pharynx, larynx

Question 1

What are the three subdivisions of the pharynx

Answer 1

nasopharynx, oropharynx, laryngopharynx/hypopharynx

Question 2

______ is
-Cuboidal in shape
- Positioned posterior to the nose and extends inferiorly to the Uvula
- Located at Level of C1

Answer 2

Nasopharynx

Question 3

Cancers in the _____have symptoms, such as consistent sore throat, pain while swallowing, pain in the ear, and cervical node enlargement

Answer 3

pharynx

Question 4

Adenoids are located within the

Answer 4

nasopharynx

Question 5

Nasopharynx is located close to the base of the

Answer 5

brain

Question 6

_____usually occur in the lateral walls of the nasopharynx

Answer 6

carcinomas

Question 7

There is a strong connection between nasopharyngeal cancers and the

Answer 7

Epstein. Barr virus (EBV)

Question 8

Oropharynx is Positioned posterior to the oral cavity and extends from the

Answer 8

soft palate (Superiorly) to the hyoid bone (inferiorly)

Question 9

________ is
located at level C2 to C3
Contains lymphoid tissue called palatine tonsils

Answer 9

Oropharynx

Question 10

Most cancers in the oropharynx occur in the

Answer 10

tonsils

Question 11

Oropharynx is Associated with

Answer 11

alcohol consumption, smoking, and HPV

Question 12

The Laryngopharynx extends from the

Answer 12

hyoid bone to esophagus

Question 13

_____ is
- located C3 to C6
- Posterior to larynx
- Made up of the pyriform sinuses, postcricoid and lower posterior pharyngeal walls

Answer 13

Laryngopharynx

Question 14

The _____ is the superior border of the laryngopharynx at the level of C3

Answer 14

epiglottis

Question 15

_______ is the most common location for cancer within the hypopharynx

Answer 15

Pyriform sinus

Question 16

Majority of pharynx cancers have what histology

Answer 16

squamous cell carcinoma (SCC)

Question 17

_______drains to subdigastric, upper cervical, submaxillary and parapharyngeal nodes

Answer 17

Oropharynx

Question 18

_____drains to cervical nodes, retropharyngeal node (node of Rouviöre), and jugulodigastric nodes

Answer 18

Nasopharynx

Question 19

______drains to midcervical nodes, superior deep, middle and low jugular nodes; and retropharyngeal node (node of Rouviöre)

Answer 19

Hypopharynx

Question 20

Oropharynx tumors spread to lymph nodes and invade structures located

Answer 20

close to the tumor

Question 21

The hypopharynx commonly spreads to lymph nodes and invades

Answer 21

nerves and muscles nearby

Question 22

The _____ extend from the epiglottis to the cricoid cartilage

Answer 22

Larynx

Question 23

Cancer in the larynx is strongly associated with

Answer 23

cigarette smoking

Question 23

The larynx is located at the level of

Answer 23

C3 to C6

Question 24

Common symptoms of larynx cancer is

Answer 24

constant soreness of the throat and hoarseness

Question 24

The larynx includes the

Answer 24

supraglottis, glottis, and subglottis

Question 25

_____ = epiglottis, false vocal cords, ventricles, aryepiglottic folds, arytenoids

Answer 25

Supraglottis

Question 26

____ = true Vocal cords and anterior/posterior commissures

Answer 26

glottis

Question 27

_____ = 1 cm below true Vocal cords

Answer 27

subglottis

Question 28

Supraglottic cancers spread first to what nodes?

Answer 28

jugulodigastric and midjugular nodes

Question 28

What is most common histology of larynx cancer

Answer 28

squamous cell carcinoma

Question 29

Glottic cancers rarely spread to

Answer 29

lymph nodes

Question 30

Subglottic cancers spread first to what nodes?

Answer 30

pretracheal, paratracheal, and inferior jugular nodes

Question 31

what is the clinical presentation for nasopharynx

Answer 31

- blood discharge - auditory dysfunction - respiratory dysfunction -cranial nerve involvement -squamous cell carcinoma most common

Question 32

detection and diagnosis for nasopharynx

Answer 32

- history and physical - inspection - indirect mirror examination - palpation - biopsy - fiber optic endoscopy - CT/MRI - EBV - specific serologic test - liver function test/ bone scans with advanced disease

Question 33

what is treatment for nasopharynx?

Answer 33

- opposing lateral fields to cover tumor and possible pathways of spread - supraclavicualr area treated - IMRT replacing most treatemtns

Question 34

typical dose scheme for nasopharynx

Answer 34

50-70 Gy with electron boost and special consideration to - spinal cord, optic nerve and pituitary and brainstem

Question 35

radiation treatment border for nasopharynx

Answer 35

Superior - 2 cm beyond tumor (seen on Ct) to include base of skull and sphenoid sinuses Posterior - 2 cm margin beyond mastoid process or posterior margin may extend further to allow 1.5 cm margin on enlarged nodes anterior - to include the posterior third of the maxillary sinus and nasal cavity, careful attention adequate margin (2cm) for more anterior tumors inferior - thyroid notch to allow sparing of larynx lower neck - anterior supraclavicular field with larynx block

Question 36

clinical presentation for oropharynx

Answer 36

- sore throat - pain or swallowing - upper spinal nodal swelling - referred otalgia - squamous cell carcinoma most common

Question 37

detection and diagonosis oropharynx (tonsils)

Answer 37

direct inspection palpation biopsy

Question 38

treatment for oropharynx

Answer 38

T1-T2 soft palate, tonsil , pharyngeal walls , tongue: 66-70 Gy T3-T4 - oropharygeal and T2 base of tongue 70-81.6 Gy hyper fractionation - 70 Gy

Question 39

radiation treatment border oropharynx (tonsils)

Answer 39

anterior - 2 cm from known tumor superior - 1.5 - 2.0 cm superior to the soft palate posterior - posterior spinous process inferior - level of hyoid

Question 40

clinical presentation for hypohphraynx

Answer 40

- sore throat - odynophagia - neck mass - dysphagia - weight loss - squamous cell carcinoma most common

Question 41

detection and diagnosis for hypopharynx

Answer 41

- inspection - palpation - biopsy - fiber optic endoscopy - CT/MRI

Question 42

treatment for hypopharynx

Answer 42

large fields treated to 45 Gy reduced of cord then continued to 70 Gy

Question 43

treatment borders hypopharynx

Answer 43

superior - inferior border of mandible and mastoid process, to the base of skull inferior - lower border of the cricoid cartilage 1.5 to 2.0 cm margin anterior - in front of the thyroid cartialge "shine off" (fall off) if larynx involved posterior - behind the spinous process

Question 44

larynx is made up off :

Answer 44

glottis supraglottis and subglottis

Question 45

larynx clinical presentation:

Answer 45

- persistent sore throat - hoarseness and stridor - cervial lymph node - supreglottic lesions - squamous cell carcinoma most common

Question 46

detection and diagnosis for larynx

Answer 46

- palpation - direct inspection - biopsy

Question 47

treatment for larynx

Answer 47

surgery chemo radiation therapy

Question 48

radiation treatment borders for glottis

Answer 48

superior - upper thyroid notch inferior - cricoid cartilage (lower border of C6) anterior - 1-1.5 cm shine over (flash) over the skin surface at the level of the vocal cords posterior - just anterior to the vertebral body including the anterior portion of the posteiror pharyngeal walls

Question 48

radiation treatment borders for supraglottis and subglottis

Answer 48

often much larger fields