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Therapy Prin & Procedure > Ch 32 - CNS Cancer > Flashcards

Ch 32 - CNS Cancer Flashcards

1
Q

The spinal cord is the continuation of the ________.

A

Medulla oblongata

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2
Q

Anterior and lateral portion of the spinal cord contains _______ and _____

A

Motor neurons and tracts

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3
Q

The posterior portion of the spinal cord contains _______

A

Sensory tracts

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4
Q

Blood supply of the brain comes from ________ and ________ via the Circle of Willis

A

From the internal carotid arteries and vertebral arteries

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5
Q

Gray matter is composed of

A

Supportive nerve cell bodies

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6
Q

White matter is composed of bundles of

A

myleinated nerve fibers,

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7
Q

Axons carries impulses _______ from the cell body

A

Away

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8
Q

Dendrites carries impulses _______ the cell body

A

Towards

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9
Q

Spinal cord extends to what vertebral body

A

Spinal cord extends to L1/L2

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10
Q

Spinal canal consist of

A

CSF- cerebral spinal fluid

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11
Q

The blood Brain barrier protect the brain from

A

Potentially harmful substances and hinders the penetration of some substances into the brain and CSF

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12
Q

BBB limited our treatment because

A

There’s small spaces where molecules in the blood cannot get into the different channels in the brain tissues

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13
Q

In order for substances to pass through the BBB they must be _____

A

Lipid soluble which includes alcohol, nicotine, and heroin

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14
Q

Water soluble substances needs _______ to cross the BBB via ______

A

Carrier molecule via active transport

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15
Q

Most CNS tumors are what kind

A

Metastatic tumors

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16
Q

The treatment of choice for PRIMARY brain tumor is

A

Surgery

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17
Q

Metastatic tumors to the brain usually originate in the

A

Lungs

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18
Q

What is not consider as the 3 important prognostic indicators for CNS tumors

A

The size

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19
Q

What are the 3 important prognostic indicators for CNS tumors

A

Type and grade of tumor
Age
Karnofsky score

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20
Q

T/F

Primary CNS tumors occur more often in the spine than in the brain

A

False

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21
Q

Brain tumors typically spread by the way of

A

Direct extension

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22
Q

Why would a benign tumor be considered malignant

A

Due to its location and its close proximity to other structures

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23
Q

SRS is indicated for metastatic lesions that is larger than

A

3cm

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24
Q

What is the TD5/5 for partial brain irradiation

A

6000cGy (60Gy)

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25
Q

What is the TD5/5 for whole brain

A

5000cGy (50Gy)

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26
Q

What is the TD5/5 for spinal

A

4500-5000 (45-50Gy)

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27
Q

What is the most common malignant CNS pediatric tumor

A

Medulloblastoma

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28
Q

Which part of the brain is the center for memory, learning, reasoning, judgement, intelligence and emotions

A

Cerebrum

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29
Q

SRS is thought to be accurate within

A

1mm

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30
Q

At what dose can hair lose become permanent

A

Greater than 4000 (40Gy)

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31
Q

At what dose is hair loss temporary

A

Between 2000-4000cGy (20-40Gy)

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32
Q

What would you recommend a patient wash their hair with while on treatment for a brain tumor

A

A mild shampoo (baby shampoo)

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33
Q

How much CSF circulates within the CNS

A

3-5 ounces

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34
Q

Only these types can pass through the BBB

A

Lipid soluble

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35
Q

Brain tumors occur most often in people ages

A

Pediatric (3-12yrs)

Geriatrics ( 50-80yrs)

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36
Q

What is the term for the structure in the brain that is Latin for little brain”

A

Cerebellum

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37
Q

Patients that are unable to work fall nto what range of the karnofsky scale

A

40-70

38
Q

What is the TD5/5 for the lens of the eyes

A

10Gy

39
Q

What is the TD5/5 for the optic chiasm

A

50Gy

40
Q

Which of the following does NOT provide protection for the brain

A

Cerebellum

41
Q

A gliomas spreads primarily by the way of …

A

Local invasion (direct extension)

42
Q

The BBB protects…

A

The brain from potentially toxic substances

But not heroine or alcohol

43
Q

Weakened proximal pelvic muscle, impotence, and bladder paralysis might indicate a signal tumor in what region

A

Limbo sacral

44
Q

What is the current 5 yr survival of patients with PRIMARY CNS tumor

A

35%

45
Q

What type of tumor is classified by primitive neuroectodermal cell

A

Medulloblastoma

46
Q

What is the most common type of brain tumor

A

Metastatic lesions

47
Q

Where do most brain mets originate from

A

Lungs

48
Q

Which cell is responsible for myelin production

A

Schwann cells

49
Q

What factors can limit the usefulness of surgery for CNS neoplasm

A

Tumor location an extent
Patient status
Risk of neurological damage

50
Q

Which portion of the brain is the site for intelligence and judgement

A

Cerebrum

51
Q

What condition is a contradiction for SRS

A

5 lesions

52
Q

What is one of the late effects of brain radiation in children

A

Decreased IQ

53
Q

Which of the following is the most significant to the prognosis of brain tumors

A

Tumor grade

54
Q

Which of the following Beam arrangements is most typical for treatment of a malignant malignant primary brain tumors

A

Small field with 1-3cm margins

55
Q

What is the dose at which radiation necrosis of brain tissue is most likely to occur

A

6000cGy (60Gy)

56
Q

Epilation may be permanent when the cranial is treated beyond the threshold dose of ____ cGy

A

Beyond 4000cGy

57
Q

Patients treated to the cranial should be advised to protect their heads from direct sunlight because the sun

A

Enhances radiation induced side effects

58
Q

These are small round blue cells that become CNS malignancies

A

Primitive neuroectodermal cells

59
Q

Medullolastoma mostly Present in the

A

Cerebellum

60
Q

What’s the 3 yr survival rate for GBM is roughly

A

2%

61
Q

How much cerebral spinal fluid (CSF) is secreted each day

A

Half liter (0.5L)

62
Q

A fold of tissue that separates the brain hemisphere and the cerebrum from the cerebellum is the ….

A

Tentorium

63
Q

Brain tumors are the ____ leading cause of death in children

A

Second and is the most common pediatric solid tumor

64
Q

Function of this portion of the brain is coordination of voluntary muscular movement and is known as the little brain

A

Cerebellum

65
Q

75% of all CNS tumors occur in the

A

Cerebrum

66
Q

Gliomas of pediatrics occur in the

A

Cerebellum

67
Q

Of the 3 prognostic indicator, __________ is the primary prognostic indicator for CNS tumors

A

Tumor grade associated with tumor type

68
Q

The brain is protected by

A

Cranial bones
Meninges
CSF

69
Q

For the brain:
____ matter is located on the outside, forms the cortex and have supportive nerve cells.
_____ after is on the inside and contains bundles of myelinated fibers that sends and receives signals

A

Gray Outside

White Inside

70
Q

For the spinal cord:

___ matter is on the outside while ____ matter is on the inside

A

White Outside

Gray Insides

71
Q

The spinal cord extends to what level

A

L1-L2

72
Q

What is aphasia

A

Difficulty speaking

73
Q

What is hemiplegia

A

Paralysis on one side of the body

74
Q

What is paresis

A

Weakening of the muscles

75
Q

Symptoms for frontal tumor

A

Personality changes
Memory loss
Gait disorder
Speech changes

76
Q

Symptom for parietal tumors

A

Loss of vision
Spatial disorientation
Seizures

77
Q

Symptoms for occipital tumors

A

Loss of sight

78
Q

Symptoms for temporal tumors

A

Hearing and smelling changes

Hallucinations

79
Q

The _____ area is the most frequent site for spinal tumor seeding

A

Lumbosacral

80
Q

Presentation for spinal cord tumor

A

Pain
Weakness
Loss of sensation
Weakness in distal part of extremity

81
Q

When _____ is present, whole brain treatment is given

A

Metastatic disease

82
Q

Most common site in the brain for brain mets

A

Cortex

83
Q

Whole brain technique is used to treat

A

Brain mets

Lymphoma

84
Q

What is the typical dose to treat whole brain

A

20-40Gy

85
Q

The Treated Volume (TV) is the volume enclosed by the desired prescription isodose and contains…

A

GTV, CTV, PTV

86
Q

The Irradiated volume (IR) is the tissue volume that receive significant dose and contains…

A

GTV, CTV, PTV and TV

87
Q

The CTV is ______ cm beyond the GTV

A

1-3cm beyond the GTV

88
Q

The PTV is ____cm beyond the CTV

A

0.5cm-1cm beyond the CTV

89
Q

TD5/5 for spinal cord

A

47Gy

90
Q

TD5/5 for ear

A

30-55Gy

91
Q

Td5/5 for brain stem

A

50Gy

92
Q

SRS are done on tumors that are

A

Spherical
LESS than 5cm
Accuracy occurs to 1mm

Therapy Prin & Procedure (17 decks)

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