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Sim Lecture > Lab # 4 Lung > Flashcards

Lab # 4 Lung Flashcards

1
Q

Lung cancer is the ________ cause of cancer related deaths in both men and women in the U.S., surpassing breast cancer in women

A

leading

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2
Q

The most significant etiology is related to

A

tobacco and the number of cigarettes smoked.

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3
Q

Lung cancer lends itself to ___________ techniques due to tumor location, tumor burden, reduction of tumor, and location of critical structures.

A

shrinking field (i.e. boost; cone down; off-cord)

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4
Q

how many lobes are in the right lung?

A

three

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5
Q

how many lobes are in the left lung?

A

two

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6
Q

what is the major airway into the thoracic cavity?

A

trachea

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7
Q

where does the trachea begin and end?

A

inferior border of the larynx and ends at the level of T5

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8
Q

what is the area of bifurication?

A

where the trachea divides into the left and right bronchi

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9
Q

what is the bifurication of the trachea refered to?

A

carina

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10
Q

the area where the blood, lymphatics, and nerves enter and exit each lung

A

hilum

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11
Q

is the anatomical area separating the lungs; it includes the heart, thymus, great vessels, and other structures that help position the lungs on either side of midline.

A

mediastinum

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12
Q

where do tumor cells gain access to the circulatory system

A

hilium and carina

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13
Q

what is included in the mediastinum

A

he heart, thymus, great vessels, and other structures that help position the lungs on either side of midline

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14
Q

Lung cancer is most frequently divided into

A

Small Cell Lung Cancer (SCLC) and Non–Small Cell Lung Cancer (NSCLC)

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15
Q

what histologies are included in NSCLC

A

adenocarcinoma, large cell carcinoma, and epidermoid (squamous cell) carcinoma

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16
Q

Squamous Cell lung cancer arises most commonly in the

A

lining and central portion of the lung

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17
Q

Adenocarcinoma arises more often in the

A

periphery of the lung

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18
Q

_________ is now the most common form of lung cancer in North America.

A

adenocarcinoma

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19
Q

is it becoming more and more common for nonsmokers and never smokers to present with which histology?

A

adenocarcinoma

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20
Q

what is another name for small cell lung cancer

A

oat cell lung cancer

21
Q

where does SCLC arise?

A

in the central region

22
Q

Due to its rapid growth, SCLC has an early _____ and _____ involvement

A

lymphatic spread

Superior vena cava

23
Q

what are some signs of superior vena cava syndrome

A

swollen face, telangiectasia, and shortness of breath due to tumor obstruction

24
Q

is superior vena cava syndrome an oncologic emergency?

A

yes

25
Q

what are the primary routes of spread for lung cancer?

A

blood, lymphatics, and intrathroacic direct extension

26
Q

what is the order of lymphatic involvement

A

intrapulmonary nodes  hilar nodes  mediastinal nodes  supraclavicular (S/C) nodes.

27
Q

Involvement of the S/C nodes increases disease incidence in the ________ or __________

A

superior mediastinal nodes or upper lobe of the lung.

28
Q

which type of lung cancer is usually treated with PCI as well

A

SCLC

29
Q

when is PCI performed?

A

after a patient’s lung radiation therapy

30
Q

where does lung mets occur most often in the

A

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

31
Q

what is virchow’s node?

A

name given to the nodes in the left S/C fossa.

32
Q

another mets site is……

A

the lymph nodes of the S/C fossa (i.e. scalene nodes).

33
Q

Small Cell Lung Cancer (SCLC) treated with

A

multiagent chemotherapy and localized radiation therapy offers the best chance for a positive response to treatment

34
Q

Surgery is the treatment of choice for Non-Small Cell Lung Cancer (NSCLC) when the tumor is ______ and ______

A

small and localized

35
Q

If the tumor is inoperable due to its size, location, or regional lymph node involvement what is the best treatment?

A

high dose radiation therapy

36
Q

The signs and symptoms of lung cancer are often subtle and especially difficult to differentiate from the symptoms of ________

A

COPD

37
Q

Treatment borders for upper lobe tumors include the

A

primary tumor with a 2 cm margin, both hilar areas, the superior mediastinum, and both supraclavicular areas.

38
Q

what is prescription for lung cancer?

A

Primary tumor – 180cGy / fraction x 25 fx. = 4500 cGy

39
Q

what is the energy used when treating lung cancer?

A

6MV

40
Q

what is boost prescription for lung cancer?

A

200cGy / fraction x 10 fx. = 2000 cGy

41
Q

what are other names for boost?

A

shrinking field, cone down, off-cord

42
Q

during the boost, _____________ can be used to avoid the tolerance dose to critical structures

A

oblique fields

43
Q

what is the total dose for lung cancer?

A

6500 (to 7000) cGy

44
Q

what are the critical structures when treating the lungs?

A

spinal cord
heart
esophagus
normal lung

45
Q

what is the TD 5/5 for the spinal cord?

A

4700 cGy

46
Q

what is the TD 5/5 for the heart?

A

4000 cGy

47
Q

what is the TD 5/5 for the esophagus?

A

5500 cGy

48
Q

what is the TD 5/5 for the normal lung?

A

1750 cGy

Sim Lecture (19 decks)

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