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Cancer and Laryngectomy Flashcards

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1
Q

3 types of H & N Cancer Treatments?

A
  1. Radiation Therapy
  2. Chemotherapy
  3. Surgery
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2
Q

What are some side effects of radiation therapy with or w/o chemo? (9 total)

A
  1. Xerostomia
  2. Inflammation (mucositis)
  3. Pain
  4. Alopecia
  5. Reduced Taste
  6. Anorexia
  7. Decreased Tongue/Jaw ROM
  8. Reduced Pharyngeal Constriction
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3
Q

What are some communication styles post laryngectomy?

3

A
  1. Electrolarynx
  2. Esophageal Speech
  3. TEP
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4
Q

How does an electolarynx work?

A

vibrates tissue in the neck

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5
Q

how does esophageal speech work?

A

burping

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6
Q

How does a TEP (tracheo esophageal puncture) work?

A
  • Provides Respiratory Support
  • Cognition (occlusion of stoma, and cleansing prosthesis )
  • Adequate Vibratory PE Segment
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7
Q

What are some TEP Complications?

tracheo esophageal puncture

A
  1. Aspiration/Leakage of food
  2. Aspiration of Prosthesis
  3. Stenosis
  4. Stoma and Fistula Infection
  5. Spasm
  6. Migration of Fistula Enlargement
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8
Q

Tobacco Products kill over how many people per year?

A

over 5 million

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9
Q

second hand smoke kills over how many people per year?

A

600,000

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10
Q

over how many different chemicals are found in cigarette smoke?

A

over 4000 chemicals

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11
Q

what are some chemicals found in cigarette smoke?

A
  1. acetic acid- found in floor wipes
  2. acetanisole- an ingredient in some perfumes
  3. toluene- found in dynamite and gasoline
  4. formaldehyde- a poison used to preserve the dead
  5. geraniol and nicotene- found in pesticides
  6. acetone- removes nail polish
  7. hydrazine- found in rocket fuel
  8. cadmium- found in batteries
  9. cinnemaldhyde- pet repellant
  10. methanol- found in antifreeze
  11. urea- found in urine
  12. benzene- a fuel solvent
  13. ammonia- strips dirt
  14. Tar
  15. CO- carbon monoxide
  16. arsenic
  17. Hydrogen Cyanide
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12
Q

Laryngeal cancer occurs in over how many american’s per year?

A

over 15,000

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13
Q

how many deaths does laryngeal cancer cause per year?

A

over 4800 deaths per year.

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14
Q

90% of laryngeal cancers are what type of cancer?

A

squamous cell carcinomas-related to smoking

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15
Q

what can increase the risk of laryngeal cancer?

A

heavy alcohol intake.

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16
Q

Where is the location of glottic cancer?

A

the true vocal folds

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17
Q

where is the location of supraglottic cancer?

A

above the larynx (above true vocal folds)

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18
Q

where is subglottic cancer?

A

below true vocal folds

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19
Q

what type of cancer accounts for 65% of the laryngeal cancers?

A

cancer involving the glottis (true vocal folds)

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20
Q

what type of cancer accounts for 35% of laryngeal cancers?

A

supraglottic cancer: includes

  • false vocal folds
  • arytenoids
  • ariepiglottic folds-
  • epiloglottis
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21
Q

which cancer is the most rare (only 5%) ?

A

subglottic cancer is rare

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22
Q

what is the risk of second primary tumors, especially if the patient continues smoking and drinking alcohol…?

A

25%

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23
Q

what is the overall survival rate of glottic cancer?

A

85%

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24
Q

5 year survival rate for stage 1 glottic ?

A

95%

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25
5 year survival rate for stage 2 glottic?
85%
26
5 year survival rate for stage 3 glottic?
60%
27
5 year survival rate for stage 4 glottic?
35%
28
What is the overall survival rate for supraglottic cancer?
55%
29
what is the overall survival rate for stage 1 supraglottic?
65%
30
what is the overall survival rate for stage 2 supraglottic
65%
31
what is the overall survival rate for stage 3 supraglottic?
55%
32
what is the overall survival rate for stage 4 supraglottic?
40%
33
what are the 5 areas of cancer staging based upon?
1. Location 2. Tumor Size 3. Lymph Node Involvement 4 Cell type and tumor grade (how close to normal it is) 5. metastis- has it expanded from primary location?
34
A primary tumor of TX would mean?
primary tumor cannot be evaluated
35
a primary tumor of T0 would mean?
no evidence of primary tumor
36
a primary tumor of Tis would mean?
Carcinoma in situ- early cancer that has not spread to neighboring tissue
37
T1, T2, T3, T4 refers to what?
size and/or extent of the primary tumor
38
a regional lymph node with NX would mean?
regional lymph node cannot be evaluated
39
a regional lymph node with N0 would mean?
no regional lymph node involvement (no cancer found in lymph)
40
a regional lymph node with N1, N2, N3 would mean?
involvement of regional lymph nodes (number and/or extent of spread)
41
Distant Metastasis if MX would mean?
distant metastasis cannot be evaluated
42
Distant Metastasis of M0 would mean?
no distant metastasis
43
Distant Metastasis of M1 would mean?
distant metastasis- cancer has spread to different parts of the body.
44
How large is T1?
1 cm (size of a pea)
45
how large is T2?
2 cm (size of a peanut)
46
how large is T3]?
4 cm (walnut)
47
how large is T4?
5 cm, size of a lime
48
A cancer that is: Tis, N0, M0 is in what stage?
Stage 0
49
A cancer that is: T1, N0, M0, is in what stage?
Stage 1
50
A cancer that is: T2, N0, M0 is in what stage?
Stage 2
51
A cancer that is: T3, N0, M0 is in what stage?
Stage 3
52
A cancer that is: T1, N1, M0 is in what stage?
Stage 3
53
A cancer that is: T2,N1, M0 is in what stage?
Stage 3
54
A cancer that is: T3, N1, M0 is in what stage?
Stage 3
55
A cancer that is in: T4, N0, M0 is in what stage?
Stage IVA
56
A cancer that is in: T4, N1, M0 is in what stage?
Stage IVA
57
A cancer that is in: Any T, N2, M0 is in what stage?
Stage IVA
58
Any T, N3, , M0
Stage IVB
59
Any T, Any N, M1
Stage IVC
60
What are 3 types of head and neck cancers?
1. Glottic 2. Supraglottic 3. Subglottic
61
What are the 5 structures affected by oral cancers?
1. tongue 2. floor of mouth 3. mandible 4. maxilla 5. palate
62
5 type sof partial laryngectomy?
1. supraglottic laryngectomy 2. supracricoid laryngectomy 3. Hemilaryngectomy (one side) 4. cordectomy 5. subtotal laryngectomy
63
what are 7 components that can accompany a partial laryngectomy?
1. total/partial glossectomy 2. neck re/dissection (SCMs, lymph nodes- can be radical, modified, simple, composite 3. total/partial mandibulotomy 4. cricohyoidplexy 5. cricopharyngeal myotomy 6. cricohyoidepiglottoplexy 7. Permanent Tracheostomy
64
what is a total laryngectomy?
total removal of the larynx
65
what 5 anatomical structures are removed in a total laryngectomy?
1. Hyoid 2. Pre-epiglottic Space 3. Thyroid 4. Cricoid 5. one to four tracheal rings
66
which muscles are sectioned from the lateral edge of the thyroid cartilage and cricoid insertions?
Hypo pharyngeal constrictor muscles.
67
after removal of the specimen (larynx), what happens to the trachea?
it's sutured to the skin of the neck, either in the original skin incision or in a separately made incision.
68
what happens to the constrictor muscles? why?
constrictor muscles are usually reconstructed in the midline to support support a one to two layer mucosal closure in an effort to reduce fistula formation.
69
Why would a patient get a tracheostomy tube?
1. due to upper airway obstruction at or above level of vocal folds. 2. potential upper airway obstruction (edema post surgery) 3. provision of respiratory care
70
how does a person get a tracheostomy tube?
-tube is inserted into the trachea via surgical incision
71
What is an outer canula?
holds the trachea site open
72
what is an inner canula?
actual breathing tube in trachea
73
what is an obturator
smooth tip for initial insertion
74
3 components of a tracheostomy tube?
1. outer canula 2. inner canula 3. obturator
75
what does a cuffed trach tube prevent?
prevents aspiration. used with ventilators inflated for + pressure
76
what is a cuffless trach tube?
- aspiration may occur - may interfere with laryngeal elevation during swallowing - assist breathing and secretion removal - long term use
77
what is a fenestrated trach tube?
- smaller - used for weaning and decannulation - short term (3-5 days)
78
what are the two ventilator options?
dependent or trached

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