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Pathophysiology II > Head and Neck > Flashcards

Flashcards in Head and Neck Deck (46):
1

Infectious rhinitis

The Common cold
-usually viral. The issue is that the virus destroys the cilia and that starts the inflammatory process. Increased mucous and constriction = stuffy nose. Also makes the passage susceptible to bacterial infection

2

Causes of infectious rhinitis

-adenovirus
-echovirus
-rhinovirus

3

Allergic rhinitis

Hay fever
-initiated by hypersensitivity reactions, plant pollens, environmental toxins, fungi, animals, and dust mites
-igE mediated, similar to asthma

4

S/S of allergic rhinitis

-musocal edema, redness, prominent eosinophils, puts individual at risk for asthma

5

Nasal polyps

-Caused by recurrent rhinitis
-Overactive mucosal cells with inflammatory cells.
-can become ulcerated and infected, leading to epistaxis

6

Sinusitis

Inflammation of the lining of the paranasal sinuses. Usually occurs with recurrent rhinitis

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Mucocele

Accumulation of mucus secretions of the sinus d/t obstruction of the ostea

8

S/S of sinusitis

Facial pain, redness of nose, cheeks, eyelids, nasal discharge, coughing, pharyngeal irritation, hyposmia

9

Pharyngitis

-d/t 1 or 2 degree bacterial infection
-most common cause = b hemolytic streptococci, which increases risk of glomerulonephritis and rheumatic fever

10

S/s of pharyngitis

- redness and edema of mucosa
-enlargement of tonsils and lymph nodes
-pseudomembrane is visible
-follicular tonsillitis

11

Nasopharyngeal carcinoma

-associated with EBV virus
1. Keratinizing = hard to treat
2. Non-keratinizing = easy to treat
3. Basaloid/ undifferentiated

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Things that affect nasopharyngeal carcinoma

-heredity
-age
-EBV infection

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S/S of nasopharyngeal carcinoma

-Nasal obstruction
-epistaxis
-cervical lymph nodes show metastaces

14

Croup

Laryngotracheobronchitis in children
-creates seal bark cough or stridor d/t narrowing of the airway and causes choking episodes

15

Smokers with chronic laryngitis

Squamous carcinoma risk increase

16

Singers nodules

Bilateral lesions d/t imposing strain on the vocal cords

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Reactive nodules/ polyps

Unilateral polyps in heavy smokers

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Singers nodules and reactive nodules clinical features

-smooth and round
-a few mm in diameter
-on the true vocal fold
-can be sessile or pedunculated
-cause changes in the voice
-usually always benign
-can lead to ulceration and bleeding

19

Otosclerosis

-abnormal bone deposition in the middle ear that anchors the stapes into the oval window
-prevents stapes from vibrating and the degree of immobilization determines the severity of hearing loss
-affects both ears
-genetic causes, or measles

20

Branchial cyst

-congenital epithelial cysts that form because of a failure to obliterate the 2nd bronchial cleft during development
-most common in young adults 20-40
-lateral part of the neck
-contents of cyst can either be clear and watery or mucinous with debris
-rarely is malignant
-congenital

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S/S of branchial cyst

- dysphagia, dysphonia, dyspnea, and strider

22

Laryngeal squamous papilloma

-benign neoplasm on the true vocal fold
-raspberry like proliferation
-cause = HPV 6 and 11
-never over 1 cm
-can ulcerated and cause bleeding

23

Laryngeal squamous carcinoma

-SCC in chronic smokers
-contributing factors = nutritional, asbestos, irradiation, infection w/ HPV

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S/S of larygeal squamous carcinoma

Hoarseness, dysphagia, dysphonia

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Fibrous ankylosis

Bony overgrowth seen in otosclerosis that binds stapes to the oval window

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Acute/chronic otitis media

-ear infection
-usually affects infants and children
-usually viral in nature
-becomes chronic in individuals who are immunocompromised

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When otitis media is viral in nature it is called:

Serous; watery fluid coming out of ear

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When otitis media is bacterial in nature it is called:

Suppurative; pus like fluid coming out of ear

29

Cholesteatoma

Fluid filled cyst that forms with chronic otitis media

30

Two outcomes of chronic otitis media

1. If infection is perforated, it can spread to mastoid air cells, which are involved in balance
2. If infection is perforated, it can go to the cranial vault and cause temporal celebritis = more serious

31

Thyroglossal duct cyst

-congenital
-cause: the thyroglossal duct connects the thyroid and tongue, and it is supposed to stretch and disappear at birth. When it doesn’t go away = cyst
-MIDLINE swelling
-in front of Adam’s apple

32

Paraganglioma

“Carotid body tumor”
-carotid body is responsible for chemoreceptors
-clusters of neuroendocrine cells
-cause= overstimulation
-when it occurs in the adrenal medulla = pheochromocytoma
-the rest occur in the head and neck region

33

Xerostomia

-Dry mouth d/t decreased saliva
-usually occurs in people older than 70
-mainly in sjrogens syndrome
-complication of radiation and medication

34

S/s of xerostomia

-dry mucosa
-atrophy of papillae of the tongue with fissuring and ulcers
-increased risk of candidas, difficulty swallowing

35

Mucocele

Most common lesion of the salivary gland
-cause: blockage/ rupture of salivary gland duct. Leakage of saliva into the surrounding connective tissue
-usually on the lower lip as a result of trauma
-most common in toddlers, young adults, and elderly
-filled with mucin and inflammatory cells, mainly macrophages

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S/S of mucocele

Swelling of lower lip, with a blue hue

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Ranula

Mucocele on the floor of the mouth
-Cause: damage to the sublingual gland

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Plunging ranula

Cyst that goes through the connective tissue that connects the mylohyoid
-midline swelling

39

Sialadenitis

-Infection of the salivary glands
-cause: trauma, viral/bacterial infection or autoimmune disease
-clinical rule = unilateral involvement

40

Viral cause of sialadenitis

-most commonly mumps
-affects the parotid

41

Non specific bacterial cause of sialadenitis

Affects the submandibular gland

42

Sialolithiasis

Caused by ductal obstruction, formed by food debri

43

Pleomorphic adenoma

Mixed tumor of ductal and myoepithelial cells
-60% are in the parotid, next common spot is the salivary gland
-increased risk d/t radiation
-has the potential to become malignant
-cause = mutation on the PLAG1 gene “ pleiomorhpic adenoma gene”

44

S/S of pleiomorphic adenoma

-Painless, slow growing, mobile
-can be in the parotid, submandibular, buccal areas

45

Warthin tumor

-2nd most common salivary gland benign neoplasm
-exclusively in the parotid gland
-smokers have 8x the risk of getting it
-usually never malignant

46

Nucoepidermoid carcinoma

-mixed squamous cells, mucus-secreting cells, and intermediate cells
-mainly in the parotid
-cause= translocation event in ch. 11 and 19
-MECT1-MAML2 fusion leads to tumor