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HNN > Oral Cancer > Flashcards

Oral Cancer Flashcards

1
Q

What is the most common kind of head and neck cancers?

A

SCC

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2
Q

What is leukoplakia?

A

A precancerous lesion presenting as a white patch of plaque that cannot be scraped off due to hyperkeratosis.
1/3rd of population gets this, but only a quarter of these become malignant.
Most common on vermillion border of lower lip, buccal mucosa, hard and soft palates.

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3
Q

What is erythroplakia?

A

A precancerous lesion that appears as a red velvety patch of epithelial atrophy with pronounced dysplasia.
Less common than leukoplakia, but more likely to become malignant.
Mainly in the buccal mucosa or palates.
Associated with heavy tobacco use.

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4
Q

List risk factors for oral SCC?

A 
Being male.
Smoking. 
Alcohol.
Older Age. 
HPV. 
Actinic radiation.
Genetics.
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5
Q

How does an oral SCC look macroscopically and microscopically?

A

Macroscopically 0 Raised nodular lesion with central ulceration and hard edges.
Microscopically - differentiated and keratinising.

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6
Q

List common sites of oral SCC?

A

Lips most common and recognised early so good surgical prognosis.
Tongue lateral border or anteriorly.
Cheek or floor of mouth - less common in UK, generally asymptomatic so local invasion can occur and surgical removal difficult.

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7
Q

List the histological progression of oral cancer?

A 
Normal.
Hyperplasia/hyperkeratosis.
Mild Dysplasia.
Severe Dysplasia. 
SCC.
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8
Q

How is oral SCC treated?

A

Radiotherapy and surgical removal.

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9
Q

How can oral cancer be detected?

A

Better education for patients to understand these lesions and be vigilant.
90-second visual and tactile examination by dentists.
Earlier diagnosis = better prognosis.

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10
Q

Name superficial lymph nodes that drain the head and neck?

A 
Occipital 
Posterior Auricular 
Preauricular 
Submandibular 
Submental
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11
Q

What other nodes drain the head and neck?

A

Superficial cervical and deep cervical.

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12
Q

Describe Occipital nodes?

A

Where trapezius attaches to the skull.
Associated with the occipital artery.
Drain posterior scalp and neck.

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13
Q

Describe Posterior Auricular nodes?

A

Posterior to the ear, near SCM attachment.
Associated with the posterior auricular artery.,
Drain posterolateral scalp.

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14
Q

Describe Pre-Auricular nodes?

A

Anterior to the ear.
Associated with superficial temporal and transverse facial arteries.
Drain the anterior auricle, anterolateral scalp, upper face, eyelids and cheeks.

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15
Q

Describe Submandibular nodes?

A

Inferior to the body of mandible.
Associated with the facial artery.
Drains structures along the facial artery, forehead teeth, tongue and gingiva.

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16
Q

Describe Submental nodes?

A

Inferior and posterior to the mental process.

Drain central lower lip, chin, floor of mouth, lower incisors, tip of tongue.

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17
Q

Which nodes drain to the superficial cervical nodes?

A

Occipital and posterior auricular nodes.

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18
Q

Which nodes drain to deep cervical nodes?

A

Pre-auricular, submandibular, submental and superficial cervical nodes.

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19
Q

Describe Superficial Cervical nodes?

A

Collection of nodes along the external jugular vein on the superficial surface of the SCM muscle.

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20
Q

Describe Deep Cervical nodes?

A

Form a chain along the internal jugular vein.

Divided to upper and lower groups by the tendon of omohyoid.

21
Q

What is the most superior deep cervical node and what does it drain?

A

Jugulodigastric node.

Drains the tonsils.

22
Q

What node is associated with the lower group of the deep cervical nodes that drins the tongue and lingual tonsil?

A

Jugulo-omohyoid.

23
Q

Name the intrinsic tongue muscles and their function?

A

Superior longitudinal - shortens tongue, curls apex and sides.
Inferior longitudinal - Shorten tongue, and uncurls apex.
Transverse - Narrows and elongates.
Vertical - Flattens and widens.

24
Q

Where do intrinsic tongue muscles originate and insert?

A

In the substance of the tongue.

25
Q

Describe genioglossus?

A

Mental process - tongue.

Protrudes tongue and depresses the centre.

26
Q

Name the extrinsic tongue muscles?

A

Genioglossus, hyoglossus, styloglossus and palatoglossus.

27
Q

Describe Hyoglossus?

A

Hyoid - tongue.

Depresses the tongue.

28
Q

Describe Styloglossus?

A

Styloid process - tongue.

Elevates and retracts the tongue.

29
Q

Describe Palatoglossus?

A

Soft palate - tongue.

Elevates the back of tongue, depresses the soft palate and moves palatoglossal fold towards the midline.

30
Q

What innervates the tongue muscles?

A

All tongue muscles are innervated by the hypoglossal nerve except palatoglossus, which is innervated by the vagus nerve.

31
Q

Where is the larynx located?

A

Laryngopharynx to trachea.

Lies between C4-6.

32
Q

Name the 3 single cartilages that exist in the larynx?

A

Thyroid cartilage
Cricoid cartilage
Epiglottis

33
Q

Describe the thyroid cartilage?

A

2 fused plates of hyaline.
Forms the anterior wall of the larynx.
Larger in males due to the influence of sex hormones at puberty.

34
Q

What connects the thyroid cartilage to the hyoid bone?

A

The thyrohyoid membrane.

35
Q

Describe the cricoid cartilage?

A

Ring of hyaline.

Forms the inferior wall of the larynx.

36
Q

What attaches the thyroid and cricoid cartilage?

A

Cricothyroid ligament.

37
Q

What attaches the cricoid cartilage to the first tracheal cartilage?

A

Cricotrachael ligament.

38
Q

Where is the landmark for an emergency airway?

A

Cricotrachal ligament inferior to the cricoid cartilage.

39
Q

Describe the structure of the epiglottis?

A

Large, leaf shaped piece of elastic cartilage.
Covered in epithelium.
At the entrance of the larynx.

40
Q

Describe swallowing?

A

The pharynx and larynx rise.
This causes the pharynx to widen and the epiglottis moves down to close off the glottis.
This prevents food/drink from entering the larynx and helps it go down the oesophagus.

41
Q

What does the glottis consist of?

A

The vocal folds, the vestibular folds and the space inbetween them (rima glottidis).

42
Q

Name the 3 paired cartilages of the larynx?

A

Arytenoid cartilages
Corniculate cartilages
Cunieform cartilages.

43
Q

Describe the arytenoid cartilages?

A

Triangular shaped.
Mainly hyaline.
At the posterior, superior border of the cricoid cartilage., with which they form a synovial joint.

44
Q

Describe the Corniculate cartilages?

A

Horn-shaped.
Elastic cartilage.
Located at the apex of arytenoid cartilage.

45
Q

Describe the Cunieform cartilages?

A

Club shaped.
Elastic cartilage.
Anterior to the corniculate cartilages.
Support the vocal folds and lateral eipglottis.

46
Q

Describe the function of the Vestibular folds of the larynx?

A

When brought together, function to hold the breath against pressure in the thoracic cavity.
e.g. when lifting heavy objects.

47
Q

Describe how the vocal folds function?

A

Intrinsic laryngeal muscles contract and pull elastic ligaments tight, which stretches vocal cords into the airway and narrows the rima glottidis.
Air passing through the larynx vibrates the folds and produces sound.
Pitch varies due to tension in the folds.
The greater the air pressure, the louder the sound.

48
Q

Describe the histology of the larynx?

A

Superior to the vocal folds is non-keratinised stratified squamous epithelium.
Inferior to the vocal folds is pseudostratified ciliated columnar with goblet cells. Mucous is produced to trap dust and cilia waft it to the pharynx.

HNN (18 decks)

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