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Radiation Therapy Practices/Procedures: 1. (A) TREATMENT SITES and Tumors > Lung > Flashcards

Lung Flashcards

1
Q

the RT lung has how many lobes?

A

3 lobes

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2
Q

the LT lung has how many lobes?

A

2 lobes

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3
Q

why is there a difference in the number of lobes for RT and LT lungs?

A

the LT lung has less lobes (2) than the RT (3) since the heart is on the left side as well

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4
Q

which lung is wider and shorter than the other?

A

the RT lung is wider and shorter than the LT

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5
Q

Our lung is lined by two membranes called the _____

A

pleura

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6
Q

Name the two “pluera” and say which lines the SURAFCE of the lung

and which lines the THOARCIC WALL

A

SURFACE OF LUNG is lined by “Visceral pleura”

THORACIC WALL is lined by “Parietal pleura”

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7
Q

what is the space between the pleura called?

A

pleural cavity

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8
Q

The _______ is the bifurcation of the trachea

A

carina

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9
Q

where does the trachea bifurcate?

A

at the carina

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10
Q

define “bifurcate”

A

divide into two; divide into two branches

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11
Q

at what spinal column(s) is the carina roughly located?

A

T4 and T5

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12
Q

The trachea divides into the 1.______ bronchi, then into the 2.______ bronchi, then to the 3._____ bronchi, THEN to the _____, and lastly to the ______ ducts

A
  1. primary bronchi
  2. secondary bronchi
  3. tertiary bronchi
  4. bronchioles
  5. alveolar
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13
Q

what structure divides into the primary bronchi?

A

the trachea

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14
Q

what is the function of our “Alveolar ducts”

A

where oxygen and carbon dioxide are exchanged! (respiration)

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15
Q

The _____ is where blood vessels, lymphatic vessels, and nerves gain entry into the lungs

A

hilum

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16
Q

what is the main symptom of lung cacner?

A

cough

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17
Q

A Pancoast tumor occurs when ______________

A

the tumor is in the apex of the lung

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18
Q

a patient with a Pancoast tumor can experience pain where (2 specific areas), muscle _____, and ____ syndrome

A

pain under shoulder and arm

muscle atrophy

Horner syndrome

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19
Q

what is “Horner syndrome”?

A

an interruption of nerve supply from the brain

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20
Q

define “apex” (anatomically)

A

tip; top of something; forming point/top

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21
Q

what occurs when the tumor compresses the superior vena cava, which makes it difficult for the patient to breathe?

hint - ‘…syndrome…’

A

superior vena cava syndrome (SVC)

-which is considered an emergent treatment (ie. oncologic emergency)

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22
Q

what is the main method of regional spread for lung cancer?

A

Nodal involvement/lymphatic spread

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23
Q

All lymph involved with the lungs drains into the __________ nodes

A

intrapulmonary

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24
Q

lymph nodes near the Lung include (4)

A

Bronchopulmonary nodes, hilar nodes, interlobar nodes, and mediastinal nodes

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25
Q

name the 4 superior mediastinal nodes -

*hint - * PT.PRE.RT.AN

SMN = SNL skit
“parakeet preteen is retro az fuck”

A

Paratracheal
Pretracheal
Retrotracheal
Azygos nodes

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26
Q

name the 3 Inferior Mediastinal Nodes -

*hint - *

SC.PE.PL

A

Subcarinal
Paraesophageal
Pulmonary ligament nodes

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27
Q

what are the three main Lung cancers?

A
  1. Small Cell Lung Cancer (SCLC)
  2. Non-Small Cell Lung Cancer (NSCLC)
  3. Mesothelioma
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28
Q

SCLC can also be called “________” and includes anaplastic carcinomas

A

oat cell

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29
Q

T/F:
SCLC includes anaplastic carcinomas

A

TRUE

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30
Q

describe “anaplastic”

A

Anaplastic is a word pathologists use to describe very abnormal-looking cancer cells. While most cancer cells share some features (shape or size) with normal cells, anaplastic cells do not look anything like normal cells.

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31
Q

the following are characteristic of SCLC or NSCLC?

  1. Very aggressive
  2. Metastasizes early to brain, therefore PCI (prophylactic cranial irradiation) is often used
  3. Connected to tobacco use
  4. Located centrally (which has worse prognosis), near proximal bronchi
  5. More common in men
A

Small Cell Lung Cancer

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32
Q

SCLC metastasizes early to where?

A

brain

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33
Q

what treatment technique is often used for SCLC in regard to it metastasizing early to brain

A

PCI (Prophylactic Cranial Irradiation)

34
Q

if the tumor is located centrally… does that carry a better or worse prognosis?

A

worse

35
Q

which Lung cancer is typically centrally located, near the bronchi of the lung?

A

SCLC

36
Q

SCLC is connected to _________ use

A

tobacco use

37
Q

which lung cancer is more common in women?
Which is more common in men?

A

SCLC is more in men
NSCLC is more in women

38
Q

which lung cancer is very aggressive and has a high mortality rate?

A

SCLC

39
Q

what falls under the umbrella of NSCLC? (3 pathologies)

A

adenocarcinoma, large cell carcinoma, and epidermoid/squamous cell carcinoma

40
Q

T/F:
Adenocarcinomas ARE connected to tobacco use

A

FALSE

Adenocarcinomas ARE NOT connected to tobacco use

41
Q

which lung cancer is located more peripherally (sides) of the lungs?

A

NSCLC

42
Q

which cancer of the Lung has a better prognosis?

SCLC or NSCLC

A

NSCLC

43
Q

which Lung cancer occurs in the linings of the Lungs? (ie. ‘cancer of the pleura’)

A

Mesothelioma

44
Q

which Lung cancer is connected to asbestos exposure?

A

Mesothelioma

45
Q

compared to NSCLC and SCLC, is Mesothelioma more common, or less?

A

LESS

46
Q

DISTANT spread of Lung cancer occurs through the _________ system

A

circulatory

47
Q

Lung cancer can spread to distant sites such as - (8)

A

liver, brain, bones, bone marrow, adrenal glands, kidneys, cervical lymph nodes, and the contralateral lung

48
Q

what sit atop EACH kidney (so we have 2)

A

Adrenal glands

49
Q

the following are characteristic of SCLC or NSCLC?

  1. Located more toward the periphery (sides) of the lungs
  2. More common in women
  3. Better prognosis than SCLC
A

Non-Small Cell Lung Cancer

50
Q

WORLDWIDE, what cancer is the most common form of cancer?

A

Lung cancer

51
Q

in the US, what is the second most common cancer in both men and women?

A

Lung cancer

52
Q

what cancer is the leading cause of DEATH in the US among men and women?

A

Lung cancer

53
Q

the risk of developing lung cancer, like many other cancers, increases with ____

A

age

54
Q

the leading risk factor for lung cancer, other than age, is what?

A

smoking

55
Q

Approximately, ___% of lung cancer cases can be attributed to smoking

A

80

56
Q

T/F:
Individuals with a history of lung cancer are at a higher risk of developing a second lung cancer

A

TRUE

57
Q

is there a difference in risk for people who smoke normal cigarettes vs people who smoke filtered cigarettes (ex. e-cigs)

A

No - same risk, both bad

58
Q

Cigar Smoking and Pipe Smoking are risk factors for lung cancer… however these activities are more associated with upper aerodigestive tract OR straight up lung?

A

more associated with upper aerodigestive tract

59
Q

______ is the second leading cause of lung cancer and the leading cause among non-smokers

A

Radon

60
Q

exposure to ___________ is linked to mesothelioma

A

asbestos (mold)

61
Q

what is the leading cause of lung cancer for non-smokers

A

Radon
–> “Radon, air pollution, and asbestos are additional risk factors for lung cancer… considered environmental or occupational exposures”

62
Q

define “synergistic effect”

A

working together

63
Q

the ______ system transports oxygen from the air into the blood and removes carbon dioxide from the blood

A

respiratory system

64
Q

blood supply to the lungs comes from the ____________ and _________ arteries

A

pulmonary and bronchial arteries

65
Q

involvement of the lymphatics tends to follow the branches of the _______ tree

A

bronchial

66
Q

define “hemoptysis”

A

blood in the sputum

67
Q

define “dyspnea”

A

shortness of breath

68
Q

what syndrome may be indicated by swelling in the face and arms, distended veins in the upper chest, dyspnea, and orthopnea?

A

SVC (superior vena cava syndrome)

69
Q

define “orthopnea”

A

shortness of breath that occurs when lying flat

70
Q

what is “paraneoplastic syndrome” ?

A

this syndrome occurs when hormone-like substances are released into the blood and cause issues in areas away from the site of cancer

71
Q

define “atelectasis”

A

complete or partial collapse of a lung

72
Q

define “pneumonitis”

A

inflammation of the lung

73
Q

what happens in surgical procedure - Lobectomy

A

entire lung lobe is removed

74
Q

what is the preferred surgical procedure for a patient with an early-stage Lung cancer (like stage 1 or 2)

A

a Lobectomy

75
Q

what happens in surgical procedure - Pneumonectomy

A

An entire lung is removed

76
Q

what is the most effective chemo agent for treating Lung cancer?

A

CISPLATIN

77
Q

what is the standard of care for Lung cancer in a patient who is not a surgical candidate?

A

concurrent or sequential chemo and radiation with radiation doses of 45-60 Gy using standard fractionation

78
Q

what aspect of our lungs can have dramatic effect on radiation therapy simulation and treatment planning?

A

lung motion

79
Q

what is the simplest method to reduce lung motion?

A

breath hold

80
Q

define “odynophagia”

A

painful swallowing

81
Q

in treating lung cancer, stereotactic body radiation therapy is reserved for:

A. patients with small tumors

B. Medically inoperable patients with early-stage NSCLC

C. Patients with SVC syndrome

D. Both A and B

A

D. Both A and B

Radiation Therapy Practices/Procedures: 1. (A) TREATMENT SITES and Tumors (16 decks)

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