EXAM 1 Head and Neck Flashcards
(95 cards)
1
Q
What is the lay person’s name for Infectious rhinitis?
A
common cold
2
Q
What are common causes of infectious rhinitis?
A
Adenovirus, echovirus, rhinovirus
3
Q
What are some sign and symptoms of acute stage of infectious rhinitis?
A
- nasal mucosa is thickened, edematous, red
- nasal cavities are narrowed
- turbinates are enlarged
4
Q
What can infectious rhinitis extend to produce?
A
pharyngotonsilitis
5
Q
T or F. Infectious rhinitis can lead to secondary bacterial infections?
A
True
6
Q
What is another name of allergic rhinitis?
A
Hay fever
7
Q
What are some factors that initiate allergic rhinitis?
A
Hypersensitivity reactions:
- plant pollens, fungi, animal allergens, dust mites
8
Q
How many of the US population is affected by allergic rhinitis?
A
20%
9
Q
What is the major pathophysiology behind allergic rhinitis?
A
- It is an IgE mediate immune response when allergen binds to IgE on mast cells leading to degranulation and release of histamine –> leading to histamine related symptoms
- has early and late-phase response like asthma (from slides)
10
Q
What are s/s of allergic rhinitis?
A
- mucosal edema
- redness
- mucus secretion
- leukocytic infiltration in which esoinophils are prominent
11
Q
T or F. Allergic rhinitis can be caused by infection?
A
False it is not due to infection but an immune mediated response to an allergen.
12
Q
Recurrent rhinitis can cause _____ to the walls of the nares.
A
- focal protrusions of the mucosa such as nasal polyps
13
Q
What is a nasal polyp made of?
A
- edematous mucosa harboring hyperplastic or cystic mucous gland infiltrated with neutrophisl, eosinophils, plasma celsl with lymphocytses
14
Q
Whats the danger with nasal polyps?
A
They can become ulcerated or infectious; obstructs breathing.
15
Q
What most commonly precedes an acute sinusitis?
A
- acute or chronic rhinitis
16
Q
The impairment of draining of sinus by inflammatory edema of the mucosa causes?
A
suppurative exudate, producing empyema of the sinus
17
Q
Obstruction of outflow in sinusitis can lead to?
A
accumulation of mucous secretions forming mucoceles
18
Q
A rare complication of sinusitis is that it can cause:
A
Osteomyelitis (bone), cellulitis (skin), meningitis (brain, in immuno-compromised patients)
19
Q
What are some common inflammatory diseases of the nasopharnyx?
A
common diseases: pharyngitis, tonsillitis
common causes: rhinovirus, echovirus, adenovirus
less common causes: respiratory syncytial viruses and influenza
20
Q
What are some critical s/s?
A
Redening and edema of mucosa with reactive enlargement nearby tonsils and lymphs nodes
21
Q
Most common bacterial infection of the nasopharynx is?
A
B-hemolytic streptococci
22
Q
What is the pseudomembrane?
A
exudative membrane covering the tonsils, looks “white”
-nasopalatine and palatine tonsils are also enlarged and covered with exudate
23
Q
What are you at risk with the bacterial infection by B-hemolytic streptococci?
A
Risk of rheumatic fever and glomerulonephritis
24
Q
Explain how rheumatic fever occurs? What organ is in danger?
A
Body makes antibodies against the strep which are “nonspecific.” These antibodies can attack other tissues like the myosin filaments of the heart resulting in cardiac muscle/ valve damage
- sometimes the kidney gets attacked as well
25
What are two important characteristics of nasopharyngeal carcinoma?
- close anatomic relationship to lymphoid tissue
| - association with EBV infection
26
What are three important patterns of Nasopharyngeal carcinoma?
- Keratinizing Squamous cell carcinoma (SCC)
- Non-kertatinizing SCC
- Undifferentiated/basaloid carcinomas that have an abundant non-neoplastic, lymphocytic infiltrate
27
What are three risk factors for Nasopharyngeal carcinoma?
- Heredity
- Age
- EBV (Ebstein Bar Virus)
28
A patient with Nasopharyngeal carcinoma would present with what clinical symptoms?
- Nasal obstruction
- Epistaxis
- Cervical LN mets (70%)
29
What is another term for the Larynx? And what are its most common disorders?
Voicebox
- Larygnitis especially in heavy smokers
- Croup - laryngotracheobronchitis in children
30
A child comes in with inflammatory narrowing of the airway producing inspiratory stridor. What is the diagnosis?
Croup - laryngotracheobronchitis
31
Laryngitis predisposes people to what?
Squamous epithelial metaplasia and sometimes overt carcinoma
32
What is needed to resolve laryngitis?
- nothing, usually resolves on its own
33
Reactive nodules or polyps are most found in what two populations?
- heavy smokers
| - individual who impose great strain on vocal cords (singer's nodules --> Pitch perfect haha )
34
What are the difference between singers' nodules and polyps?
- Singer's nodules are bilateral lesions
| - Polyps are unilateral
35
Describe vocal cord nodules and polyps?
- smooth, rounded, sessile or pedunculated excrescences that are a few millimeters in greatest dimension and are located in the true vocal cords
36
IMPORTANT: What are vocal cord nodules or polyps covered by?
- Covered by squamous epithelium that may become keratotic, hyperplastic, or even slightly dysplastic
37
What can happen to impinging nodules?
ulceration
38
What are some signs/symptoms of vocal cord nodules or polyps?
cause changes in voice and porgressive hoarseness
39
Do vocal cord polyps or nodules give rise to cancer?
Nope.
40
What does dysplastic mean in terms of nodules?
Nodules can touch each other and cause ulceration.
41
What are Laryngeal squamous papillomas?
Benign neoplasms that are usually located on true vocal cords, form soft rasberry like porliferations rarely more than 1 cm in diameter.
42
What is one of the clinical symptoms of Laryngeal papilloma?
Raspy voice
43
What is the process of how we can get hemoptysis with Squamous papilloma?
Free edge papilloma --> Ulceration --> Hemoptysis
44
What are the different variations in the number of papillomas in children and adults?
- usually singles in adults and multiple in children
45
What are the two types of virus that cause the squamous papilloma lesions?
HPV Type 6 and 11
46
Do squamous papilloma become malignant? Do they recur?
NO. and yes, they frequently recur.
47
What population is Squamous cell carcinoma seen in?
Chronic male smokers
48
What are contributing factors to getting Squamous Cell Carcinoma?
nutritional factors, exposure to asbestos, irradiation, infection with HPV
49
What age group and gender is SCC seen in?
men in the 6th decade of life
50
How does SCC manifest?
persistent hoarseness, dysphagia, dysphonia
51
Describe the steps of how Acute/chronic otitis media can lead to Paragangliomas?
Acute/chronic otitis media --> Ostosclerosis --> polyps --> Labyrinthitis --> Carcinomas --> paragangliomas
52
What population does actue/chronic otitis media occur in usually? Is it usually caused by bacteria or virus .
- infants and children
| - Viral typically
53
Describe what type of infection (viral/bacterial) causes the two types of exudate?
Serous: viral
| - Suppurative: bacterial
54
What are the most common types of bacterial causes of acute/chronic otitis media?
- S. pneumoniae, H. influenzae, M. catarrhalis
55
What can chronic otitis media lead to?
- Cholesteatomas or the formation of stone
56
What are the two devastating pathways that a chronic infection can take?
- Chronic infection --> perforation --> spread into mastoid spaces
- Chronic infection--> performation --> cranial vault --> temporal cerebritis or abscess
57
What is the main problem that occurs in otosclerosis?
- abnormal bone depsoition in the middle ear about he rim of the oval window into which footplate of the stapes fit
58
What is the pathophysiology of otosclerosis?
What is the pathophysiology of otosclerosis? - first there is a fibrous ankylosis of the footplate followed in time by bony overgrowth anchoring into the oval window
59
What ear is usually affected?
usually both ears are affected
60
What governs the severity of the situtation?
degree of immobilization governs the severity of hearing loss
61
How rapidly does otosclerosis progress?
most instances the process is slowly progressive spanning over decades, leading to eventual marked hearing loss
62
What does the brachial cyst arise from?
remnants of the 2nd brachial arch
63
What population is branchial cyst most common in?
Young adults between ages of 20-40 years
64
What does the content of the cyst look like?
It may be clear and water OR mucinous and contain desquamated, granual cellular debris
65
Do the cysts change in size? Are they malignant?
- cysts enlarge slowly
| - they are rarely the site of malignant transformation
66
What is the Thyroglossal cyst?
- cysts that are left over when the thyroid migrates from base of tongue into the neck before birth
67
What is the thyroglossal cyst connected to? and where does it lie?
- connected to the back of the tongue by a small tract
| - lies in the middle of neck in front of "adam's apple"
68
What are paraangliomas (carotid body tumor)?
- clusters of neuroendocrine cells associated with sympathetic and parasympathetic systems
69
What is the most common location for paraganglioma?
- It is most often found within the adrenal medulla where they give rise to pheochromocytomas
70
Where do the 70% of extra-adrenal parangangliomas occur?
in the head and neck region
71
Define Xerostomia?
-decrease in the production of saliva leading to dry mouth
72
What population is the incidence of this the highest?
high as 20% in people over 70 YO
73
What are some causes of Xerostomia?
- MAJOR feature of autoimmune disorder SJORGREN SYDNROME (has added symptom of dry eyes)
- complication of radiation therapy, medications
74
What are some s/s of xersotomia?
- dry mucosa and or atrophy of papillae of tongue with fissuring and ulcerations
75
What are some complications that comes with Xerostomia?
- increased rates of dental caries, candidiasis, difficulty in swallowing and speaking
76
What are Mucoceles and what are the most common cause of them?
- most common lesion of the salivary glands
- results from either blockage or rupture of salivary gland duct with consequent leakage of saliva into surrounding connective tissue stroma
77
Where are they most often found in the body? What age is most susceptible to them?
- often found on lower lip and result of trauma
| - occur at all ages, most common in toddlers, young adults and elderly who are more prone to falling
78
What do mucocele present as clinically?
- fluctuant swellings of lower lip that have a blue trasnlucent hue
- cytic spaces are filled with mucin and infalmmatory cells and esp macrophages
79
What are Ranula?
- mucoceles that occur in the floor of the mouth
80
How do Ranulas occur?
they occur when epithelial-lined cysts that arise when duct of sublingual gland has been damaged
81
What is a plunging ranula?
- description of cyst that has dissected through connective tissue stroma connecting two bellies of mylohydoi muscle
82
What is a sialadentitis and what causes it?
- inflammation of the salivary glands
| - induced by trauma, viral/bacterial infection, autoimmune disease
83
What is the most common form of viral sialadentitis?
- Mumps where parotid is specifically is affected
84
What two bacterias are the biggest causes of sialadentitis?
S. aureus and streptococcus viridans
85
What is Sialolithiasis?
secondary to ductal obstruction produced by stones
86
How does stone formation occur in sialadentisis?
- obstruction by impacted food debris or by edema
87
How common are neoplasms?
not very, less than 2% of all tumors
88
T or F? 40% of submandibular, 50% of minor slaivary galnd, 70% to 90% of sublingual tumors are cancerous
True
89
What are distinctive s/s of parotid gland tumors?
swellings in front of and eblow the ear
90
What are pleomorphic adenoma?
- benign tumors, mixed tumors consisting of both epithelial and messenchymal differnetiation
- 60% in parotid
91
Does PLAG1 lead to increased cell growht?
Yes
92
What is an obvious s/s of pleomorphic adenoma?
bulge on the side of the face
93
What is the warthin tumor and what gland does it effect?
- 2nd most common salivary gland neoplasm
| - EXCLUSIVELY in the parotid gland
94
What is the risk ratio of someone who smokes vs someone who doesn't for warthin tumor?
8X more likley
95
What is genetically significant of mucoepidermoid carcinoma?
- Balance translocation of chromosome 11 & 19 causes a fusion protein that causes the tumor
