lymphatics

Question 1

majority of the lymph drainage into what duct? then into?

Answer 1

thoracic duct then into the left subclavian vv

Question 2

lymph nodes relative vessels in and out

Answer 2

LN have multiple vessels returning lymph entering them but only one vessel leaving to return the fluid to circulation

Question 3

typical lymph drainage pattern from the oral cavity, exception

Answer 3

usually down and in towards the internal jugular, crossover can occur but not always

Question 4

why is SCC common in the floor of the mouth

Answer 4

common with tobacco use and alcohol> mostly accumulate on the floor of the mouth=increased exposure

Question 5

typical lymph drainage patterns at the tongue

Answer 5

ant 2/3: anterior drainage

post 1/3: posterior drainage

Question 6

lymph nodes/gland confusion

Answer 6

entirely possible to palpate a mass and have it be either a LN or gland as the salivary glands often have LN associated with them

Question 7

staging and grading tumors, primary indicator?

Answer 7

• Stage and grade determine prognosis
• Staging reflects the clinical extent of the tumor
• Grading a tumor reflects its histologic subtype
• Of the two, staging is the primary indicator of prognosis

Question 8

grading tumors

Answer 8

• Degree of differentiation exhibited by cells
• How closely cells resemble normal tissue structure
• Grade I – low grade
• Grade II – moderately differentiated
• Grade III – poorly differentiated

Question 9

staging tumors

Answer 9

• Based upon the size and extent of metastatic spread of the lesion
• Tumor-node-metastasis (TNM) system used for most cancers

Question 10

Staging – TNM system components

Answer 10

• Size, in cm, of the tumor (T)
• Involvement of lymph nodes (N)
• Presence or absence of distant metastasis (M)

Question 11

T of staging classes

Answer 11

TX: No information available on primary tumor
T0: No evidence of primary tumor/ tumor not found
Tis: Carcinoma in situ at primary site
T1: Tumor less than 2 cm
T2: Tumor 2-4 cm in diameter
T3: Tumor greater than 4 cm
T4: Tumor has invaded adjacent structures

Question 12

Staging – “N” classes

Answer 12

NX: Nodes not assessed
N0: No clinically positive nodes (not palpable)
N1: Single clinically positive ipsilateral (on same side) node less than 3 cm
N2: Single clinically positive ipsilateral node 3 to 6 cm; or Multiple ipsilateral nodes with all less than 6 cm; or bilateral or contralateral nodes with none greater than 6 cm
N3: Node or nodes greater than 6 cm

Question 13

Staging – “M” classes

Answer 13

MX: Distant metastasis not assessed
M0: No distant metastasis
M1: Distant metastasis is present

Question 14

Stage 0 TMN classes

Answer 14

0 Tis, N0, M0

Question 15

stage 1 TMN classes

Answer 15

T1 N0 M0

Question 16

stage 2 TMN classes

Answer 16

T2 N0 M0

Question 17

stage 3 TMN classes

Answer 17

T3 N0 M0
T1 N1 M0
T2 N1 M0
T3 N1 M0

Question 18

stage 4 TMN classes

Answer 18

T4 N0 M0
T4 N1 M0
Any T N2 M0
Any T N3 M0
Any T Any N M1

Question 19

Stage and grade of tumors indicates?

Answer 19

prognosis

Question 20

Treatment plans based upon?

Answer 20

stage and grade, among other factors