Head and Neck Flashcards
ant to posterior
sub v, phrenic n, ant scalene, subclavian artery, middle scalene
ant triangle ant border
ant border midline neck
post boundery anterior triangle
SCM
inferior/apex of ant triangle
sternal notch
superior border of ant triangle
lower border of mandible
contents of anterior triangle
carotid sheath
post neck triangle boundaries
ant- SCM, post- trapezius, base middle third clavicle, apex- intersection of SCM and trapezius
main content post triangle
spinal accessory nerve
recurrent laryngeal n fxn
all muscles of larynx except cricothyroid muscle which is innervated by superior laryngeal nerve
RLN on left
loops behind aortic arch
RLN on right
loops behind subclavian artery
SCC of head and neck risks
alcohol and tobacco, Male > female
SCC tx stage 1 or 2
surgery or radiation
SCC tx stage 3 or 4
surgery followed by radiation or chemo
size cut off for oral SCC
4 cm or other concerning features
if concerning features of > 4cm
resection with MRND, post op radiation
malignant salivary gland
usually small glands
MC salivary malignant tumor
mucoepidermoid cancer
MC benign salivary tumor
pleomorphic adenoma
mucoepidermoid salivary tumor tx
resection, modified radical neck dissection, post op radiation
adenoid cystic cancer
slow growing with local invasion especially nerves
tx adenoid cystic cancer
resection, MRND, radiation (very sensitive to radiation)
isolated cancer in lymph node
neck exam, fiberoptic laryngoscopy, biopsies of LN or excision, CT of head and neck, then consider PET scan, then OR for ipsilateral tonsillectomy
if no primary found after isolated + LN
ipsilateral MRND, bilateral XRT
