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19 Cards in this Set

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GRAFTS
BONE,SKIN
STSG (SPLIT THICKNESS SKIN GRAFT0
TISSUE FROM INTESTINES
JEJUNUM->PHARYNX
TRACHEOTOMY
NEEDED WHEN ORAL SURGERY DONE
-CHECK SWELLING (PEAKS WITHIN 2-3 DAYS)
NECK DISSECTION
PURPOSE:TO REMOVE LYMPH NODES
RADICAL:LYMPH NODES
MUSCLES AND NERVES
HEAD & NECK CANCER INVOLVES:
NASAL CAVITY
THROAT
LARYNX (TRACHEA)
NSG DIAGNOSIS POST OP
-INEFFECTIVE AIRWAY CLEARANCE
-NUTRITION
-ALTERED TISSUE PERFUSION
-RISK FOR BLEEDING
SURGERY FOR HEAD & NECK CANCER:
12-16 HR LONG
-CANCER MUST BE REMOVED
-RECALL FCN OF STRUCTURES OF HEAD AND NECK
FOR HEAD & NECK CANCER
AGE :
SURVIVAL RATE:
TYPE OF CARCINOMA:
MOST COMMON SITES:
AGE > 40
1 YR SURVIVAL-82%
5 YR SURVIVAL-54%
SCCA-SQUARMOUS CELL CARCINOMA
SITES: ORAL AND LARYNX
RISK FACTORS:
SMOKING
ETOH
ASBESTOS/RADIATION
CHRONIC IRRITATION
DEFICIENCY IN VIT A
S/S OF HEAD & NECK CANCER
SORE(BLEEDS EASILY)
LUMP OR THICKENING
RED PATCH(ERYTHOPLAKIA)
WHITE PATCH(LEUKOPLAKIA)
DIFFICULTY CHEWING/SWALLOWING
LATER:DIFFICULTY MOVING TONGUE/JAW
LARYNX:COUGH/HOARSENESS
**GET DENTAL EXAMS**
FLAPS
REMOVAL OF SKIN AND TISSUE FROM AREA OF THE BODY:
-FREE FLAP
-MYOCUTANEOUS (MUSCLE AND SKIN)
-PECTORALIS MAJOR
-BLD SUPPLY
DIAGNOSTIC TESTS FOR HEAD & NECK CANCER:
-PANENDOSCOPY (LARYNGOSCOPY,FLEXIBLE ESOPHAGOSCOPY,BRONCHOSCOPY)
-NASOPHARYNGOSCOPY
-PHARYNGOSCOPY
-STAGING DONE W/TUMOR NODE METASTASIS
-DENTAL ASSESSMENT
-PULMONARY FCN
-PSYCHOSOCIAL ASSESSMENT
-NUTRITION
-COMMUNICATION
-COGNITIVE MOTOR SKILLS
GOALS OF TXT FOR HEAD & NECK CANCER
-REMOVE PRIMARY DISEASE & METASTATIC LYMPH NODES
-PRESERVE STRUCTURE & FCN
-MAXIMIZE COSMETIC & FUNCTIONAL OUTCOME
IF RADIATION DONE PRE-OP
PT DOESNT HEAL AS WELL
LARYNGECTOMY
PERMANENT STOMA
-PT CANNOT CHOKE/ASPIRATE ON FOOD
-ONLY WAY TO ASPIRATE:INHALING SOMETHING THROUGH STOMA
MOST COMMON AND MODIFIED COMPLICATIONS
-NERVE DAMAGE (FACIAL DROOPING)
-NUMBNESS IN EAR
-PROBLEMS WITH CALCIUM
INEFFECTIVE AIRLWAY CLEARANCE
TRACH/STOMA(IS BALLOON UP/DOWN)
1ST-CHECK FOR PATENCY
SUCTION
INCREASE HOB
STOMA/ICC CARE (INTERCANNULA CARE)
ALTERD TISSUE PERFUSION
-NOTHING AROUND THE NECK (PIN TRACH/O2 TO GOWN)
-AVOID PRESSURE ON FLAPS/GRAFTS
-325 MG ASA EVERY DAY (TO PREV CLOT)
-WARM ROOM
-LEECHES
ALTERED NUTRITION/IMPAIRED SWALLOWING/ALTERED ORAL MUCOUS MEMBRANES
-OFTEN MALNOURISHED PRE OP
-SHORT TERM VS LONG TERM PEG-NG FEEDS
-ORAL CARE
-LOSS OF TASTE,SALIVA
-XEROSTOMIA (DRY MOUTH)