Cancer & Laryngectomy Flashcards
(102 cards)
1
Q
How many people does tobacco kill every year?
A
5 million
2
Q
How many people does second hand smoke kill each year?
A
600,000
3
Q
How many people will die from tobacco in the next 24 hours?
A
1,100
4
Q
What is the leading cause of laryngeal cancer?
A
Cigarettes
5
Q
Tobacco is the leading cause of what kind of cancer?
A
Head & Neck cancer
6
Q
How many different chemicals are in cigarette smoke?
A
4,000
7
Q
Name the 17 chemicals found in cigarettes named in the powerpoint slide:
A
Acetic Acid Acetanisole Toluene Formaldehyde Geraniol Acetone Hydrazine Cadmium Cinnemaldhyde Methanol Urea Benzene Ammonia Tar CO Arsenic Hydrogen Cyanide
8
Q
What is acetic acid found in?
A
Floor wipes
9
Q
What is acetanisole found in?
A
an ingredient in some perfumes
10
Q
What is Toluene found in?
A
dynamite & gasoline
11
Q
What is Formaldehyde found in?
A
poison used to preserve the dead
and cherries in juice
12
Q
What is Geraniol and Nicotine found in?
A
Pesticides
13
Q
What is acetone found in?
A
Nail polish remover
14
Q
What is Hydrazine found in?
A
Rocket fuel
15
Q
What is cadmium found in?
A
batteries
16
Q
What is cinnemaldehyde found in?
A
pet repellant
17
Q
What is methanol found in?
A
antifreeze
18
Q
What is urea found in?
A
Urine
19
Q
What is Benzene found in?
A
Fuel Solvent
20
Q
How many Americans does Laryngeal cancer occur in per year
A
15,000
21
Q
How many deaths does Laryngeal cancer cause?
A
4,200
22
Q
90% of laryngeal cancers are what kind of carcinomas?
A
Squamous cell carcinomas
23
Q
What is the etiology of squamous cell carcinomas?
A
smoking
24
Q
What can increase the risk of laryngeal cancer by 3X
A
Heavy alcohol intake
25
What are the 3 types of laryngeal cancer?
supraglottic, glottic, subglottic
26
What does glottic cancer effect?
the true vocal folds
27
What does supraglottic cancer effect?
False vf's, arytenoids, aryepglottic folds, epiglottis
28
What does subglottic cancer effect?
The trachea area
29
Which cancer is most rare?
Subglottic (about 5% of laryngeal cancers)
30
Which cancer accounts for 65% of laryngeal cancers
Glottic cancer
31
What cancer accounts for 35% of laryngeal cancers?
Supraglottic
32
The risk of second primary tumors has been reported as 25% if the patient continues to do what?
smoke and consume heavy alcohol
33
What is the overall 5 year survival of glottic cancer percentage?
85%
34
What is the 5 year survival percentage for a patient at stage I glottic cancer?
95%
35
What is the 5 year survival percentage for a patient at stage II glottic cancer?
85%
36
What is the 5 year survival percentage for a patient at stage III glottic cancer?
60%
37
What is the 5 year survival percentage for a patient at stage IV glottic cancer?
35%
38
What is the overall 5 year survival of supraglottic cancer percentage?
55%
39
What is the 5 year survival percentage for a patient at stage I supraglottic cancer?
65%
40
What is the 5 year survival percentage for a patient at stage II supraglottic cancer?
65%
41
What is the 5 year survival percentage for a patient at stage III supraglottic cancer?
55%
42
What is the 5 year survival percentage for a patient at stage IV supraglottic cancer?
40%
43
What is cancer staging based on?
```
Location of the tumor
Tumor size
Lymph node involvement
Cell type & tumor grade(how close it is to normal cells)
Metastasis
```
44
What does T refer to?
Tumor size
45
What does N refer to?
Lymph nodes
46
What does M refer to?
Metastasis
47
What does TX mean?
Primary tumor cannot be evaluated
48
What does T0 mean?
No evidence of primary tumor
49
What does Tis mean?
Carcinoma in situ(early cancer that has not spread to neighboring tissue)
50
What does T1, T2, T3, T4 refer to?
Size or extent of the primary tumor
51
What does NX mean?
Regional lymph nodes cannot be evaluated
52
What does N0 mean?
No regional lymph node involvement (no cancer found in lymph nodes)
53
What does N1, N2, N3 refer to?
Involvement of regional lymph nodes(number and extent of spread)
*ANY N TYPE WILL BE REMOVED
54
What does MX mean?
Distant metastasis cannot be evaluated
55
What does M0 mean?
No distant metastasis (cancer has not been spread to other parts of the body)
56
What does M1 mean?
Distant metastasis (cancer has spread to distant parts of the body)
57
What system can be used to group cancer into stages?
The TNM system
58
Describe TMN Stage 0:
Tis, N0, M0 (best stage to catch cancer)
59
Describe TMN Stage I:
T1, N0, M0
60
Describe TMN Stage II:
T2, N0, M0
61
Describe TMN Stage III:
T3, N0, M0
T1, N1, M0
T2, N1, M0
T3, N1, M0
62
Describe TMN Stage IVA:
T4, N0, M0
T4, N1, M0
Any T, N2, M0
63
Describe TMN Stage IVB:
Any T, N3, M0
64
Describe TMN Stage IVC:
Any T, Any N, M1
65
Visually, what does glottic cancer look like?
bloody type
66
Visually, what does subglottic cancer look like?
crystalized, white look
67
Which structures can be affected in Oral cancers?
```
Tongue
Floor of mouth
Mandible
Maxilla
Palate
```
68
T/F: Any of the oral cancer structurescan have cancer and spread to the bone.
TRUE
69
T/F: Most oral cancers are related to tobacco
TRUE
70
T/F: Smokers have increased circulation
False: they have decreased circulation
71
Name the 3 H/N Cancer Treatments?
Radiation Therapy
Chemotherapy
Surgery
72
Is voice therapy appropriate for H&N Cancer treatments?
No
73
What does cancer treatment depend on?
The extent of the cancer
74
Cancer is usually taken out and followed up with what?
Radiation
75
Name the 10 side effects of radiation therapy with or without chemo:
```
Xerostomia
inflammation
Pain
Fibrosis
Alopecia
Reduced Taste
Anorexia
Decreased tongue/ jaw ROM
Reduced pharyngeal constriction
Narrowing of esophagus
```
76
What is xerostomia
decreased salivary glands and dry mouth
77
What is fibrosis?
Hardening of tissue
78
What are the different types of partial laryngectomys?
```
Supraglottic laryngectomy
supracricoid laryngectomy
hemilaryngectomy
cordectomy
subtotal laryngectomy
hemisupraglottic laryngectomy
**** GO BACK&READ THROUGH THE PARTIAL LARYNGECTOMYS BECAUSE THIS LIST IS INCOMPLETE AND DOESNT HAVE DETAILS
```
79
Partial laryngectomys can possibly occur with:
```
total/partial glossectomy
neck/re/dissection (SCM's, lymoh nodes)- radical, midified, simple composite
total/partial mandibulotomy
cricohyoidplexy
cricohyoidoepiglottoplexy
cricopharyngeal myotomy
permanent trachoestomy
```
80
If the neck is dissected, what is removed?
SCM
81
3 Reasons why we use tracheostomy tube
- The upper airway is obstructed at or above the level of the vf's.
- Potential upper airway obstruction(edema post surgery)
- Provision of respiratory care
82
How are tracheostomy tubes used?
The tube is inserted into the trachea via surgical incision btwn 3rd & 4th tracheal ring
83
What are the 3 parts of the tracheostomy tube?
outer cannula, inner cannula, obturator
84
What does the outer cannula do?
holds the trach site open
85
What does the inner cannula do?
It's the actual breathing tube in the trachea
86
What does the obturator do?
Its the smooth tip for initial insertion
87
Where is the incision made for a tracheostomy tube?
Around the 3rd cartilaginous ring of the trachea. It's routed out through the neck hole
88
What does the cuffed trach tube do?
Prevents aspiration used with ventilators inflated for + pressure
89
What does the cuffless trach tube do?
Aspiration may occur and may interfere with laryngeal elevation during swallowing. It assists in breathing and secretion removal. This is long term use.
90
What does the fenestrated tube do?
It's smaller and used for weaning and decannulation. It's short term (3-5 days) and has a hole in it.
91
What are the parts of the speaking valve?
Passy Muir, Provox
92
What does the total laryngectomy include?
-removal of the larynx (resection of the hyoid bone, pre epiglottic space, thyroid cartilage, cricoid cartilage, and one to four tracheal rings)
93
Where are the hypopharyngeal constrictor muscles sectioned from?
From the lateral edge of the thryroid cartilage and cricoid insertions
94
After the larynx is removed, where does the trachea go?
The trachea is sutured to the skin of the neck, either in the original skin incision or in a seperately made incision.
95
After the larynx is removed, where do the constrictor muscles go?
They're usually reconstructed in the midline to support a one or two layer mucosal closure in an effort to reduce fistula formation
96
Name 3 ways you can communicate post-laryngectomy:
Electrolarynx
Esophageal Speech
TEP
97
What is an electro larynx?
It vibrates tissue. The patient will find a sweet spot and press down on the button while mouthing speech. They cost between $400-800.
98
What is esophageal speech?
"Burping" it sounds more natural than electrolarynx but it's very hard to teach and learn. You swallow in aor and burp it out.
99
What is TEP?
Tracheal Esophageal Puncture: The prosthesis reed device is used so it has a hole through it. It sits in a hole made in the back of the trachea and infront of the esophagus and creates the source while the patient occludes.
100
What does TEP sound like?
a low gravely voice.
101
How often should TEP's be changed out?
once a month
102
What are 6 TEP complications that can occur?
```
Aspiration
Aspiration of prosthesis
Stenosis
Stoma & fistula infection
Spasm
Migration or fistula enlargement
```
