Neck Swelling

Question 1

Midline neck swellings

Answer 1

Thyroid
Lymph node
Thyroglossal cyst
Subhyoid bursa
Lipoma
Submental dermoid 
Thyroid
Ludwig's angina

Question 2

Sub divisions of anterior triangle

Answer 2

Sub mental - hyoid , anterior belly of digastric
Submandibular - anterior and posterior belly of digastric, mandible
Carotid - stylohyoid and posterior belly of digastric, superior belly of omohyoid, anterior border of SCM
Muscular- superior belly of omohyoid, anterior border of SCM, midline

Question 3

Supra hyoid muscles

Answer 3

Mylohyoid
Geniohyoid
Stylohyoid
Digastric

Question 4

Infra hyoid muscles

Answer 4

Sterno hyoid
Sterno thyroid
Thyro hyoid
Omohyoid

Question 5

Beahr’s triangle

Answer 5

Common carotid
Inferior thyroid artery
Recurrent laryngeal nerve

Question 6

Joll’s triangle

Answer 6

Lateral - Upper pole of thyroid gland and superior thyroid vessels
Superior - Attachment line of strap muscles to the hyoid
Midline
Cricothyroid muscle - floor
Content - external branch of the superior laryngeal nerve

Question 7

Naso pharynx

Answer 7

From base of the skull to soft palate

Contains - adenoid, Eustachian tube, fossa of Rosenmuller

Question 8

Oropharynx

Answer 8

From soft palate to epiglottis

Contains - palatine tonsil, lingual tonsil and base of the tongue

Question 9

Laryngopharynx (hypo pharynx)

Answer 9

Starts from epiglottis to cricoid cartilage (C6)

Contains - piriform sinus, post cricoid area and posterior pharyngeal wall

Question 10

Trotter’s triad

Answer 10

In nasopharyngeal carcinoma

1. Ear ache (involvement of trigeminal nerve)
2. Conductive deafness ( serous otitis media )
3. Paralysis of soft palate

Question 11

Complications of radical neck dissection

Answer 11

1. Seroma formation
2. Infection
3. Flap necrosis
4. Carotid blow out
5. Injury to vital structures - frozen shoulder due to spinal accessory nerve damage, trachea, phrenic nerve, vagus nerve, RLN, carotid.
   Haemorrhage
   Lymph ooze
   Pneumothorax, chylous fistula
   Fascial and laryngeal edema
   Cerebral irritation
   Local recurrence
   If IJV is removed increased intracranial tension will be there for 8-10 days

Question 12

Spontaneous regression of the primaries

Answer 12

Neuroblastoma

Melanoma

Question 13

Types of SCC where RT is contraindicated

Answer 13

Verrucous carcinoma

Marjolins ulcer

Question 14

Name of the gland in the floor of the mouth from which Ranula develops

Answer 14

Gland of Nuhn and Blandin

Question 15

Gray scale parameters that favours malignancy

Answer 15

size: larger-more likely malignant
shape: round, L/T <2
heterogenous echotexture
loss of central fatty hilum/thinning of hilum
eccentric versus concentric thickening of cortex
presence of microcalcifications
necrosis: cystic/coagulative
Ill defined capsular margins: invasion