Oropharyngeal cancer

Question 1

What type of cancer is most commonly seen in oropharyngeal cancer?

Answer 1

Squamous cell carcinoma

Question 2

What are the main risk factors for the development of oropharyngeal cancer?

Answer 2

Tobacco
Alcohol abuse
HPV infection

Question 3

Unless discovered incidentally at the dentist, most oropharyngeal cancer present in advanced stages. T/F?

Answer 3

True

Question 4

What are the symptoms of oropharyngeal cancer?

Answer 4

Sore throat
Oral pain
Dysphagia
Weight loss
Neck mass
Trismus

Question 5

Most patients with oropharyngeal cancer will benefit from prophylactic placement of a gastronomy tube before treatment. T/F?

Answer 5

True

Question 6

What factors indicated locally advanced disease is oropharyngeal cancer?

Answer 6

Trismus
Inability to protrude the tongue
Presence of a large and fixed cervical node

Question 7

What signs of field cancerisation in oropharyngeal cancer may be seen by use of a head light?

Answer 7

Leukoplakia

Erythroplakia

Question 8

Base of the tongue tumours require biopsy under general anaesthesia. T/F?

Answer 8

True

Question 9

What imaging is undertaken to establish the location size and extent of an oropharyngeal cancer?

Answer 9

CT scan

Question 10

How are stage 1 and 2 oropharyngeal cancer treated?

Answer 10

Surgery or radiotherapy

Question 11

How is stage 3 oropharyngeal cancer treated?

Answer 11

Surgery followed by postoperative radiotherapy or concurrent chemoradiotherapy

Question 12

How is stage 4 B/C oropharyngeal cancer treated?

Answer 12

Chemotherapy

Question 13

Who is involved in the MDT for the care of oropharyngeal cancer patients?

Answer 13

ENT surgeons
Oral and maxillofacial surgeons
Oncologists
Restorative dentistry consultant
Head and neck clinical nurse specialist
Dietician
Speech therapist
Social worker

Question 14

How soon after surgery for oropharyngeal cancer can speech and swallowing therapy begin?

Answer 14

After the suture lines are healed

Question 15

At what point in treatment, can those oropharyngeal cancer patients receiving radiotherapy, receive speech and swallowing therapy?

Answer 15

Prior to, during and after treatment

Question 16

The occipital lymph nodes exist near the attachment of which muscle?

Answer 16

Trapezius muscle

Question 17

To which lymph node does lymph from the posterior scalp and neck drain?

Answer 17

Occipital node

Question 18

Which lymph node exists posterior to the ear near the attachment of the sternocleidomastoid muscle?

Answer 18

Mastoid nodes

Question 19

Drainage from the occipital and mastoid nodes passes to the superficial cervical nodes along which vein?

Answer 19

External jugular vein

Question 20

Which arteries are associated with the pre-auricular and parotid nodes?

Answer 20

Superficial temporal and transverse facial arteries

Question 21

Which nodes drain lymph from the anterior surface of the auricle, the anterolateral scalp, upper half of the face and eyelids and cheeks?

Answer 21

Pre-auricular and parotid nodes

Question 22

Which artery is associated with the submandibular nodes?

Answer 22

Facial artery

Question 23

To which nodes do the pre-auricular, parotid and submandibular nodes drain to?

Answer 23

Deep cervical nodes

Question 24

The deep cervical nodes form a chain along which vein?

Answer 24

Internal jugular vein

Question 25

Which lymph node is the most superior node in the deep cervical lymph node chain?

Answer 25

Jugulodigastric node

Question 26

To which node does the pharyngeal part of the tongue drain to?

Answer 26

Jugulodigastric node

Question 27

To which nodes does the oral part of the tongue drain to?

Answer 27

Directy into deep cervical nodes and indirectly into these nodes through the submittal and submandibular nodes

Question 28

Which bones is the root of the tongue attached to?

Answer 28

mandible | hyoid bone

Question 29

All of the muscles of the tongue are innervated by CN XII other than which muscle which is innervated by CN X?

Answer 29

Palatoglossal muscle

Question 30

What are the four intrinsic muscles of the tongue?

Answer 30

Superior longitudinal muscle Inferior longitudinal muscle Transverse muscle vertical muscle

Question 31

What is the function of the superior longitudinal muscle of the tongue?

Answer 31

Shortens tongue, curls apex and sides of tongue

Question 32

What is the function of the inferior longitudinal muscle of the tongue?

Answer 32

Shortens tongue, uncurls apex and turns it downwards

Question 33

What is the function of the transverse muscle of the tongue?

Answer 33

Narrows and elongates the tongue

Question 34

What is the function of the vertical muscle of the tongue?

Answer 34

Widens and flattens the tongue

Question 35

What are the four extrinsic muscles of the tongue?

Answer 35

Genioglossus muscle Hyoglossus muscle styloglossus muscle palatoglossal muscle

Question 36

Which extrinsic tongue muscle protrudes the tongue?

Answer 36

Genioglossus muscle

Question 37

Which extrinsic tongue muscle depresses the tongue?

Answer 37

Hypoglossus muscle

Question 38

Which extrinsic muscle elevates and retracts the tongue to aid in swallowing?

Answer 38

Styloglossus muscle

Question 39

Which extrinsic muscle depresses the palate and elevates the back of the tongue?

Answer 39

Palatoglossus muscle

Question 40

Name the cartilages which make up the larynx?

Answer 40

Cricoid cartilage, thyroid cartilage, epiglottis, paired arytenoid cartilages, paired corniculate cartilages and paired cuneiform cartilages

Question 41

From which bone is the larynx suspended?

Answer 41

Hyoid bone

Question 42

Which paired cartilages articulate with the superioposterior part of the cricoid cartilage?

Answer 42

Arytenoid cartilages

Question 43

The arch of the cricoid cartilage exists anterior to the lamina. T/F?

Answer 43

True

Question 44

What is the anatomical name for the Adams apple (which is part fo the thyroid cartilage)?

Answer 44

Laryngeal prominence

Question 45

The 'stem' of the epiglottis articulates with which other cartilage of the larynx?

Answer 45

thyroid cartilage

Question 46

The vocal ligament attaches the the anterior angle of which laryngeal cartilages?

Answer 46

Arytenoid cartilages

Question 47

An aperture in the lateral part of what membrane allows the passage of the superior laryngeal artery, internal branch of the superior laryngeal nerve and lymphatics?

Answer 47

Thyrohyoid membrane

Question 48

What is the name of the upper chamber of the laryngeal cavity between the laryngeal inlet and the vestibular folds?

Answer 48

Vestibule

Question 49

What is the function of the vestibular fold?

Answer 49

To hold breath against pressure in the thoracic cavity

Question 50

What is the name of the lower chamber of the laryngeal cavity between the vocal folds and inferior opening of the larynx?

Answer 50

Infraglottic space

Question 51

What nerve fibres innervate the geniohyoid muscle?

Answer 51

C1 fibres

Question 52

What is the function of the geniohyoid muscle?

Answer 52

Pulls hyoid bone forwards during swallowing

Question 53

The styloglossus muscle exists between the superior-posterior aspect of the tongue and the styloid process which exists on which bone of the skull?

Answer 53

Temporal bone

Question 54

The hypoglossus muscle is deep to the genioglossus muscle. T/F?

Answer 54

False - it is the other way around

Question 55

Physiologically, the jugulodiagstric and jugulomoid nodes are large. Why is this?

Answer 55

These drain the palatine and lingual tonsils respectively

Question 56

Lymph from which structures in the head and neck drains directly to deep cervical nodes?

Answer 56

``` Oropharynx Laryngopharynx Larynx Thyroid Middle ear Posterior part of tongue ```

Question 57

What lymph nodes exist within the posterior triangle of the neck?

Answer 57

Superior cervical nodes

Question 58

What is the term for an enlarged supraclavicular lymph node as the result of spread of abdominal cancer?

Answer 58

Virchow's node

Question 59

Which cartilage of the larynx is the only one to form a complete ring?

Answer 59

Cricoid cartilage

Question 60

In which structure in the larynx would an emergency airway be inserted?

Answer 60

Cricothyroid membrane

Question 61

Where would a planned / elective airway be inserted in the neck?

Answer 61

Between tracheal cartilages 2 - 4

Question 62

Pressing on the cricoid cartilage can suppress vomiting. T/F?

Answer 62

True

Question 63

From which artery does the lingual artery arise?

Answer 63

External carotid artery

Question 64

Describe the venous drainage of the tongue?

Answer 64

This is via the deep lingual veins and the dorsal lingual vein. The dorsal lingual vein and sublingual vein come together to form the lingual vein. This all then drains to the internal jugular vein.