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Head And Neck > Larynx And Pharynx > Flashcards

Larynx And Pharynx Flashcards

1
Q

What is the superior border of the larynx?

A

Epiglottis and the aryepiglottic folds

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2
Q

What is the inferior border of the larynx?

A

Inferior rim of the cricoid cartilage

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3
Q

What is the lining of the larynx in the newborn?

A

Columnar ciliated epithelium

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4
Q

What are the true cords lined by?

A

Nonkeratinized squamous epithelium

Also the seromucinous glands are decreased or absent here

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5
Q

What is the exception of the lamina propria in the vocal cords?

A

Few, if any lymphatic channels are found

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6
Q

What forms most of the anterior surface of the larynx?

A

Thyroid cartilage

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7
Q

What is the only complete ring and forms most of the posterior support of the larynx?

A

Cricoid cartilage

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8
Q

What is different about the epiglottis?

A

It is elastic cartilage while the others are hyaline cartilage which ossifies with age

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9
Q

What can cause a contact ulcer and where do they occur?

A

Endotracheal intubation, acid reflux, vocal cord abuse (shouting, coughing)
Occurs posterior portion of one or both sides of the glottis

Presents with hoarseness, coughing, and pain

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10
Q

Where are vocal cord polyps usually located? How do they differ from nodules?

A

Unilateral, anterior third of the vocal cord and less than 5 mm in size
Nodules are usually bilateral and occur slightly more posterior at the border of the anterior and middle third of the vocal cord

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11
Q

What are some nonneoplastic cysts of the larynx?

A

Laryngoceles, saccular cysts, ductal cyst

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12
Q

What is a laryngocele?

A

A cystic dilation of the saccule of morgani, communicate with the larynx, and are air filled

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13
Q

What are saccular cysts?

A

They also occur at the laryngeal saccule but do not communicate with the larynx and are filled with mucin

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14
Q

What part of the larynx may be affected in sarcoidosis?

A

Supraglottic larynx

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15
Q

What is a good histologic clue for dysplasia in the larynx?

A

Dyskeratotic cells

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16
Q

What molecular abnormality is associated with worsening atypia and invasion?

A

LOH at 3p and 9p, p53 mutations
Over expression of cyclin D1 and EGFR
And others

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17
Q

What should not be seen in verrucous carcinoma?

A

No infiltrating nests of tumors should be present

18
Q

What does a foreign body reaction look like in the larynx and what causes it?

A

Foreign body giant cell reaction that is walled off by fibrous tissue
Caused by Teflon used as a synthetic substance injected into a paralyzed vocal cord
The giant cells contain birefringent clear material present intermixed with chronic inflammation and fibrosis
Other materials such as silicone, gore-Tex and titanium can be used

19
Q

What can cause granulomas in the larynx?

A

TB, leprosy, histo, blastomycosis, cocci, candidiasis, rhinoscleroma, sarcoidosis, wegener’s, foreign body reaction, amyloidosis, necrobiosis (rheumatoid nodules), crohn’s disease

20
Q

What is the characteristic of leprosy in larynx?

A

Painless and develop supraglottically and progress to the glottis
Appear nodular and ulcerated and can lead to stenosis
Mixture of chronic inflammatory cells and large, foamy macrophages

21
Q

What does a rheumatoid nodule look like in the larynx?

A

Necrobiotic collagen nodules with central fibrinoid necrosis surrounded by palisading histiocytes with some lymphocytes and occasional multinucleated giant cells

22
Q

What does eosinophilic angiocentric fibrosis?

A

Fibrosis that wraps around blood vessels and has numerous eosinophils
IgG4-related sclerosing disease

23
Q

What is absent from pseudoepitheliomatous hyperplasia that will keep you from thinking true invasion?

A

Severe cytologic atypia and dyskeratosis should not be seen

24
Q

What can you look for in necrotizing sialometaplasia to keep from diagnosing cancer?

A

Retains a lobular architecture and should have intact myoepithelial layer
May have some cytologic atypia

25
Q

What lesion in the upper aerodigestive tract is more likely to have squamous dysplasia and concurrent SCC?

A

Speckled and red lesions (erythroplakia)

26
Q

How does severe dysplasia due to smoking differ from HPV?

A

Smoking - maintains some surface maturation and keratinization
HPV - basaloid appearance without surface keratinization or scattered dyskeratotic cells

27
Q

What are some variants of SCC??

A

Verrucous, papillary, basaloid, spindle cell, adenosquamous, adenoid and undifferentiated

28
Q

What is the metastatic potential of verrucous carcinoma?

A

None

29
Q

With GERD being a cause of contact ulcer, what is responsible for the damage?

A

Pepsin

30
Q

How do cyst in the larynx generally form?

A

Repeated increases of intralaryngeal pressure, infection, trauma or in association with tumors

31
Q

What is the most common benign laryngeal tumor? And how are they divided?

A

Squamous papilloma
Juvenile and adult type
Peak age at 5 and then again at 20-40

32
Q

What subtypes of HPV most commonly cause laryngeal papilloma?

A

HPV 6 and 11

33
Q

How do granular cell tumors appear grossly?

A

Smooth, round, polyploid-sessile, firm, homogeneous, and generally < 2 cm, cut surface reveals grayish -yellow color

34
Q

What does granular cell tumors look like histologically?

A

Acanthosis and pseudoepitheliomatous hyperplasia
Usually no pleomorphism, increased mitoses or necrosis
Islands of cells are separated by dense fibrovascular tissue
Granules that are PASD

35
Q

What are the granules in granular cell tumor?

A

Lysosomes

36
Q

How is the larynx subdivided?

A

Based of the relative location of the glottis
Supraglottis, glottis, and subglottis
The true vocal cord and the anterior commissure comprise the glottis

37
Q

Where are the paraganglia located in the larynx?

A

The superior paraganglia are located in the false cords

The inferior paraganglia are located near the cricoid cartilage

38
Q

Where in the larynx does sarcoidosis occur?

A

Supraglottic

39
Q

What may wegener lead to in the larynx?

A

Subglottic stenosis

40
Q

What is tracheopathica osteoplastica?

A

Affects men over 50
Presents as hemoptysis, cough, wheezing or hoarseness
Due to islands of hyaline cartilage or lamellar bone present as cobblestone of hard, irregular nodules in larynx lumen

Head And Neck (6 decks)

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