True Learn- Head and Neck Flashcards
Most common tumor of upper and lower lip
-Lips most common site of oral cavity cancer
-90% of lip cancer located on lower lip
-Upper lip: basal cell carcinoma
-Lower lip: squamous cell carcinoma
Not able to elevate pitch after thyroidectomy. Nerve injured?
-External branch of the superior laryngeal nerve: exits the carotid sheath, descends along the side of the pharynx beneath the sternothyroid, and innervates the cricothyroid muscle, elevating the pitch of phonation; separation from the superior thyroid artery occurs 1 cm proximal to the point that the superior thyroid artery pierces the capsule of the superior pole of the thyroid= risk of injury during thyroidectomy
-Superior laryngeal nerve: from the vagus nerve (cranial nerve X); descends along the posterior aspect of the internal carotid artery; divides into external & internal branches at the level of the hyoid
-External= purely motor; internal branch= purely sensory
-Cricothyroid muscle= intrinsic muscle of the layrnx
-All other intrinsic muscles of the larynx receive motor innervation from the recurrent laryngeal nerve (RLN)
Abdominal pain, diarrhea, flushing, new mass in mouth
-Carcinoid syndrome: diarrhea, facial flushing, abdominal pain, asthma
-Well-differentiated neuroendocrine tumors can occur anywhere along the GI tract- more commonly rectum and small bowel, but rarely in the sublingual gland
-Tumor releases serotonin in the bloodstream. Serotonin is metabolized by the liver, so tumors within the portal circulation typically do not cause carcinoid syndrome unless they have metastasized to the liver or beyond the portal circulation
-Initial diagnostic test is to measure 24-hour urinary excretion of 5-HIAA (plasma 5-HIAA not yet validated)
Neck triangles
Anterior Triangle:
Superior Border: Inferior border of the mandible.
Posterior Border: Anterior border of the sternocleidomastoid muscle (SCM).
Medial Border: Midline of the neck.
Subdivisions:
-Submandibular Triangle: Bounded by the anterior and posterior bellies of the digastric muscle and the inferior border of the mandible.
-Muscular Triangle: Bounded by the superior belly of the omohyoid muscle, the SCM, and the midline of the neck.
-Carotid Triangle: Bounded by the posterior belly of the digastric muscle, the SCM, and the superior belly of the omohyoid muscle.
-Submental Triangle: Bounded by the anterior bellies of digastric laterally and the body of the hyoid bone inferiorly
Posterior Triangle:
Anterior Border: Posterior border of the SCM.
Posterior Border: Anterior border of the trapezius muscle.
Inferior Border: Middle third of the clavicle.
Subdivisions:
-Occipital Triangle: Superior part of the posterior triangle, bounded by the SCM, trapezius, and the inferior belly of the omohyoid.
-Subclavian Triangle (Supraclavicular Triangle): Inferior part of the posterior triangle, bounded by the SCM, trapezius, and the clavicle.
-Submandibular triangle= level 1B lymph node station; facial artery and vein pass through triangle
Brachial cleft anomaly
Branchial cleft anomalies are, most commonly, sinuses, cysts, or remnants of cartilage that arise from developmental errors in the embryonic pharyngeal apparatus. Definitive management of these remnants requires full surgical excision of the remnant. Incompletely removed remnants can result in subsequent infection
2-year-old who did not have his indicated vaccinations presenting with difficulty breathing
Cricothyroid ligament in children under the age of 5 is very small, making emergency cricothyroidotomy very difficult, therefore emergency tracheostomy should be considered.
Emergency tracheostomy used to be common in children prior to vaccination and judicious use of antibiotics when acute epiglottitis was common.
Cystic hygroma
-Lymphatic malformation; benign, cystic fluid collection lined with lymphatic endothelium. Classically in the posterior neck region, but also in the axillary, mediastinal, inguinal, and retroperitoneal regions.
-Half of all cystic hygromas are present at birth; can be identified on prenatal ultrasound
-Indications for treatment include airway compromise, infection, hemorrhage, or deformity/cosmesis.
