Oropharyngeal Disease Flashcards
taste vs sensation in anterior 2/3 of tongue
taste: CN7
sensation: CNV3
most common oral cavity cancer
squamous cell carcinoma
risk factors for oral cavity cancer
tobacco, alcohol, betel
etiology of oropharyngeal cancer
adults: tobacco and alcohol
kids: HPV 16 and 18
sjorgen syndrome definition
autoimmune disorder w/ inflamamtion of epithelial tissue
most common med disorder w/ xerostomia (dry mouth)
primary: salivary and lacrimla disorder
secondary: after other diseases like rheumatoid, SLE, scleroderma
hallmarks of sjogren syndrome
T cell infiltrates in exocrine tissue
autoAb
sx: cracked lips, fungal infections, xerstomia
typicall middle aged females, parotid enlargement
sjogren syndrome complications
dental caries, non hodgkin lymphoma
oral hairy leukoplakia appearance, association
assoc w/ immunosuppression esp HIV
corrugated shaggy tongue surface bilaterally, erythroplakia has higher malignant potential than leukoplakia
factors in candidiasis infection
smoking, foreign bodies, DM, immunosuppression
patho and tx of lichen planus
T cell rxn to antigens
white lesions bilateral and ymmetric on buccal mucosa
tx w/ topical steroids
2 notable causes of oropharyngeal dysphagia
zenkers diverticulum and reflux
extraesophageal reflux sx
laryngitis- hoarse, cough, dysphagia, phlegm
lack of usual heartburn
describe zenkers and its location
pulsion diverticulum from incomplete relaxation of UES
Killiians triange- weakness b/w inferior constrictor and cricopharyngeus
sx of zenkers
dysphagia, regurg of food, halitosis, cough, aspiration pneumonia
pulsion vs traction diverticula
pulsion- false diverticulum, from pressure w/i organ causing herniation of mucosa and submucosa thru muscle
traction- true (all layers), from pulling force external to hollow organ
common locations for foreing bodies to get stuck
C6 at cricopharyngeus
T4 at descending aortic arch pushing esophagus
LES
battery on CXR
double lumen appearance
acidic vs alkaline caustic ingestions
acidic: toilet bowl cleaners, coag necrosis w/ eschar forming
alkaline: (drain cleaners, oven clearners, dish detergent) liquifactive necrosis followed by stricture formation over time
which glands account for what saliva
submandibular are 70%, basal flow
parotid-25%, stimulated
during stimulated flow, amounts are reversed
whartons duct
duct for submandibular gland, emerges from deep lobe and terminates at papillae lateral to frenulum of tongue
trace innervation of parotid gland
pregang PS fibers on CN9 go to otic ganglion in middle ear, post gang fibers go via auriculotemporal nerve
trace innervation of submandibular and sublingual glands
pregang PS via CN7 and chorda tympani thru middle ear, exit w/ lingual nerve of V3 to submandibular ganglion
post gang fibers to glands
how much saliva per day
1.5 L
sialolithiasis definition
calculi in ductal system of salivary glands
most common cause of inflammation
common location for sialolithiasis
whartons duct of submandibular- longer wider, more tortuous
signs and sx of mumps
fever, malaise, headache prodrome
painful swelling of one or both parotids w/ erythema of stensons orifice
ingestion of sour liquid causes pain
mumps complications
sensorineural deafness, encephalitis, orchitis,
pancreatitis
tx of mumps
no cure, supportive and symptomatic
metabolic parotid enlargement causes
DM and hyperlipidemia
decreased salivary flow
most common benign salivary gland tumor (and malignant)
pleomorphic adenoma for benign
mucoepidermoid carcinoma for malignant
histology of pleomorphic adenoma
architectural pleomorphism
whartins tumor associations
papillary cystadenoma, benign
associated w/ smoking
whartins tumor histology
cystic spaces, two rows of cells w/ pyknotic nuclei
mucoepidermoid carcinoma location
can be found elsewhere
most common in parotid
mucoepidermoid histo
squamous cells, mucus secreteing cells
most common malignancy of submandibular gland
adenoid cystic carcinoma- slow growing even / distant mets, spreads along nerves
most common congenital and malignant neck mass in peds
thyroglossal duct cyst
lymphoma
define ranula
blocked sublingual gland ducts, causes frog like appearance w/ mucosal extravasation
thryoglossal duct cyst presentation
midline neck mass in kids or young adults
moves w/ swallowing or tongue protrusion, can be infected
what is thyroglossal duct cyst
remnant along course of thryoglossal duct b/w foramen cecum of tongue and thryoid bed
surgical tx
lymphatic malformation of cystic hygroma
congenital lymphatic malforamtion, can become infected
benign but disfiguring, can impinge other structures
neck mass in adult is…
cancer until proven otherwise
