Oropharyngeal Disease

Question 1

taste vs sensation in anterior 2/3 of tongue

Answer 1

taste: CN7
sensation: CNV3

Question 2

most common oral cavity cancer

Answer 2

squamous cell carcinoma

Question 3

risk factors for oral cavity cancer

Answer 3

tobacco, alcohol, betel

Question 4

etiology of oropharyngeal cancer

Answer 4

adults: tobacco and alcohol
kids: HPV 16 and 18

Question 5

sjorgen syndrome definition

Answer 5

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

Question 6

hallmarks of sjogren syndrome

Answer 6

T cell infiltrates in exocrine tissue

autoAb

sx: cracked lips, fungal infections, xerstomia

typicall middle aged females, parotid enlargement

Question 7

sjogren syndrome complications

Answer 7

dental caries, non hodgkin lymphoma

Question 8

oral hairy leukoplakia appearance, association

Answer 8

assoc w/ immunosuppression esp HIV

corrugated shaggy tongue surface bilaterally, erythroplakia has higher malignant potential than leukoplakia

Question 9

factors in candidiasis infection

Answer 9

smoking, foreign bodies, DM, immunosuppression

Question 10

patho and tx of lichen planus

Answer 10

T cell rxn to antigens

white lesions bilateral and ymmetric on buccal mucosa

tx w/ topical steroids

Question 11

2 notable causes of oropharyngeal dysphagia

Answer 11

zenkers diverticulum and reflux

Question 12

extraesophageal reflux sx

Answer 12

laryngitis- hoarse, cough, dysphagia, phlegm

lack of usual heartburn

Question 13

describe zenkers and its location

Answer 13

pulsion diverticulum from incomplete relaxation of UES

Killiians triange- weakness b/w inferior constrictor and cricopharyngeus

Question 14

sx of zenkers

Answer 14

dysphagia, regurg of food, halitosis, cough, aspiration pneumonia

Question 15

pulsion vs traction diverticula

Answer 15

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

Question 16

common locations for foreing bodies to get stuck

Answer 16

C6 at cricopharyngeus
T4 at descending aortic arch pushing esophagus
LES

Question 17

battery on CXR

Answer 17

double lumen appearance

Question 18

acidic vs alkaline caustic ingestions

Answer 18

acidic: toilet bowl cleaners, coag necrosis w/ eschar forming
alkaline: (drain cleaners, oven clearners, dish detergent) liquifactive necrosis followed by stricture formation over time

Question 19

which glands account for what saliva

Answer 19

submandibular are 70%, basal flow

parotid-25%, stimulated

during stimulated flow, amounts are reversed

Question 20

whartons duct

Answer 20

duct for submandibular gland, emerges from deep lobe and terminates at papillae lateral to frenulum of tongue

Question 21

trace innervation of parotid gland

Answer 21

pregang PS fibers on CN9 go to otic ganglion in middle ear, post gang fibers go via auriculotemporal nerve

Question 22

trace innervation of submandibular and sublingual glands

Answer 22

pregang PS via CN7 and chorda tympani thru middle ear, exit w/ lingual nerve of V3 to submandibular ganglion

post gang fibers to glands

Question 23

how much saliva per day

Answer 23

1.5 L

Question 24

sialolithiasis definition

Answer 24

calculi in ductal system of salivary glands

most common cause of inflammation

Question 25

common location for sialolithiasis

Answer 25

whartons duct of submandibular- longer wider, more tortuous

Question 26

signs and sx of mumps

Answer 26

fever, malaise, headache prodrome

painful swelling of one or both parotids w/ erythema of stensons orifice

ingestion of sour liquid causes pain

Question 27

mumps complications

Answer 27

sensorineural deafness, encephalitis, orchitis,

pancreatitis

Question 28

tx of mumps

Answer 28

no cure, supportive and symptomatic

Question 29

metabolic parotid enlargement causes

Answer 29

DM and hyperlipidemia

decreased salivary flow

Question 30

most common benign salivary gland tumor (and malignant)

Answer 30

pleomorphic adenoma for benign

mucoepidermoid carcinoma for malignant

Question 31

histology of pleomorphic adenoma

Answer 31

architectural pleomorphism

Question 32

whartins tumor associations

Answer 32

papillary cystadenoma, benign

associated w/ smoking

Question 33

whartins tumor histology

Answer 33

cystic spaces, two rows of cells w/ pyknotic nuclei

Question 34

mucoepidermoid carcinoma location

Answer 34

can be found elsewhere

most common in parotid

Question 35

mucoepidermoid histo

Answer 35

squamous cells, mucus secreteing cells

Question 36

most common malignancy of submandibular gland

Answer 36

adenoid cystic carcinoma- slow growing even / distant mets, spreads along nerves

Question 37

most common congenital and malignant neck mass in peds

Answer 37

thyroglossal duct cyst

lymphoma

Question 38

define ranula

Answer 38

blocked sublingual gland ducts, causes frog like appearance w/ mucosal extravasation

Question 39

thryoglossal duct cyst presentation

Answer 39

midline neck mass in kids or young adults

moves w/ swallowing or tongue protrusion, can be infected

Question 40

what is thyroglossal duct cyst

Answer 40

remnant along course of thryoglossal duct b/w foramen cecum of tongue and thryoid bed

surgical tx

Question 41

lymphatic malformation of cystic hygroma

Answer 41

congenital lymphatic malforamtion, can become infected

benign but disfiguring, can impinge other structures

Question 42

neck mass in adult is…

Answer 42

cancer until proven otherwise