Exam 3 tumors

Question 1

How many brain tumors prevalence?

Answer 1

63,000 new in adults
4,000 in children
increase is due to better Dx rather than more happening

Question 2

What are the age ranges most common? and what is a term for this?

Answer 2

0-15
50-70
Bimodal

Question 3

location of the tumor determines what?

Answer 3

impairments and functional limitations that result

Question 4

which tumor type is most common?

Answer 4

meningioma 34.4% benign

Question 5

next most common tumor?

Answer 5

glioblastoma 16.7% malignant

Question 6

primary brain tumors

Answer 6

originate in CNS

typically don”t metastasize due to lack of lymphatics in the CNS

Question 7

Glioma origin

Answer 7

from glial cells 42%
cerebral cortex, brain stem, optic nerve, spinal cord
benign in children, malignant in >75y/o

Question 8

Types of gliomas

Answer 8

astrocytomas
oligodendroglioma
ependymoma
medulloblastoma

Question 9

Types of primary brain tumors

Answer 9

glioma
meningiomas
pituitary adenoma
Schwannomas
primary CNS lymphomas

Question 10

Astrocytomas

Answer 10

most common
“contained”–less likely to metastasize–easier to remove
diffuse–infiltrate surrounding brain tissues. 3 types: low grade, intermediate grade(anaplastic), glioblastomas

Question 11

Low grade astrocytomas

Answer 11

slowest growing age 30-40
frontal lobe in adults(cerebrum=personality changes)
cerebellum in children
unilateral headaches
easy to remove=better survival rates
surgery, radiation, chemo

Question 12

intermediate grade (anaplastic) astrocytomas

Answer 12

grow at a moderate rate

Question 13

glioblastomas

Answer 13

highly malignant, fastest growing
most common malignant tumor in adults
unilateral headache to general headache
rapid progression of symptoms, seizures
surgery, radiation, chemo, stereotactic radiosurgery

Question 14

oligodendrogliomas (glioma)

Answer 14

tumors in myelin producing oligodendrocytes
~50% frontal lobe, ~50% parietal/temporal
slow growing but progressive- several years
40-60 y/o
chronic headaches, partial/general seizures

Question 15

Ependymoma (glioma)

Answer 15

ependymal lining of ventricular system
4th ventricle--more in children
central canal of spinal cord
increased ICP
BILATERAL headaches

Question 16

Medulloblastoma (glioma)

Answer 16

primitve embryonic cells- pluripotent stem cells
rapid growth malignant tumor in cerebellum
20% of childhood brain tumors
hydrocephalus-4th ventricle compressions, inc. ICP
may metastasize to spinal cord or higher brain areas.

Question 17

Meningioma

Answer 17

33% of all tumors
slow growing, well encapsulated
cells in dura mater or arachnoid
if the tumor compresses tissue hard/long enough= cell death

Question 18

Pituitary Adenoma

Answer 18

benign epithelial tumor of the pituitary
compression of the optic chiasm= tunnel vision(temporal field deficit)
effects on hormone secretion, rare before puberty
3:1 females to males

Question 19

Schwannoma

Answer 19

encapsulated neoplastic Schwann cells
8th CN (or any cranial nerve) = acoustic neuroma
symptoms: facial paralysis, deaf, balance

Question 20

Primary CNS lymphoma

Answer 20

lymphocytes, 1% of all intracranial tumors
increased frequency in aids
60% in the cerebral hemisphere (also cerebellum and brainstem)
changes in behavior, personality, confusion, dizziness
enlarged lymph nodes, fever, night sweats, unexplained weight loss, fatigue

Question 21

secondary tumors are also called:

Answer 21

metastatic tumors

Question 22

secondary tumors details

Answer 22

spread to the CNS from outside the brain. blood-brain barrier “somewhat” protects from metastasis

Question 23

metastatic brain tumor origins(2ndary)

Answer 23

from malignancy outside CNS that spreads to brain through arterial circulatory system
1/3 start from lung cancer, then breast cancer, skin, GI, kidneys in that order

Question 24

Metastatic brain tumor (2ndary) symptoms

Answer 24

• Headache-same side as tumor- that interrupts sleep and is worse upon waking (red flag)
• with nausea and vomiting, papilledema, focal signs, elicited by postural changes, coughing, or exercise
• May be due to local swelling, distortion of blood vessels, invasion of meninges, and/or increased ICP(causes drowsiness and decreased levels of consciousness to potential coma)
• Also seizures, cognitive and personality changes
• -Altered mental status (May start as subtle changes in concentration, memory, affect, personality, initiative, and/or abstract reasoning-May progress to severe cognitive problems and confusion)

Question 25

Focal signs

Answer 25

frontal lobe, occipital, temporal,. cerebellum(sxs from damage to these lobes) +
Brainstem-Reticular formation (consciousness and attention), Vital functions associated with cardiovascular and respiratory systems > death
Can be associated with gait disturbances, diplopia, weakness, headache, vomiting, facial numbness and weakness and personality changes
Pituitary glands–Tumors here are typically large
Compress the pituitary gland and causes pituitary disorders: Cushing disease, hypothyroidism, Addison disease, diabetes

Question 26

Papilledema

Answer 26

swelling of the optic nerve

Question 27

Metastatic brain tumor (2ndary) interventions

Answer 27

Intervention: corticosteroids, brain irradiation, surgery, and/or chemotherapy

Question 28

Rating of disability of function scale

Answer 28

Karnofsky Performance Scale