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Treatment sites- Chapter 3 laura nappi Part 1 > pharynx, larynx > Flashcards

pharynx, larynx Flashcards

1
Q

What are the three subdivisions of the pharynx

A

nasopharynx, oropharynx, laryngopharynx/hypopharynx

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2
Q

______ is
-Cuboidal in shape
- Positioned posterior to the nose and extends inferiorly to the Uvula
- Located at Level of C1

A

Nasopharynx

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3
Q

Cancers in the _____have symptoms, such as consistent sore throat, pain while swallowing, pain in the ear, and cervical node enlargement

A

pharynx

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4
Q

Adenoids are located within the

A

nasopharynx

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5
Q

Nasopharynx is located close to the base of the

A

brain

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6
Q

_____usually occur in the lateral walls of the nasopharynx

A

carcinomas

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7
Q

There is a strong connection between nasopharyngeal cancers and the

A

Epstein. Barr virus (EBV)

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8
Q

Oropharynx is Positioned posterior to the oral cavity and extends from the

A

soft palate (Superiorly) to the hyoid bone (inferiorly)

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9
Q

________ is
located at level C2 to C3
Contains lymphoid tissue called palatine tonsils

A

Oropharynx

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10
Q

Most cancers in the oropharynx occur in the

A

tonsils

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11
Q

Oropharynx is Associated with

A

alcohol consumption, smoking, and HPV

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12
Q

The Laryngopharynx extends from the

A

hyoid bone to esophagus

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13
Q

_____ is
- located C3 to C6
- Posterior to larynx
- Made up of the pyriform sinuses, postcricoid and lower posterior pharyngeal walls

A

Laryngopharynx

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14
Q

The _____ is the superior border of the laryngopharynx at the level of C3

A

epiglottis

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15
Q

_______ is the most common location for cancer within the hypopharynx

A

Pyriform sinus

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16
Q

Majority of pharynx cancers have what histology

A

squamous cell carcinoma (SCC)

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17
Q

_______drains to subdigastric, upper cervical, submaxillary and parapharyngeal nodes

A

Oropharynx

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18
Q

_____drains to cervical nodes, retropharyngeal node (node of Rouviöre), and jugulodigastric nodes

A

Nasopharynx

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19
Q

______drains to midcervical nodes, superior deep, middle and low jugular nodes; and retropharyngeal node (node of Rouviöre)

A

Hypopharynx

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20
Q

Oropharynx tumors spread to lymph nodes and invade structures located

A

close to the tumor

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21
Q

The hypopharynx commonly spreads to lymph nodes and invades

A

nerves and muscles nearby

22
Q

The _____ extend from the epiglottis to the cricoid cartilage

A

Larynx

23
Q

Cancer in the larynx is strongly associated with

A

cigarette smoking

23
Q

The larynx is located at the level of

A

C3 to C6

24
Q

Common symptoms of larynx cancer is

A

constant soreness of the throat and hoarseness

24
Q

The larynx includes the

A

supraglottis, glottis, and subglottis

25
Q

_____ = epiglottis, false vocal cords, ventricles, aryepiglottic folds, arytenoids

A

Supraglottis

26
Q

____ = true Vocal cords and anterior/posterior commissures

A

glottis

27
Q

_____ = 1 cm below true Vocal cords

A

subglottis

28
Q

Supraglottic cancers spread first to what nodes?

A

jugulodigastric and midjugular nodes

28
Q

What is most common histology of larynx cancer

A

squamous cell carcinoma

29
Q

Glottic cancers rarely spread to

A

lymph nodes

30
Q

Subglottic cancers spread first to what nodes?

A

pretracheal, paratracheal, and inferior jugular nodes

31
Q

what is the clinical presentation for nasopharynx

A
  • blood discharge
  • auditory dysfunction
  • respiratory dysfunction
    -cranial nerve involvement

-squamous cell carcinoma most common

32
Q

detection and diagnosis for nasopharynx

A
  • history and physical
  • inspection - indirect mirror examination
  • palpation
  • biopsy
  • fiber optic endoscopy
  • CT/MRI
  • EBV - specific serologic test
  • liver function test/ bone scans with advanced disease
33
Q

what is treatment for nasopharynx?

A
  • opposing lateral fields to cover tumor and possible pathways of spread
  • supraclavicualr area treated
  • IMRT replacing most treatemtns
34
Q

typical dose scheme for nasopharynx

A

50-70 Gy with electron boost and special consideration to

  • spinal cord, optic nerve and pituitary and brainstem
35
Q

radiation treatment border for nasopharynx

A

Superior - 2 cm beyond tumor (seen on Ct) to include base of skull and sphenoid sinuses

Posterior - 2 cm margin beyond mastoid process or posterior margin may extend further to allow 1.5 cm margin on enlarged nodes

anterior - to include the posterior third of the maxillary sinus and nasal cavity, careful attention adequate margin (2cm) for more anterior tumors

inferior - thyroid notch to allow sparing of larynx

lower neck - anterior supraclavicular field with larynx block

36
Q

clinical presentation for oropharynx

A
  • sore throat
  • pain or swallowing
  • upper spinal nodal swelling
  • referred otalgia
  • squamous cell carcinoma most common
37
Q

detection and diagonosis
oropharynx (tonsils)

A

direct inspection
palpation
biopsy

38
Q

treatment for oropharynx

A

T1-T2 soft palate, tonsil , pharyngeal walls , tongue: 66-70 Gy

T3-T4 - oropharygeal and T2 base of tongue 70-81.6 Gy

hyper fractionation - 70 Gy

39
Q

radiation treatment border oropharynx (tonsils)

A

anterior - 2 cm from known tumor

superior - 1.5 - 2.0 cm superior to the soft palate

posterior - posterior spinous process

inferior - level of hyoid

40
Q

clinical presentation for hypohphraynx

A
  • sore throat
  • odynophagia
  • neck mass
  • dysphagia
  • weight loss
  • squamous cell carcinoma most common
41
Q

detection and diagnosis for hypopharynx

A
  • inspection
  • palpation
  • biopsy
  • fiber optic endoscopy
  • CT/MRI
42
Q

treatment for hypopharynx

A

large fields treated to 45 Gy reduced of cord then continued to 70 Gy

43
Q

treatment borders hypopharynx

A

superior - inferior border of mandible and mastoid process, to the base of skull

inferior - lower border of the cricoid cartilage 1.5 to 2.0 cm margin

anterior - in front of the thyroid cartialge “shine off” (fall off) if larynx involved

posterior - behind the spinous process

44
Q

larynx is made up off :

A

glottis supraglottis and subglottis

45
Q

larynx clinical presentation:

A
  • persistent sore throat
  • hoarseness and stridor
  • cervial lymph node - supreglottic lesions
  • squamous cell carcinoma most common
46
Q

detection and diagnosis for larynx

A
  • palpation
  • direct inspection
  • biopsy
47
Q

treatment for larynx

A

surgery chemo radiation therapy

48
Q

radiation treatment borders for glottis

A

superior - upper thyroid notch

inferior - cricoid cartilage (lower border of C6)

anterior - 1-1.5 cm shine over (flash) over the skin surface at the level of the vocal cords

posterior - just anterior to the vertebral body including the anterior portion of the posteiror pharyngeal walls

48
Q

radiation treatment borders for supraglottis and subglottis

A

often much larger fields

Treatment sites- Chapter 3 laura nappi Part 1 (32 decks)

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