagia esophageal webs, IDA;

A

Plummer vinsons syndrome

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20
Q

PVSyndrome has mucosal atrophy of what

A

Mouth
Pharynx
Esophagus

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21
Q

Example of immunosuppresion that increases risk of ds of head and neck

A

Renal transplant

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22
Q

Patients w HN neoplasm develops a second tumor in the ?

A

Aerodigestive tract

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23
Q

Ways to develop HN second tumor?

A

Synchronous

Metachronous

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24
Q

Incidence and site of second primary tumor depends on? (Metachronous)

A

Site and inciting factors

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25
Q

Secondary lesion in the cervical esophagus would mean a primary lesion at

A

Oral cavity

Pharynx

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26
Q

Laryngeal CA prone to develop

A

Lung Ca

27
Q

N classification is same for most HN tumors except with

A

Nasopharynx

Thyroid gland

28
Q

M clasification:
Mx?
M1?

A

Mx cannot assess

M1 presence of distant metastasis

29
Q

Primary tumor stage (T): tumor invades adjacent structures or skin of face

A

T4A

30
Q

Tumor invades masticator space or encases the carotid A

A

T4B

31
Q

Tumor is 2-4 cm

A

t2

32
Q

Greater chance of node metastasis when?

A

Tumor gt 4mm depth of invasion

33
Q

Metastasis in bilateral or contralateral all nodes <6cm

A

N2c

34
Q

Techniques shown to be accurate in detecting postivie NODE

A

CT scan

mri

35
Q

For distant metastasis technique?

A

Chest xray
LFT
PET

36
Q

For second tumor technique?

A

Bronchoscopy

37
Q

What stage when?
T2, N3, M0
T2, N1, M0

A

Stage IVb

Stage III

38
Q

Pathologic N staging helps in?

A

Detection of occult micro ds;

Determining prognosis

39
Q

Stage 4a?
Stage 4b?
Stage 4c?

A

Advanced all!!
Resectable
Unresectable
Distant metastatic ds

40
Q

When symptoms include hoarseness?

A

Nerve involvement

41
Q

Ct scan is best used in?

A

Evaluating bony destruction

42
Q

Mri best used in?

A

Soft tissue involvement; parotid and parapharyngeal space tumors

43
Q

CXR is done to?

A

Rule out synchronous lung lesions

44
Q

Superior detection of lung metastasis

A

Positron emmision tomo

45
Q

Lymphatic spread if upper lip?

A

Same side

46
Q

Lymphatic spread if lowr lip?

A

Bilateral

47
Q

Anything that is N2

A

Stage Iva

48
Q

Treatment options for early stage ds

A

Surgery

Radiotherapy

49
Q

Late stage treatment?

A

Combination of:
Surgery+radio
Chemo+radio
Or all 3

50
Q

Nodes at risk should be tx surgically vy?

A

Selective neck dissection

51
Q

Primary tumor is removed surgically, if no and n1 involved what should u do?

A

Radiotherapy

52
Q

Gold standard for removal of nodal metastasis

A

Radical neck dissection (classical)

53
Q

Disadvantage of RND

A

Cosmetic
Morbidity
Dysfunction of shoulder

54
Q

If you dissect level 1-5, what other structures do u dissect?

A

Scm
IJV
Spinal accessory n
Submandibular gland

55
Q

Modified radical neck dissection preserves?

A 
Excised in rnd (1 or combi)
scm 
Ijv
Cn11
Submandibular gland
56
Q

MRND is also known as?

A

Functional neck dissection

57
Q

3 types of MRND

A

Type 1
Type 2
Type 3

58
Q

What do you preserve in type 2 mrnd?

A

Cn11

Scm

59
Q

In type 3 mrnd what do you preserve?

A

Cn11
Scm
Ijv

60
Q

Indication for type 2 mrnd?

A

Thyroid CA

Metastatic CA

61
Q

Most tumors of aerodigestive undergo this mrnd?

A

Type 1

62
Q

Neck dissection that preserves lymphatic compartments which is normally removes in Classical

A

Selective ND

63
Q

Factors considered for neck masses

A

Age of px
Etiology (mic)
Location

64
Q

Common neck masses in adults?

A 
Midline masses: DDSL
Dermoid
Delphian
Sebaceous cyst
Lipoma

Surgery (8 decks)

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