Head and Neck

CHAPTER 10
Head and Neck


Jonathan M. Lee and Margaret M. Moore


Test Taking Tips


• Know that the treatment for benign parotid tumors is superficial parotidectomy and that the treatment for malignant parotid tumors is total parotidectomy.


• Know the staging for squamous cell cancer of the head and neck. There is often a question about squamous cell cancer of the head and neck and the appropriate adjuvant treatment (in regards to the size of the primary tumor).


ANATOMY


Name the 3 auditory ossicle bones:


Malleus (hammer), incus (anvil), stapes (stirrup)


Name the nerve that crosses the internal carotid artery 1 to 2 cm above the carotid bifurcation:


Hypoglossal nerve


The hypoglossal nerve supplies motor innervation to all of the muscles of the tongue except:


Palatoglossus


The phrenic nerve lies on top of what muscle?


Anterior scalene


Name the branches of the facial nerve:


Temporal, zygomatic, buccal, marginal mandibular, cervical branches


Which branch of the facial nerve is most often injured in carotid surgery?


Marginal mandibular nerve


Name the branches of the trigeminal nerve:


Opthalmic (V1), maxillary (V2), mandibular (V3)


What nerve is found within the carotid sheath?


Vagus


The recurrent laryngeal nerve innervates all of the muscles of the larynx except:


Cricothyroid muscle


Which nerve is responsible for sensory innervation of the larynx above the level of the vocal folds?


Internal branch of the superior laryngeal nerve


Which nerve is responsible for sensory innervation of the larynx below the level of the vocal folds?


Recurrent laryngeal nerve


Name the branches of the thyrocervical trunk:


STAT


Suprascapular artery


Transverse cervical artery


Ascending cervical artery


Inferior thyroid artery


What is the first branch of the external carotid artery?


Superior thyroid artery


Name the blood supply to the nose:


Anterior/posterior ethmoidal arteries off the ophthalmic artery


Superior labial artery from the facial artery


Sphenopalatine artery off the internal maxillary artery


What nerve innervates the strap muscles?


Ansa cervicalis


Image


FIGURE 10-1. Lymph node compartments in the neck. The central compartment (level VI) is defined laterally by the carotid sheaths, superiorly by the hyoid bone, and inferiorly by the suprasternal notch. The lateral compartment contains superior jugular (level II), middle jugular (level III), and inferior jugular (level IV) lymph nodes, as well as the posterior triangle nodal tissue bound by the posterior border of the sternocleidomastoid, the anterior border of the trapezius, and the clavicle (level V). The division between levels II and III is a horizontal plane defined by the inferior body of the hyoid bone. The division between levels III and IV is a horizontal plane defined by the inferior border of the cricoid cartilage. Level I contains the submental and submandibular lymph nodes. a., artery; m., muscle; n., nerve; v., vein. (Reproduced with permission from The University of Texas MD Anderson Cancer Center. Visual Art © 2008 The University of MD Anderson Cancer Center. All rights reserved.)


Define the regions of the cervical lymph nodes:


Level I: submental and submandibular nodes


Level II: upper jugular nodes


Level III: middle jugular nodes


Level IV: lower jugular nodes


Level V: posterior triangle


Level VI: anterior compartment


Level VII: upper mediastinal nodes


Image


FIGURE 10-2. Diagrammatic representation of the relations of the parotid gland to the facial nerve and its branches. a., artery; m., muscle; n., nerve; v., vein. (Modified from Skandalakis’ Surgical Anatomy: The Embryologic Basis of Modern Surgery. Paschalidis Medical Publications; 2004, with permission.)


What structure divides the parotid gland into superficial and deep lobes?


Facial nerve


What is the name of the duct in the parotid gland?


Stenson duct


What is the name of the duct in the submandibular gland?


Wharton duct


What is the most common nerve injured in parotid surgery?


Greater auricular nerve


TUMORS


What is the most common type of cancer of the oral cavity, pharynx, and larynx?


Squamous cell carcinoma


What is the biggest risk factor for head and neck cancer?


Tobacco


What is the most common location for an oral cavity cancer?


Lower lip


Oral cavity cancer is most likely to spread to which regional lymph nodes?


Submental and submandibular (level I)


What is the most common benign head and neck tumor in adults?


Hemangioma


What is the most common tumor of the nasopharynx in children?


Lymphoma


What is the most common benign neoplasm of the nose and paranasal sinuses?


Papilloma


What is the most common benign lesion of the larynx?


Papilloma


What is the treatment for an early glottic squamous cell carcinoma?


Primary radiation versus conservative surgical resection—laser versus endoscopic (if recurs perform chordectomy)


What is the treatment for an advanced glottic squamous cell carcinoma?


Laryngectomy, modified radical neck dissection, and postoperative radiation


Where do head and neck tumors most often distantly metastasize?


Lung

Aug 13, 2019 | Posted by in ABDOMINAL MEDICINE | Comments Off on Head and Neck
Premium Wordpress Themes by UFO Themes