Fiser Chapter 19 HEAD AND NECK Flashcards Preview

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Flashcards in Fiser Chapter 19 HEAD AND NECK Deck (92)
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1

Anterior neck triangle

SCM, sternal notch, inferior border of digastric muscle

Contains carotid sheath

2

Posterior neck triangle

SCM posterior border, trapezium, clavicle

Contains accessory nerve (to SCM, trap, platysma) and brachial plexus

3

Parotid vs sublingual vs. submandibular gland secretions

Parotid -> serous

Sublingual -> mucin

Submandibular -> 50/50

4

False versus true vocal cords

False are superior to true in larynx

5

Location of vagus nerve in neck

Between carotid and IJ

6

Location of phrenic nerve in neck

On top of anterior scalene muscle

7

Location of long thoracic nerve in neck

Posterior to middle scalene muscle

8

Sensory nerve to face

Trigeminal with ophthalmic, maxillary, mandibular branches

Mandibular branch also gives taste to anterior 2/3 of tongue, floor of mouth, gingiva

9

Motor nerve to face

Facial nerve with temporal, zygomatic, buccal, marginal mandibular, cervical branches

10

Taste nerves

Trigeminal anterior 2/3 of tongue
Glossopharyngeal posterior 1/3 of tongue

11

Swallowing nerve

Glossopharyngeal (motor to stylopharyngeus, also taste posterior 1/3 tongue)

12

Motor nerve to tongue

Hypoglossal (motor to all of tongue except palatoglossus): tongue deviates toward same side of injury

13

Laryngeal muscle innervation

Superior laryngeal nerve innervates cricothyroid muscle

Recurrent laryngeal nerve innervates all the rest

14

Gustatory sweating after parotidectomy

Frey's syndrome: injury to auriculotemporal nerve, that then cross-innervates with sympathetic fibers to sweat glands of skin

15

Thyrocervical trunk branches

STAT:

Suprascapular artery
Transverse cervical artery
Ascending cervical artery
inferior Thyroid artery

16

External carotid artery branches

STAPLF (like staple) OPAMST

1. Superior thyroid artery
2. Ascending pharyngeal
3. Lingual
4. Facial
5. Occipital
6. Posterior auricular
7. Maxillary
8. Superficial temporal

17

Trapezius flap blood supply

transverse cervical artery

18

Pectoralis major flap blood supply

Either thoracoacromial artery or internal mammary artery

19

Torus palatine and Toru mandibular

Congenital bony mass on upper palate of mouth, or on lingual surgace of mandible
Tx: Nothing

20

Radical versus modified radical neck dissection

Radical: takes accessory nerve, SCM, IJ, omohyoid, submandibular gland, sensory nerves C2-C5, cervical branch of facial nerve, ipsilateral thyroid

Modified: leaves accessory nerve, SCM, IJ

No mortality difference between them. Most morbidity occurs from accessory nerve resection

21

Most common cancer of oral cavity, pharynx, and larynx; risk factors

Squamous cell carcinoma

Risk factors tobacco and EtOH

22

Erythroplakia versus leukoplakia

Erythroplakia more premalignant

23

Oral cavity borders

Mouth floor, anterior 1/3 of tongue, gingiva, hard palate, anterior tonsillar pillars, lips

24

Most common site for oral cavity CA

Lower lip (more common than upper lip d/t sun exposure)

25

Oral cancer location with lowest survival rate

Hard palate (hard to resect)

26

Risk factor for oral cavity cancer

-Plummer-Vinson synrome (glossitis, cervical dysphagia from esophageal web, spoon fingers, iron-deficiency anemia)

27

Oral cavity cancer treatment

-Wide resection (1 cm margins)

-MRND: tumors >4 cm, clinically positive nodes, or bone invasion

-Postop XRT: advanced lesions (>4 cm, positive margins, or nodal/bone involvement)

28

Lip cancer, most common site, site where most aggressive, and when flaps needed

Lower lip

Along commissure

Flaps if > 1/2 lip removed

29

Tongue cancer with jaw invasion, can you still operate?

Yes (commando procedure)

30

Verrucous ulcer

Well-differentiated SCCA often found on the check, associated with oral tobacco; not aggressive, rare metastasis

Tx: full cheek resection +/- flap; NO MRND