Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

N&SS - ENT > The Neck, Glands of the Face, and H&N Cancers > Flashcards

The Neck, Glands of the Face, and H&N Cancers Flashcards

1
Q

What kind of cancer makes up the majority of head and neck cancers?

A

Squamous cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are cancers of the head and neck most associated with epidemiologically?

A

Tobacco use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Aside from heavy smoking, what other risk factors are there for head and neck cancers?

A 
Heavy alcohol consumption
Poor dentition
Socially disadvantaged groups
Poor diet (low fibre)
GORD
HPV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Is smoking the only way someone can use tobacco?

A

No, it can be chewed too.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How might a pt with a head and neck tumour present?

A
  • Persistent hoarse voice
  • Sore throat
  • Cough
  • Earache
  • Neck lump
  • Mouth lesion
  • Recurrent unilateral nosebleeds
  • Systemic features e.g. weight loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How are early-stage H+N cancers usually managed?

A

Surgery or radiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What supportive Rx might a pt with a H+N tumour need?

A

Nutritional support
Communication support
Dentition support
Psychological support - for cancer and for possible cosmetic effect.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the salivary glands called?

A
  • Parotid gland
  • Submandibular
  • Sublingual
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where do the parotid glands:

a) lie?
b) open?

A

a) below the external auditory meatus

b) on the buccal membrane opposite second upper molar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where do the submandibular glands:

a) lie?
b) open?

A

a) beneath and infront of angle of the jaw

b) floor of the mouth lateral to frenulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where do the sublingual glands:

a) lie?
b) open?

A

a) below the tongue

b) through several ducts on the floor of the mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How much saliva is produced in one day?

A

1-1.5 Litres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the functions of saliva?

A

Lubrication
Facilitate speech, swallowing, digestion, and mastication.
Protect oral mucosa and teeth.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What symptoms might a pt have relating to salivary gland pathology?

A

Swelling
Pain (gland or ear or throat)
Difficulty eating
Dry mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How can we examine the parotid gland?

A

Ask pt to clench jaw - palpate parotid gland overlying the masseter muscle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which nerve may be affected by parotid gland pathology?

A

Facial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What other swelling can salivary gland swellings be confused with?

A

Lymph node swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What might cause parotid gland swelling?

A
  • Viral - mumps
  • Bacterial infection
  • Stone
  • Sjögren’s syndrome
  • Sarcoidosis
  • Granulomatosis
  • HIV-related lymphocytic infiltration
  • Benign or malignant tumour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What might cause submandibular gland swelling?

A
  • Stone in duct
  • Benign or malignant tumour
  • Sjögrens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the most common cause of salivary gland infection?

A

Mumps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

A pt presents with a painful swelling on the side of their face. They have experienced a dry mouth and temperature along with this.

What might this be, and what other symptoms might they have?

A

Infection of parotid gland.

  • Abnormal or foul taste
  • Discharge from ducts
  • Mouth pain especially when eating
  • Difficulty talking
  • Other signs of systemic unwellness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How should mumps or other salivary gland infections be managed?

A

Supportively - it is self-limiting and not serious.

It is however notifiable.

Encourage salivary flow.
Abx may be necessary.
Remove stones or strictures if appropriate.

23
Q

How can salivary glands become obstructed?

A
  • Calculi or stones form from mucus, cellular debris, calcium, and magnesium phosphates.
  • Duct stenosis (post-inflamm, chronic)
  • Obstructing tumour
24
Q

How does an obstructed salivry gland present?

A

Pain and swelling in region of gland, particularly at meal times (when saliva production is stimulated)

25
Q

Why are stones more common in the submandibular duct?

A

It has the thickest secretions and a smaller duct than the parotid.

26
Q

How are salivary duct stones managed?

A

Many pass spontaneously -> oral analgesics and treat any infection present.
Good hydration
Warm compress
Gland massage

Surgical removal sometimes required.

27
Q

What is sialadenosis, and with what is it associated?

A

Generalised gland swelling caused by acinar component hypertrophy within the gland.

Systemic diseases such as Sjögren’s, endocrine disorders, coeliacs, and sarcoidosis.

28
Q

Are salivary gland tumours more commonly benign or malignant?

A

Benign

29
Q

What red flags would be indicative of a malignant salivary gland tumour?

A
  • Rapid growth of swelling
  • Ulceration or induration
  • Fixation to skin
  • Sensory changes
  • PMHx of skin cancer, H+N radiation
  • Sjögren’s syndrome
30
Q

How are suspected salivary gland tumours investigated?

A

USS

31
Q

How are salivary gland tumours managed?

A

Tumours need surgical excision.

Post-op radiotherapy is needed for malignant tumours.

32
Q

What kind of condition is Sjögren’s syndrome?

A

Autoimmune

33
Q

What is the pathophysiology of Sjögren’s syndrome?

A

Autoimmune lymphocytic infiltration of exocrine glands.

34
Q

What are the symptoms of Sjögren’s syndrome?

A

Dry eyes
Dry mouth
Parotid gland swelling

35
Q

Is Sjögren’s more common in women or men?

A

Women, by a factor of 20!!

36
Q

What are the risk factors for Sjögren’s syndrome?

A
  • Other autoimmune diseases

- Vitamin D deficiency

37
Q

How is Sjögren’s managed?

A

Symptomatic treatments - artificial tears, drink plenty of water, good dental hygiene, lubricants for other affected areas e.g. skin, vagina.

DMARDs

38
Q

What is xerostomia?

A

Dry mouth

39
Q

What can cause xerostomia?

A
  • Medication
  • Irradiation of head and neck region
  • Salivary gland disease
40
Q

What symptoms might someone with long term xerostomia also have?

A
  • Burning or scalded sensation
  • Poor oral hygiene
  • Intolerance to dentures
41
Q

Who is xerostomia most common in?

A

The elderly and adolescents with T1DM.

42
Q

What drugs can cause dry mouth?

A
  • Morphine
  • TCA
  • Antihistamines
  • Antimuscarinics
  • Anti-epileptics
  • Antipsychotics
  • Beta blockers
  • Diuretics
43
Q

How should drug induced xerostomia be managed?

A

Reduce dose or change drug if possible.

Treat symptoms with hydration and other simple measures.

44
Q

What simple measures can aid xerostomia?

A
  • Frequent sips of cool drinks
  • Sucking pieces of ice
  • Sugar-free sucky sweets
  • Sugar free chewing gum
  • Petrolium jelly on lips
45
Q

What medical management can we use for xerostomia?

A

Artifical saliva
Salivary stimulants

Pilocarpine for certain indications.

46
Q

What are the indications for pilocarpine for xerostomia?

A

Xerostomia cause by H+N irradiation, and Sjögren’s syndrome.

47
Q

What red flags alongside lymphadenopathy would indicate significant underlying disease?

A

Persistent fever
Night sweats
General malaise
Weight loss

Supraclavicular or infraclavicular nodes are always suspicious of underlying malignancy.

48
Q

How common are palpable lymph nodes in children?

A

Quite - up until age 8-12 they are quite prominent.

49
Q

What nodes can signify Hodgkins disease?

A

Epitrochlear (just above the elbow crease) - not H+N, sure, but interesting none-the-less.

50
Q

Someone comes in with a neck lump. Form a list of differentials.

A
  • Reactive lymphadenoapthy
  • Lymphoma
  • Thyroid swelling
  • Thyroglossal cyst
  • Pharyngeal pouch
  • Cystic hygroma
  • Branchial cyst
  • Cervical rib
  • Carotid aneurysm
  • Sebaceous cyst
  • Lipoma
51
Q

How common are thyroglossal cysts?

A

Most common congenital anomaly of the neck - 2-4% of all neck masses.

52
Q

How does a thyroglossal cyst present?

A

Fluctuant swelling in neck midline which moves upwrads when pt sticks tongue out

53
Q

What is a thyroglossal cyst?

A

Cyst that forms from persistent epithelial tract from embryological descent of the thyroid down the midline of the neck.

N&SS - ENT (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions