Anatomy and Treatment sites- Chapter 3 laura nappi Part 1

The brain has two __________ in the cerebrum and in the cerebellum

hemispheres

The _______is the largest portion of the brain and controls thinking, emotions, speech, voluntary movement, etc.

cerebrum

The ______is located inferiorly and posteriorly in the head and controls movement, balance, and posture

cerebellum

The _______ is the most inferior portion of the brain and connects the brain to the spinal cord

brainstem

The brain is protected by

cranial bones, meninges, and cerebrospinal fluid

The central nervous system (CNS) has 3 to 5 ounces of

cerebrospinal fluid

_______ are like chambers or sinuses within the brain that communicate with the canal of the spinal cord and subarachnoid space

Ventricles

There are four ventricles: which include

two lateral ventricles, third ventricle, and fourth ventricle

The ventricles produce

cerebrospinal fluid

CNS is made of ______ matter

gray and white

Gray matter is made up of

supportive nerve cells

White matter is made up of

nerve fibers, axons, and dendrites

In the ____, gray matter is peripheral and white matter is central

brain

In the ____, white matter is peripheral and gray matter is central

spine

The ______ is the main source of blood for the brain. It is Made up of the internal carotid and vertebral arteries

circle of Willis

The spinal cord extends from the______ to the _____

medulla oblongata to the tilum terminale (Ll-L2)

The spinal cord carries messages between

brain and body

Blood-brain barrier (BBB) protects the brain from

toxins

Only substances that are_____ soluble can pass the BBB

lipid

Lipid soluble substances examples are

alcohol, nicotine, and heroin

Water-soluble substances may pass through BBB if they use a

carrier molecule

Water soluble substances are

glucose, amino acids, and sodium

glioblastoma, astrocytoma, glioblastoma multiforme), medulloblastoma, oligodendroglioma, ependymoma, meningioma, lymphoma, schwannoma

Are within the category of

gliomas

_____ is the most common primary brain tumor in children

Astrocytoma

_____ is the second most common primary brain tumor in children

Medulloblastoma

_____ are the most common primary brain tumor in adults. Specifically glioblastoma multiforme.

Malignant gliomas

Overall, the most common brain tumors are

metastatic tumors

Most common routes of spread for CNS tumors are local invasion and seeding through

cerebrospinal fluid (CFS)

Most common area for CSF seeding is in the

lumbosacral area

Low-grade CNS tumors rarely spread via the

lymphatic system

High-grade CNS tumors are more likely to spread via

lymphatic system but still rare

_____ Includes lips, buccal mucosa, gingiva, alveolar ridge, hard palate, floor of mouth, retromolar trigone, and anterior two thirds of tongue

Oral cavity

Oral cavity Extends from

lips to the posterior aspect of the hard palate

_________separate the anterior two thirds of the tongue, in the oral cavity, from the posterior part of the tongue, which is in the oropharynx

Circumvallate papillae

Oral cavity cancers are associated with

Plummer-Vinson syndrome (iron deficiency in females)

Cancers of the tongue, floor of mouth, and tonsils are associated with

human papillomavirus (HPV)

_____ are the most common site for cancer in the oral cavity

Lips

Early signs for ____ cancer are poor oral hygiene, poor dental hygiene, nonhealing ulcers, leukoplakia, and erythroplasia

oral cavity

Majority of Oral cavity cancers are

squamous cell carcinoma (SCC)

Main route of lymphatic spread for oral cavity in general is to

buccinator, jugulodigastric submandibular, and submental nodes

Upper lip drains into the

submandibular and preauricular nodes

Upper lip drains into the _____ nodes

submandibular and preauricular

Lower lip and anterior mouth drain to ____nodes

submental

Oral tongue drains to the anterior

cervical chain nodes

Buccal mucosa drains to the ______ nodes

submandibular and subdigastric

For oral cavity cancers Lymphatic and blood-borne spread is

rare

Most common site of spread for oral cavity is to

cervical lymph nodes

What are the three subdivisions of the pharynx

nasopharynx, oropharynx, laryngopharynx/hypopharynx

______ is

-Cuboidal in shape

- Positioned posterior to the nose and extends inferiorly to the Uvula

- Located at Level of C1

Nasopharynx

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

pharynx

Adenoids are located within the

nasopharynx

Nasopharynx is located close to the base of the

brain

_____usually occur in the lateral walls of the nasopharynx

Carcinomas

There is a strong connection between nasopharyngeal cancers and the

Epstein. Barr virus (EBV)

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

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

________ is

located at level C2 to C3

Contains lymphoid tissue called palatine tonsils

Oropharynx

Most cancers in the oropharynx occur in the

tonsils

Oropharynx is Associated with

alcohol consumption, smoking, and HPV

The Laryngopharynx extends from the

hyoid bone to esophagus

_____ is

- located C3 to C6

- Posterior to larynx

- Made up of the pyriform sinuses, postcricoid and lower posterior pharyngeal walls

Laryngopharynx

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

epiglottis

_______ is the most common location for cancer within the hypopharynx

Pyriform sinus

Majority of pharynx cancers have what histology

squamous cell carcinoma (SCC)

_______drains to subdigastric, upper cervical, submaxillary and parapharyngeal nodes

Oropharynx

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

Nasopharynx

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

Hypopharynx

Oropharynx tumors spread to lymph nodes and invade structures located

close to the tumor

The hypopharynx commonly spreads to lymph nodes and invades

nerves and muscles nearby

The _____ extend from the epiglottis to the cricoid cartilage

Larynx

The larynx is located at the level of

C3 to C6

The larynx includes the

supraglottis, glottis, and subglottis

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

Supraglottis

____ = true Vocal cords and anterior/posterior commissures

Glottis

_____ = 1 cm below true Vocal cords

subglottis

Cancer in the larynx is strongly associated with

cigarette smoking

Common symptoms of larynx cancer is

constant soreness of the throat and hoarseness

What is most common histology of larynx cancer

squamous cell carcinoma

Glottic cancers rarely spread to

lymph nodes

Supraglottic cancers spread first to what nodes?

jugulodigastric and midjugular nodes

Subglottic cancers spread first to what nodes?

pretracheal, paratracheal, and inferior jugular nodes

Three main pairs of salivary glands are

parotid, submandibular, and sublingual glands

The ____ is the largest of all salivary glands

parotid

The parotid opens into the

oral cavity

Most common salivary gland cancers occur in the

parotid gland

most common salivary gland malignant type is

mucoepidermoid carcinoma

Most tumors in the major salivary gland are

benign

Spread to nodes on the same side is

Ipsilateral

The thyroid left and right lobes are connected by a

isthmus

the ___ supports metabolism and creates hormones

thyroid

What are the types of thyroid cancer

Papillary, follicular, medullary, and anaplastic

Thyroid cancer lymohatics include

Internal jugular chain, anterior cervical node (Delphian node), pretracheal nodes, and paratracheal nodes

Papillary and mixed papillary-follicular cancers spread through

lymph nodes

______ thyroid cancers spread through the bloodstream to bone, lungs, liver and brain

Follicular

Medullary cancers spread regionally and to

cervical lymph nodes

Anaplastic cancers spread locally to

skin and trachea and to lymph nodes

Jugulodigastric lymph node = ______node

subdigastric

Jugulodigastric lymph node is located below the

mastoid tip

Node of Rouviére = _______ node

retropharyngeal

________ chain = posterior cervical lymph node chain

Spinal accessory

Mastoid node = _______node

retroauricular