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surgery semester 3 > Laryngology, Salivary glands, Endocrine > Flashcards

Laryngology, Salivary glands, Endocrine Flashcards

1
Q

Only vocal abductor and nerve

A

Posterior Cricoarytenoid, inervated by reccurent laryngeal nerve)

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2
Q

Plays biggest role in changing pitch of voice

A

Cricothyroid, (vocal adductor) innervated by superior laryngeal nerve

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3
Q

Where do most malignancies occur in the vocal fold layers?

A

Squamous epithelium

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4
Q

How mich can 1mm of edema in the air reduce the airway?

A

60%

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5
Q

Forced air across a constricted zone causes negative pressure and causes the vocal cords to close again

A

Bernoulli’s effect

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6
Q

Production of speech

A

Phonation

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7
Q

Oral/nasal speech balance

A

Resonation

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8
Q

Use of lips, teeth, tongue to produce speech sounds

A

Articulation

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9
Q

Source of speech energy

A

Respiration

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10
Q

Syllable stress, emphasis, inflection

A

Prosody

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11
Q

Most common test to evaluate speech

A

Videostroboscopy

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12
Q

Why do some pt’s “moan” or “pursed lips” breath?

A

Auto-PEPing

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13
Q

Where is the source of snoring?

A

Nasopharynx

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14
Q

Where is the source of gurgling sounds?

A

Oropharynx

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15
Q

Source of inspiratory stidor

A

Supraglottic

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16
Q

Source of inspiratory or biphasic stridor, hoarseness

A

Glottic

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17
Q

Source of barking cough

A

Subglottic

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18
Q

Expiratory stridor

A

Tracheobrachial

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19
Q

Indications for endoscopy

A

SPECS-R: severity of obstruction, progression of SOB, eating difficulties, cyanosis, sleep apnea, radiologic findings

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20
Q

Indications for tracheotomies

A

Bypass upper airway obstruction, prolonged intubation, pulmonary toilet, protect from aspiration, eliminate dead space with CNS depression

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21
Q

Trach Care

A

New trach = 3-5 days before making trach changes, change INNER cannula every shift/every day, HUMIDITY, minimal amount of cuff pressure to decrease scarring, infections, erosions

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22
Q

Most common congential laryngeal abnormality

A

Laryngomalacia

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23
Q

Most common cause of stridoe in neonate and chronic peds

A

laryngomalacia

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24
Q

S&S of laryngomalacia

A

Intermittent inspiratory stridor, worses with crying or feeding, has a floppy epiglottis that collapses inwards (Monitor)

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25
Q

Trachea collapsing from immature tracheal cartilage

A

Tracheomalacia

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26
Q

Most common vascular anomaly to cause stridor

A

Double aortic arch

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27
Q

Most common vascular anomaly to compress the digestive tract

A

Retroeosophageal right subclavian artery

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28
Q

High pitched stridor, mental retardation, microcephaly, narrowed endolarynx and interarytenoid cleft

A

Cri Du Chat, deletion of short arm of chromosome 5

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29
Q

Dysphagia, drooling, dyspnea in >1y/o

A

Epiglottitis, is true emergency, cuased by H. Flu

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30
Q

Dx epiglottitis

A

Thumb sign on lateral XR

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31
Q

Barky cough, inspiratory or biphasic stidor, NO drooling or dysphagia

A

Croup, caused by parainfluenza 1 virus

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32
Q

Dx of croup

A

Steeple sign with narrowed subglottis

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33
Q

Second most common cause of hoarseness in children

A

Recurrent respiratory papillomatosis, HPV 6 and 11

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34
Q

Most common head and neck neoplasm in children

A

Hemangioma

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35
Q

Tx for hemangioma

A

usually goes away, can give beta blockers

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36
Q

Sacoidosis: effect on larynx

A

Most commonly epiglottis

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37
Q

Wegeners granulomatosis: effect on larynx

A

Most commonly subglottis

38
Q

Amyloidosis: effect on larynx

A

Anterior subglottic mass

39
Q

RA arthritis: effect on larynx

A

Criocoarytenoid joint affected, causes hoarse voice

40
Q

If bilateral contact ulcers in the middle and anterior third of vocal cords

A

Vocal cord abuse and trauma

41
Q

Unilateral “bump” on vocal cord

A

Vocal cord polyp

42
Q

Most common causes of vocal cord paralysis

A

Neoplastic causes

43
Q

Unilateral vocal cord paralysis

A

Breathy, hoarse voice

44
Q

Bilateral vocal cord paralysis

A

Stridor, dyspnea

45
Q

ADDuctor spasmodic dysphonia

A

More common, sudden stop of voice

46
Q

ABDuctor spasmodic dysphonia

A

Pt sounds breathy, botox posterior cricoarytenoid muscle

47
Q

Results from histamine-mediated urticarial reactions

A

Aquired laryngeal angioedema

48
Q

C1 esterase inhibitor deficiency

A

Congenital laryngeal angioedema

49
Q

Polypod degeneration of superficial lamina propria

A

Reinkes space edema, in smokers!

50
Q

Mainly serous gland

A

Parotid gland, stensons duct and facial nerve

51
Q

Mixed serous and mucinous gland

A

Submandibular gland, whartons duct, facial/lingial artery, hypoglossal nerve

52
Q

Mainly mucuous gland

A

Sublingual gland, ducts of rivinus

53
Q

Tx of ptyalism and sialorrhea

A

Anticholinergics

54
Q

What risk does xerostomia pose?

A

dental carries

55
Q

Most common cause of acute sialadentis

A

Staph aureus

56
Q

Acute salivary gland infection

A

Acute sialadentis

57
Q

Stone in salivary gland duct

A

Acute sialoLITHiasis

58
Q

Bilateral painful parotic swelling

A

Mumps, paramyxovirus

59
Q

Firm enlargement of submandibular gland, cirrhotic changes with destruction of acinar cells

A

Kuttner Tumor

60
Q

Dry eyes, xerostomia, partoic swelling

A

Sjogren Syndrome, associated with non-hodgkins lymphoma

61
Q

Cyst that extends into cervical tissues and may look like a neck mass

A

Plunging Ranula

62
Q

If a tumor is found in a small gland…

A

The more likely it is malignant

63
Q

Most common salivary gland malignancy in children

A

Mucoepidermoid tumor

64
Q

Most common tumor of each gland

A

Pleomorphic ademoa

65
Q

Second most common salivary gland tumor

A

Warthin Tumor

66
Q

Signs of salivary gland malignancy

A

Solitary nodule, facial nerve involvement, pain, trismus, cervical lymphadenopathy

67
Q

Most common submandibular and minor salivary gland malignancy

A

Adenoid cystic carcinoma

68
Q

Injury to auriculotemporal nerve results in aberrant innervation of cutaneous sweat glands, results in sweating while eating

A

Frey Syndrome

69
Q

Stored in the thyroid

A

T3 and T4

70
Q

What does TSH do?

A

Increases iodide uptake

71
Q

Excess Iodine inhibits thyroid hormone

A

Wolff-Chaikoff effect

72
Q

Effects of thyroid hormone

A

Elevates metabolic rate, releases steriod hormones, stimulates erythopoiesis, increases sympathetic activity

73
Q

Free T4 is specific for…

A

hypo/hyperthyroidism

74
Q

TSH is most sensitive test for…

A

primary hypo/hyperthyroidism

75
Q

FNA indication

A

> 5mm…do if high risk or suspicious nodule

76
Q

Bethesda grading system for thyroid pathology

A

1: need better specimen, 2:benign, 3:atypia or redo FNA, 4: follicular neoplams, so surgical lobectomy, 5:suspicious for cancer so thyroidectomy, 6:malignant so thyroidectomy

77
Q

Most common FNA cytology result

A

Papillary cells: papillary carcinoma, but not necessarily bad prognosis, see Psammoma bodies

78
Q

2nd most common FNA cytology result

A

Follicular cells: Common, not necessarily a bad prognosis, most common in elderly females

79
Q

Aggressive FNA cytology result

A

Bizarre cells, suggests anaplastic carcinoma, in elderly, grows and erodes thru trachea

80
Q

Decreased uptake of thyroid radionucleotide studies

A

Graves disease and hyperthyroidism

81
Q

High risk thyroid neoplasia pts

A

AMES, Age (>41males, >51 females), metastatis, extent, size (>5cm)

82
Q

Most common thyroid cancer

A

Papillary carcinoma, most common in young females, increased risk with radiation exposure and Gardner syndrome

83
Q

Genes associated with Medullary Thyroid Carcinoma

A

MEN IIA/B mutation, RET-3 oncogene association

84
Q

S&S of medullary thyroid carcinoma

A

elevated calcitonin and CEA

85
Q

Thyroid Storm

A

Acute extreme state of thyrotoxicosis, sudden fever, profuse sweating, tachycardia, nausea, abd pain, tremors, restless, psychosis, coma, stupor,NEED IMMEDIATE IODINE

86
Q

Cause of goiters

A

Iodine deficiency, iodine excess, lithium, thyroid hormone resistance

87
Q

Thyroid stimulating immunoglobins stimulate hyperplasia from TSH, leading to unregulated overproduction of thyroid hormones with no negative feedback to turn off

A

Graves disease

88
Q

Tx of Graves disease

A

I131, propranolol, subtotal thryoidectomy

89
Q

Most common painful thyroiditis, presents usually with malaise or flu-like illness prior to pain

A

De Quervain, aka subactue granulomatous thyroiditis

90
Q

Most common cause of hypothyroidism, chronic autoimmune

A

Hashimoto thyroiditis

surgery semester 3 (3 decks)

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