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71 Cards in this Set
- Front
- Back
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What developmental abnormalities can we see in the EAR?
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-ABnormal size/shape
-Atresia of the ear canal -Preauricular sinuses -Preauricular cysts |
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What are the 2 major inflammatory conditions of the ear?
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-Cholesteatoma
-Otersclerosis |
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What is Cholesteatoma?
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A destructive squamous epithelial cyst in the middle ear and mastoid bone.
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What do Cholesteatomas usually develop from?
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Chronic otitis media
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When are Cholesteatomas lethal?
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When they extend intracranially
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What is otosclerosis?
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Abnormal bone deposition of the footplates of the stapes
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What happens when abnormal bone gets deposited on the stapes footplates?
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The stapes becomes unable to transmit sound vibrations
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What is the inability to transmit sound vibrations called?
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Conductive deafness
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Is otosclerosis most commonly bilateral or unilateral?
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Bilateral - involves both ears
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What is the pathology in otersclerosis similar to?
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Paget's disease
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Is otosclerosis acquired or inherited?
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Inherited - autosomal dominant
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What are the 3 developmental and congenital lesions of the NECK?
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1. Branchial cysts/sinuses
2. Thyroglossal duct cysts, sinuses, or fistulas 3. Congenital torticollis |
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What are Branchial cysts/clefts derived from and where are they located?
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-From 2nd branchial cleft
-Located at the anterior border of the SCM |
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Where are Thyroglossal duct cysts/sinuses/fistulas located?
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In the MIDLINE of the anterior neck
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What do thyroglossal duct cysts consist of?
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Respiratory epithelium covering thyroid tissue
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What is Congenital torticollis caused by?
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Infiltration of the sternocleidomastoid by fibrous tissue
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What is a Paraganglioma?
What is it derived from? |
A benign tumor of the neck derived from neural crest
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With what structure are paragangliomas in the neck associated?
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The parasympathetic and sympathetic chains
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What are 2 reasons that paragangliomas are dangerous even though benign?
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1. Can transform into malignancy
2. Often in tedious spots for removal - carotid body tumors can cause massive hemorrhage |
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What are 2 categories of malignant tumors of the neck?
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1. Primary malignancies
2. Metastatic |
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What are the primary malignancies that occur in the neck?
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Lymphomas - both Hodgkins and Non-hodgkins
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From what structures do malignant lymphomas of the neck arise?
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Lymph nodes
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Where do metastatic carcinomas of the neck arise from?
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Many places - the oral cavity, larynx, lung, pancreas, stomach, and kidney.
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How do metastatic tumors of the neck contrast to primary lymphomas?
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Metastatic tumors = unilateral
Primary lymphomas = bilateral |
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What is a Virchow's node?
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An enlarged left supraclavicular lymph node
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Where do Virchow's nodes metastasize from?
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Carcinoma of the GI tract, especially the stomach!!
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What are the 3 types of abnormalities we can see in the salivary glands?
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-Inflammatory diseases
-Cysts -Tumors (benign/malignant) |
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What are the 3 inflammatory conditions in the salivary glands?
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-Sialadenitis
-Sjogren's syndrome -Sialolithiasis |
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What is Sialadenitis?
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Mumps - epidemic inflammation of the parotid glands
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What is Sialolithiasis?
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A small stone in the salivary duct
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What ARE the salivary glands?
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-Submandibular
-Sublingual -Parotid |
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What are the 2 types of cells in the salivary glands?
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-Mucous cells
-Serous cells |
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What types of cells can be found in each salivary gland?
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-Parotid - serous only
-Sublingual - mostly mucinous -Submandibular - mixed |
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What is Sjogren's syndrome?
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An autoimmune disorder associated with lymphocytic infiltration and destruction of the exocrine glands
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What antibodies are positive in SS?
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-Anti-SS-A (ro)
and -Anti-SS-B (la) |
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What symptoms result from Sjogren's syndrome destruction of the exocrine glands?
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Dry mouth
Dry eyes |
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What is sicca complex?
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Primary sjogren's
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What is 2ndary Sjogren's syndrome?
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Sjogren's caused by other autoimmune disorders like rheumatoid arthritis
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What is a Mucocele?
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A mucus-retaining cyst in the salivary glands
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What causes a mucocele to develop?
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Plugging of the salivary duct by epithelial tissue
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Are mucoceles benign or malignant?
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Benign
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At what age are mucoceles commonly seen, and at what sites?
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-First 20 years
-Lower lip mostly, then tongue/floor of mouth (ranula) |
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How are mucoceles treated?
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By complete excision
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What do mucoceles have to be differentiated from? Why?
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Malignant mucoepidermoid carcinomas - they commonly occur on the lower lip too
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What are the 3 benign tumors to know about in the salivary glands? Which is most common?
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-Pleomorphic adenomas - most common
-Warthin tumors -Other adenomas |
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What are the 2 malignant salivary tumors to know about?
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-Mucoepidermoid carcinoma (MEC)
-Adenoid cystic carcinoma |
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How do you have to approach ANY enlarged salivary gland?
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By sampling it to look for malignancy
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Where do most pleomorphic benign adenomas occur? At what age?
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In the parotid glands, age 40-50
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How do pleomorphic adenomas typically appear?
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Well-demarcated
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What do pleomorphic adenomas consist of? (3 things)
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-Ductal epithelial cells
-Myoepithelial cells -Mesenchymal stroma |
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What is the 2nd most common bilateral benign tumor of the salivary glands?
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Warthin's tumor
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Where are Warthin's tumors?
In what patients/age? |
-In the parotid glands (both)
-Males -65 yrs and older |
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What type of tumor are Warthin's tumors?
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Biphasic
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What do warthin's tumors feel like with palpation?
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Doughy
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What does a Warthin's tumor consist of?
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Double layer of oncocytic epithelium:
-Cuboidal basal cells -Columnar lumenal cells |
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What is the most common malignant tumor in the sg's?
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Mucoepidermoid carcinoma (MEC)
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Where are the majority of MEC's located?
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In the major SG's
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Which salivary gland has poorer prognosis if a MEC is located in it?
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Submandibular
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What are the 3 cellular components of Mucoepidermoid carcinomas?
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-Mucin secreting cells
-Intermediate cells -Epidermoid cells |
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What are intermediate cells?
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Squamoid cells that lack intracellular boundaries
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What % of MEC tumors recur locally? What % metastasize?
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40% recur
15% metastasize |
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What is the prognosis for MEC patients?
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Fairly good - 5yr survival is 80%
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What do MEC's often resemble?
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SCC
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How can you differentiate MEC from SCC?
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With a mucin stain
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What are the beautiful tumors she likes?
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Adenoid cystic carcinomas
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Why are adenoic cystic carcinomas beautiful?
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They are basaloid and very purple
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At what age are ACC's common, and where do most arise? Which sg has the worse prognosis?
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50-70 yrs old
In minor salivary glands -Submandibular is bad |
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What is the metastasis rate for ACC, and what is the 5 yr survival rate?
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60% metastasis
60% 5yr survival |
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What is commonly involved in ACCs?
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Cranial nerves
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What appearance do Adenoid cystic carcinomas have?
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Sviis chheeesse
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What 3 cancers are famous for extension along the nerve?
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-Squamous cell carcinoma
-Mucoepidermoid carcinoma -Adenoid cystic carcinoma |
