Head and Neck Board Study

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Head and Neck Board Study
2014-04-07 15:06:15
Candice Head Neck Board Study

Head and Neck Board Study
Show Answers:

  1. Where does H & N met to first
  2. the oral cavity includes
    • anterior 2/3 of tongue
    • lip
    • buccal mucosa
    • retromolar trigone
    • floor of mouth
    • hard palate
  3. What is the # 1 cause of head and neck cancers
    smoking and alcohol
  4. The nasopharynx includes
    posterosuperior pharyngeal walls, lateral pharyngeal walls, eustachian tubes , and adenoids
  5. What is the #1 site for head and neck cancer
  6. Is head and neck cancer more common in men or women
    men 2:1
  7. Which h&N cancer is the # 1 cranial nerve involvement?
  8. Epstein Barr virus is linked to
    nasopharyngeal cancer
  9. 80% of H&N are _____carcinoma
    squamous cell
  10. Salivary glands are ______carcinoma
  11. Typical chemo drugs for H&N
    5 FU and Cisplatin
  12. For head and neck, what are marked on the CT
    canthus, scars, commissures, and palpable nodes
  13. Name 4 clinical presentations for Oral cancer
    • Poor oral and dental hygeine
    • Plummer-Vinson syndrome (iron deficiency in females)
    • Leukoplakia (white patches on the tongue) or erythroplasia(red patch on tongue)
    • Non healing ulcers
  14. You would typically treat a lip with
    electron, not usually surgery for cosmetic reasons
  15. The lip drains to
    submandibular, submental, preauricular, and facial nodes
  16. Lip doses are generally
  17. Floor of mouth drains to
    submaxillary and jugular nodes
  18. Doses for head and neck are typically
    50-70 GY
  19. What is the most common site for oral cavity cancer
  20. Oropharynx consists of
    • base of tongue
    • tonsils
    • soft palate
    • oropharyngeal walls
  21. #1 site for oropharynx cancer
  22. What is a typical field for oral cavity
    • opposed lats and boost
    • Anterior portion of the mandible
    • Posterior behind vetebral bodies
    • Superior 1.5cm above tongue and
    • Inferior thyroid notchLateral opposed fields
  23. Main lymphnode drainage for H&N
  24. Oropharynx is located behind the mouth from the ___ ___ to the ______
    soft palate to the hyoid bone
  25. The nasopharynx is located behind the ____ and extending from the ______ to the level of the ______ but does not include it
    • nose
    • posterior nares
    • soft palate
  26. The Hypopharynx is at the level of the ___ ___ and teminates in the ___
    • hyoid bone
    • esophagus
  27. 3 clinical presentations for a pharynx cancer
    • persistent sore throat
    • painful swallowing
    • referred otalgia
  28. Hypopharynx usually presents at stage
  29. Hypopharynx includes
    • pyriform sinus
    • postcricoid and lower posterior phayngeal walls below the base of the tongue
    • C3-C6
  30. The most common site for hypopharynx
    pyriform sinus
  31. #1 sign for nasopharynx cancer
    bloody discharge
  32. Nasopharynx treatment borders
    • Superior- 2cm beyond tumor to include base of skull and sphenoid sinus
    • Posterior- 2cm beyond mastoid process, or post margin may extend further to allow a 1.5 cm margin on enlarged nodes
    • Anterior-include posterior 1/3 of maxillary sinus and nasal cavity
    • Inferior- thyroid notch to spare larynx
    • Lower neck- anterior scv with larynx blocknaso1.png
  33. Larynx tx fields include
    • Glottis-
    • Superior-upper thyroid notch
    • Inferior cricoid cartilage C6
    • Anterior 1-1.5cm flash over skin and vocal cords
    • Posterior- anterior to vetebral body including pharyngeal wells
    • The supra and subglottis are the same except a little larger to include the jugulodigastric, cervical and scv nodes since the glottis normally does not have nodal involvement
  34. Laryngitis occurs at what dose
  35. What % of H and N cancers are Glottic
  36. If vocal cord is fixed when patient speaks then it is automatically staged a T
  37. What is the treatment of choice for laryngeal cancers
    radiation due to the preservation of the voice
  38. What is the 5 year survival rate for glottis without cord fixation and also with cord fixation
    80-90% without and 50-60% with cord fixation
  39. What is the 5 year survival rate for supraglottic with and without nodal involvement
    80-90% without nodal involvement and 30-50% with nodal involvement
  40. What is the staging for larynx cancer
    • T1- limited to cord with normal mobility
    • T2-extends to supraglottis/subglottis and or cord impairment (but cord can still move)
    • T3-Limited to larynx with cord fixation
    • T4-invades beyond larynx
  41. What is the largest salivary gland and what is the Td5/5
    parotid 3200
  42. What is the tx of choice for the parotid
  43. At what dose does xerostomia occur
    20 Gy and permanently at 40Gy
  44. What is the typical treatment for nasopharynx
    • RT#1
    • 70 GY  3 field techique Ant and 2 lats and then electron boost to cervical nodes posteriorly
  45. What is the typical treatment for the lip
    surgery unless larger than 4cm then treat with electrons