Surgery Final Exam - ENT, Plastics, Ophtho
Lectures (Answerd) 100%
ENT (4 lectures)
ENT (4 lectures)
90% of head and neck cancers are
squamous cell CA
Sub-Sites of Pharynx include the "3 P's"
Pyriform Sinus
Posterior Cricoid
Posterior Pharyngeal Wall
any patient who has an unexplained, unilateral middle ear infection MUST be
worked up for...
tumor where Eustachian tube inserts on the superior-posterior aspect of the
nasopharyngeal wall
Stage T3 Tumor (head & Neck)
glottis, supra-glottis, sub-glottis, & vocal cord are involved
Patient presents with solitary nodule and history of radiation exposure...
40% will have carcinoma (thyroid cancer)
what age range has the greatest risk for thyroid cancer?
< 15
> 45
Dx thyroid cancer
Step 1: routine TSH hormone level
Step 2: if normal TSH, ultrasound thyroid to assess # and characteristics of nodules
Step 3: fine needle aspiration of lesion
what is the most common thyroid carcinoma?
papillary thyroid carcinoma
Boundaries of neck
Boundaries of neck - pic II
Boundaries of neck - pic III
carcinoma in situ (CIS)
pre-cancerous lesion
presence of atypical changes
complete loss of epithelial stratification
Boundaries of the Hypopharynx
surrounds layrnx
superior limit = hyoid bone (becomes contiguous with oropharynx)
inferior limit = cricopharyngeus muscle (transitions to cervical esophagus)
what type of cancer is associated with chinese people?
nasopharynx cancer
What is the most common finding in nasopharynx cancer?
middle-ear effusion leading to hearing loss
Eustachian tubes
, surrounded by salpingopharyngeal fold and tubular tonsils
- enlarged due to an infection and close off tube
Smoker/drinker who vocal cord is not moving is automatically stage ____ cancer
3
What stage is a tumor limited to the larynx with vocal cord fixation?
3
Sim's Triangle
carotid artery
trachea
inferior pole of thyroid
recurrent laryngeal nerve provides sensation to all muscles except _____
circothyroid
The larynx is composed of 3 paired structures - what are they?
arytenoid, corniculate, cuneiform
What and 3 non-paired cartilages make up the larynx? ***
epiglottis
thyroid
cricoid
intrinsic muscles of vocal cords
abductors - bring vocal cords APART
adductors - bring together
What is the only abductor of the vocal cords?
posterior cricoarytenoid
The recurrent laryngeal nerve innervates ALL intrinsic muscles in the neck
EXCEPT for the ____
Cricothyroid Muscle
Cricothyroid Muscle is innervated by -____
extrinsic branch of superior laryngeal nerve
Pediatric airway
"bottleneck effect"
- cone shaped
- narrowest at the cricoid
Adult airway
- cylindrical shaped
- narrowest at glottis (true cords)
What is the hallmark of an upper airway obstruction?
stridor
- harsh, vibrating noise while breathing
Signs of upper airway obstruction
***Stridor
dysphonia (muffled void)
super-sternal chest retractions
drooling
tripod position
inspiratory stridor
Lectures (Answerd) 100%
ENT (4 lectures)
ENT (4 lectures)
90% of head and neck cancers are
squamous cell CA
Sub-Sites of Pharynx include the "3 P's"
Pyriform Sinus
Posterior Cricoid
Posterior Pharyngeal Wall
any patient who has an unexplained, unilateral middle ear infection MUST be
worked up for...
tumor where Eustachian tube inserts on the superior-posterior aspect of the
nasopharyngeal wall
Stage T3 Tumor (head & Neck)
glottis, supra-glottis, sub-glottis, & vocal cord are involved
Patient presents with solitary nodule and history of radiation exposure...
40% will have carcinoma (thyroid cancer)
what age range has the greatest risk for thyroid cancer?
< 15
> 45
Dx thyroid cancer
Step 1: routine TSH hormone level
Step 2: if normal TSH, ultrasound thyroid to assess # and characteristics of nodules
Step 3: fine needle aspiration of lesion
what is the most common thyroid carcinoma?
papillary thyroid carcinoma
Boundaries of neck
Boundaries of neck - pic II
Boundaries of neck - pic III
carcinoma in situ (CIS)
pre-cancerous lesion
presence of atypical changes
complete loss of epithelial stratification
Boundaries of the Hypopharynx
surrounds layrnx
superior limit = hyoid bone (becomes contiguous with oropharynx)
inferior limit = cricopharyngeus muscle (transitions to cervical esophagus)
what type of cancer is associated with chinese people?
nasopharynx cancer
What is the most common finding in nasopharynx cancer?
middle-ear effusion leading to hearing loss
Eustachian tubes
, surrounded by salpingopharyngeal fold and tubular tonsils
- enlarged due to an infection and close off tube
Smoker/drinker who vocal cord is not moving is automatically stage ____ cancer
3
What stage is a tumor limited to the larynx with vocal cord fixation?
3
Sim's Triangle
carotid artery
trachea
inferior pole of thyroid
recurrent laryngeal nerve provides sensation to all muscles except _____
circothyroid
The larynx is composed of 3 paired structures - what are they?
arytenoid, corniculate, cuneiform
What and 3 non-paired cartilages make up the larynx? ***
epiglottis
thyroid
cricoid
intrinsic muscles of vocal cords
abductors - bring vocal cords APART
adductors - bring together
What is the only abductor of the vocal cords?
posterior cricoarytenoid
The recurrent laryngeal nerve innervates ALL intrinsic muscles in the neck
EXCEPT for the ____
Cricothyroid Muscle
Cricothyroid Muscle is innervated by -____
extrinsic branch of superior laryngeal nerve
Pediatric airway
"bottleneck effect"
- cone shaped
- narrowest at the cricoid
Adult airway
- cylindrical shaped
- narrowest at glottis (true cords)
What is the hallmark of an upper airway obstruction?
stridor
- harsh, vibrating noise while breathing
Signs of upper airway obstruction
***Stridor
dysphonia (muffled void)
super-sternal chest retractions
drooling
tripod position
inspiratory stridor
