Head and neck cancers Flashcards
Symptoms of head and neck cancer?
Sore throat
Dyphonia
Dysphagia
Odynophagia
Mouth/throat ulcer
Neck lump
Smoking/alcohol
Family history
signs of what?
Oral cancer after biopsy
Thyroid bruit sound?
a continuous rushing sound heard over the thyroid gland when a stethoscope is placed on it
Carotid bruit sound?
whooshing sound that can be heard in the neck when blood flows through a narrowed carotid artery. It’s similar to the sound of water rushing in a river
brused and scar, what surgery?
Carotid atheroma removal, failed and leaking blood
Pulsatile soft lump
FNA?
Fine needle aspiration
neck lump, how to investigate?
FNA
head and neck investigations?
FNAC
CT/MRI/PET scan
US scan
Plain X-ray
Contrast Swallow
Endoscopy
PET scan?
Inject pt with radioactive glucose
More active a cell use more glucose and cancer cells will be very active
history f neck lump questions?
- How long?
- Site?
- Fluctuates?
- Sore?
- H&N symptoms?
- B symptoms?
- Travel?
B symptoms?
Systemic stents, not specific site symptoms
Indicative of lymphoma
examine the lump, what are you looking for?
- Site
- Size
- Shape
- Sore
- Skin
- Stuck
- Soft
Malignant lymph node?
NO
Reactive lymph node:
Oval
Soft
Smooth
Mobile
Tender
questions to ask about a hoarse voice?
- How long?
- Persistent or Intermittent?
- Pain?
- Cough/Choking/Swallowing?
- Voice use?
- Asthma/Rhinosinusitis/Reflux?
- Smoker?
- Medication? - things that dry out their mouth
- inhalers from asthma can irritate pharynx
Pt with something nasty, hoarseness is very consistent and persistent . Associated symptoms
left vocal cord not working, what is the cause?
Lungs cancer potatntially
As the recurrent laryngeal moves closely to the carina of the birfurcation of the lungs
reasons for dysphagia?
- Lumen: foreign body
- Wall: tumour, stricture, neuromuscular, pouch
- Extra luminal: Thyroid, Heart, Mediastinal mass
Parkinson’s, MNS, MS… can swallow solid food ok but liquid is difficult
2 categories of H and n disorders?
Benign
Malignant
commonenst malignant cancer of head and neck?
90% squamous carcinoma
Malignant node appearance?
Malignant neck node:
Round
Firm
Irregular
Fixed
Non-tender
Causes of airway obstruction?
Infection, tumour, foreign body
tx for airway obstruction?
Tracheostomy/cricothyroidotomy
