Chapter 30 WS Flashcards
What are the three most significant variables that affect prognosis for patients with lung cancers of the respiratory system?
1) Stage or extent of the disease
2) clinical performance status as measured with the Karnofsky performance scale,
3) weight loss, especially greater than 5% of the total body weight over 3 months.
Mesothelioma is associated with exposure to what carcinogen.
asbestos
How long is the latent period between exposure and the development of mesothelioma?
20-40 years
what is the carina and radiographically at what vertebral level is it located?
bifurcation of the trachea
T4/5
Where do oxygen and carbon dioxide exchanges take place?
Aveoli and capillaries
What is the area of the lung called where the blood, lymphatic vessels, and nerves enter and exit the lungs?
hilum
What is the significance of the carina and hilum with regards to distant spread?
This is where tumor cells gain access to the circulatory system.
What is the mediastinum and what structures/organs are located in it?
The anatomy between the lungs and contains the:
- heart,
- thymus,
- large vessels,
- trachea,
- esophagus,
- lymph nodes and
- other structures.
List three of the earliest symptoms of lung cancer?
Weight loss, cough, hemoptysis (coughing up blood)
Describe three criteria related to an individual’s tobacco exposure that appear to increase the risk of development of lung cancer.
1) An increase duration of smoking
2) An increased use of unfiltered cigarettes
3) an increased number of cigarettes consumed
What is superior vena cava syndrome and what are some of the signs?
Symptoms/signs due to the compression of the superior vena cava (can be caused by lesions in the right lob that extend into the mediastinum)
Signs include: dyspnea; facial, neck and arm edema; orthopnea; cyanosis.
List the criteria for a tumor to be considered a Pancoast tumor.
- Resides in superior sulcus with the following clinical presentation
- Pain around the shoulder and down the arm
- Atrophy of the hand muscles
- Horner syndrome
- Bone erosion of the ribs and sometimes the vertebrae
What are the manifestations of Horner Syndrome?
- Ipsilateral miosis (contracted pupil),
- ptosis (drooping eyelid),
- enophthalmos(recession of the eyeball into the orbit), and
- anhidrosis (loss of facial sweating).
What is hypertrophic pulmonary osteoarthropathy and how does it manifest?
A frequently seen phenomenon associated with lung cancer.
Manifests by clubbing of the distal phalanges of the fingers.
What is a thoracentesis?
A surgical procedure in which a needle is inserted into the pleural space to remove excess fluid.
Also called a pleurocentesis
Prior to planning treatment, a CT scan of the brain is usually done for which two types of lung cancer.?
Small cell lung cancer and adenocarcinomas.
Also undifferentiated carcinomas
What is the most common pathological type of lung cancer in the U.S.?
Adenocarcinoma
Where in the lung do Squamous cell carcinomas most commonly arise?
Centrally in the proximal bronchi
Where in the lung do Adenocarcinomas most commonly arise?
Peripherally
List three patterns of spread for lung cancer.
Direct, Lymphatic, & hematogenous
Name the two groups of lymphatics that are primarily responsible for the regional spread of bronchogenic carcinoma.
Mediastinal and intrapulmonic
Lymph is drained from the left side of the body into the _________________ before entering the circulatory system via the __________________.
thoracic duct
left subclavian vein
Lymph is drained from the right side of the body into the __________ before entering the circulatory system via the ___________
right lymphatic duct
right subclavian vein
Where do lung cancers most commonly metastasize to? (7)
- Cervical lymph nodes,
- liver,
- brain,
- bones,
- adrenal glands,
- kidneys, and
- contralateral lung
