Flashcards in Handout Deck (137)
aka Abrikossof tumor, derived from Schwann cells
Granular Cell Myoblastoma
✔in striated muscles
✔firm, submucosal swellings in the mid 1/3 of tongue
tx: wedge excision
An 85 y/o hypertensive man is evaluated in the ER for recent onset of epistaxis. His BP is 150/80 mmHg, and Hct is 39%. What is most likely source of bleeding?
✔Posterior Nasal Septum
Arise form the dental lamina associated with impacted toot.
Xray: multilocular radioluscent appearance "soap bubble"
Clinically not performed;
removes: level I to V, spinal accessory nerve, IJV, and SCM,
✔Radical Neck Dissection or Crile's Procedure
Preserves spinal accessory nerve, IJV and SCM.
✔ Modified Radical Neck Dissection or Functional Neck Dissection
Preserves lymphatic structures normally removed in RND or MRND.
✔Selective Neck Dissection
For ORAL Malignancies: Supraomohyoid Dissection (I, II, and III)
For LARYNGEAL Malignancies: Laterala Neck Dissection (II, III and IV)
For THYROID Malignancies: Posterolateral Neck Dissection (II, III, IV, and V)
The classic complete neck dissection for palpable adenopathy in the posterior triangle of the neck includes removal of which of the following?
✔Transverse process, C2-C4
Most common on the lateral and ventral surface, presents with ulcerations and exophytic masses.
Cancer of the Tongue
Malignant Features of Salivary gland tumors.
Horizontal fracture through the maxilla superior to the maxillary dentition.
Le fort I
✔mobile hard palate
Pyramidal fracture through the maxilla and orbit, outlining the nose.
Le Fort II
Fracture of the facial bones from the skull.
Le Fort III
✔complete craniofacial separation
2nd most common facial fracture; presents with trismus, malocclusion, numbness, and loose or missing teeth.
Presents acutely with nausea, vomiting, fatigue, muscle weakness, confusion and decreased level of consciousness.
Occurs among patients with chronic renal failure.
Persistent hyperparathyroidism and hypercalcemia following successful renal transplant.
3 Normal areas of Narrowing in Esophagus
✔level of Cricopharyngeus: C6
✔level of Left mainstem Bronchus: T4-T5
✔level of Diaphragmatic hiatus: T10
Gold standard in Gerd diagnosis.
24-hr pH monitoring
Fundus of stomach is made to enrupt to the distal esophagus creating of new LES.
✔retching with inability to vomit
✔inability to pass a ngt
Hallmark of Intestinal metaplasia.
presence of intestinal goblet cells in Barrett esophagus
Gastric pouch extending above the crural impression (at least 2cms).
Area of potential weakness situated behind the esophagus at the level cricopharyngeus muscle.
✔defect in Zenker's Diverticula
✔regurgitation of undigested food
✔halitosis, choking and aspiration
Diverticula located 5cms above and below the level of carina; associated with both traction and pulsion.
Mid thoracic Diverticula
Pulsion diverticula that occurs at the distal 10cms of the esophagus.
✔usually single and occurs at the right side
A 79 y/o retired opera singer presents with dysphagia, which has become progressively worse during the last 5 years. He states that he is sometimes aware of a lump on the left side of his neck and that he hears a gurgling sounds during swallowing. He sometimes regurgitates food during eating. What is most likely the diagnosis?
Zenker's (pharyngoesophageal) syndrome
A 30 y/o psychiatric patient has barium swallow after removal of a foreign body to rule out a small perforation of the esophagus. No perforation is seen, but an epiphrenic diverticula is visualized. An epiphrenic diverticulum may be associated with?
Primary motility disorder characterized by loss of peristaltic waveform in the esophageal body and failure of LES to relax.
✔occur at any age
✔causes functional obstruction
Triad of LES:
✔Aperistalsis of Esophageal body
✔Failure of LES to relax
Gold standard test for achalasia.
Endoscopy: to r/o malignancy
Tx: Heller's myotomy + patial fundoplication
✔pneumatic dilatation: most effective non surgical tx