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Flashcards in Neoplasia Deck (131):
1

list the major cause of death in the US in 2005

- heart disease 26.6%
- malignant neoplasms (cancer) 22.8%
- cerebrovascular disease (stoke) 5.9%
- chronic lower respiratory disease 5.3%
- accidents 4.8%
- diabetes 1.3%
- Alzheimer's disease 2.9%
- influenza & pneumonia 2.6%
- kidney disease 1.8%
- septicemia 1.4%

2

what does the incident of cancer rise with

age

3

at what age is the peak of cancer incidents

75

4

what happens after the age of 25, every 5 years

the risk of developing cancer doubles

5

at what age do half of all cancers become clinically evident

people over 70 years old

6

what can double in the next 50 years due to an increase in the elderly population

worldwide number of deaths due to cancer

7

what is neoplasia

an abnormality of cell growth and multiplication

8

what is the abnormality and multiplication of cell growth characterized by in neoplasia

- excessive cellular proliferation usually producing a tumour
- uncoordinated growth occurring without apparent purpose
- persistence of excessive cell proliferation and growth even after inciting stimulus is removed

9

what is the abnormality and multiplication of cell growth characterized by in neoplasia at a molecular level

neoplasia is a disorder of growth regulatory genes:
- oncogenes eg can code for tissue growth factors
- tumour suppressor genes, on the other hand might downgrade the cell cycle & stop division

10

which gene dominates in neoplasia and enhances cell division

oncogenes causing lumps of tumours & tissues

11

what can neoplasia be triggered by

- viruses
- hereditary factors
- failure of immune system
- chemical carcinogens
- exposure to UV, or X-ray radiation

12

give an example of a hereditary factor which triggers neoplasia

retinoblastoma which is seen in children is due to an inherited abnormal chromosome 13

13

give an example of a virus which triggers neoplasia

retrovirus which are bits of RNA eg HIV

14

give an example of chemical carcinogens which can trigger neoplasia

- smoking
- soot
- asbestos

15

what type of neoplasia can exposure to UV cause

malignant melanoma

16

what 3 factors can neoplasms be classified as

1. site of origin
2. biological behavior
3. cell of origin

17

how is the site of origin of the neoplasm described

eg tumours in the breast, uterus etc were different from eachother which were first recognized by Egyptian embalmers

18

list the most common new cases of cancer in the US in 2008

- non-melanoma skin cancer - over 1 million
- lung cancer - over 250,000
- prostate cancer - over 186,000
- breast cancer (female) - over 182,000
- colon and rectal cancer - nearly 149,000
- bladder cancer - nearly 69,000
- non-Hodgkin lymphoma - over 66,000
- melanoma - over 62,000
- kidney (renal cell) cancer - over 46,000
- leukemia - over 44,000
- endometrial cancer - over 40,000
- pancreatic cancer - over 37,600
- thyroid cancer - over 37,000

19

what are the 2 main types of biological behavior of neoplasms

- benign
- malignant

20

how is benign neoplasms in relation to their origin

they stay at the site of origin

21

how is benign neoplasms in relation to danger and damage

less dangerous
but can do damage by compressing neighboring tissue

22

what is the appearance of a benign neoplasm

smooth surface with fibrotic capsule (capsulated in a sheet so it is smooth)

23

what is the rate of growth of a benign neoplasm

slow

24

what do the cells appear to look like of a benign neoplasm

resemble normal tissue

25

how are malignant neoplasms in relation to origin

they invade other tissue

26

what are malignant neoplasms which invade other tissues

secondary tumours are metastases

27

how dangerous are malignant neoplasms

fatal if not treated

28

what are untreated malignant neoplasms referred to as

cancers

29

what is the appearance of a malignant neoplasm

irregular and not encapsulated

30

what do cells appear to look like of a malignant neoplasm

cells have many abnormalities and do not resemble normal tissue

31

list the properties of benign tumours

- slow growth rate
- no infiltration
- no metastasis
- high patient survival rates after successful removal

32

list the properties of malignant tumours

- rapid growth rate
- infiltrative
- metastasizing
- poor patient survival rates:
tendency for local and distant recurrence (metastasis)

33

list the properties of tumours that are inbetween benign and malignant

low-grade malignant locally aggressive borderline
- variable growth rate
- locally infiltrative
- low or no metastatic potential
- intermediate patient survival rates:
tendency for local recurrence after successful surgical removal

34

list the types of neoplasms which are from the cell of origin and state what they are the uncontrollable division of

- neuroma - neural
- lipoma - fat cells
- adenoma - glandular eg liver, renal, endocrine
- osteoma - bone
- schwannoma - schwann cells
- meningioma - meninges

35

which neoplasm causes cancer and which doesn't

- malignant neoplasm causes cancer
and benign neoplasm does not cause cancer

36

what suffix does a benign neoplasm generally end with

oma

37

what suffix does a malignant neoplasm generally end with

sarcoma/carcinoma

38

give example of which neoplasms with the suffix oma (generally for benign) can be malignant

lymphoma
meningioma

39

which common cancer has very successful survival rates

nonmelanoma skin cancer

40

list in order from most to least rate of survival probabilities where if survived for 5 years, will be most likely to survive there after

- testis
- melanoma
- Hodgkin's lymphoma
- breast
- uterus
- cervix
- bladder
- larynx
- prostate
- NHL
- rectum
- colon
- kidney
- leukemia
- ovary
- multiple myeloma
- brain
- stomach
- esophagus
- lung
- pancreas

41

how much % of survival chance is there for pancreas cancer if survive for 5 years

5%

42

what is the most common ocular tumour

melanoma

43

what are melanocytes found in

uvea (choroid, ciliary body and iris)
&
conjunctiva & eyelid (extra ocular)

44

what are the two types of ocular melanoma called

uveal melanoma
&
extraocular melanoma

45

what can intracranial tumours effect

any point in the visual pathway, as well as other areas in the brain associated with visual reflexes

46

what is the area of the brain where intracranial tumours can effect visual reflexes

brain stem

47

what type of tumour can intracranial tumours be

benign or malignant

48

what else can intracranial tumours be

primary or metastatic

49

how many new primary intracranialneoplasms a year in the US are there

13,000

50

which cell types can intracranial neoplasms arise from

glial cells
or
meninges

51

in which case can an intracranial neoplasm arise from tumours of neurons

in childhood called medulloblastoma

52

how many % of all brain tumours are of glial origin

65%

53

what is the name of the brain tumours which are of glial origin

gliomas

54

how many % of all brain tumours originate from meninges

10%

55

what is the name of brain tumours which originate in the meninges

meningiomas

56

how many % of intracranial tumours does an acoustic neuroma account for

6-10%

57

which type of brain tumour is an acoustic neuroma incident rate similar to

meningiomas

58

acoustic neuroma occurs in what ratio of the population

1 in 100,000 people

59

what type of tumour is an acoustic neuroma

benign and slow growing

60

which period of life is an acoustic neuroma likely to be in

4th and 5th decades of life
avg age 46 years old

61

which cell is an acoustic neuroma the result of

Schwann cells
ie is a Schannoma of vestibular part of the 8th cranial nerve

62

where does the acoustic neuroma originate in

internal acoustic meatus

63

where does the 8th cranial nerve com from and where does it go

comes from the ear and goes to the brain stem

64

what is the name of the 8th cranial nerve

vestibulo cochlea

65

what two parts is the vestobulo cochlea CN coming from

the ear
&
the cochlea

66

explain why the name acoustic neuroma, does not reflect the actual origin of the intracranial tumour itself

the tumour comes from a branch of the vestibular system so it is not acoustic, but is actually vestiublar.
its not a neuroma (which is uncontrollable division of nerve cells) but is an uncontrollable division of Schwann cells which are found around the 8th CN in the internal auditory meatus.

67

what is the internal auditor meatus

the hole which the 8th CN goes through

68

what does the internal auditory meatus connect

the ear to the brain stem

69

what effect does the acoustic neuroma have

it squats the 8th CN in the internal auditory meatus

70

what is the 4th ventricle

a space located behind the internal auditory meatus

71

what happens with the growth of the acoustic neuroma tumour in relation to the 4th ventricle

the tumour bulges out into the cerebella pontine angle and carries on growing & squashing the 8th CN

72

list the various sizes of an acoustic neuroma

- intracanalicular
- 1cm
- 2cm
- 3cm

73

what is a 1cm acoustic neuroma referred to as

small

74

what is a 2cm acoustic neuroma referred to as

medium

75

what is a 3cm acoustic neuroma referred to as

large

76

what is the intracanalicular acoustic neuroma referred to as

very small, stuck in the canal

77

what does a large size acoustic neuroma do

squeezes the cerebellum

78

list the 8 symptoms of an acoustic neuroma

- loss of hearing
- disturbances of balance
- facial palsy
- disturbances of taste
- odd facial sensations
- difficulty swallowing
- ataxia
- raised intracranial pressure

79

which CN is loss of hearing linked with

8th vestibulocochlear nerve

80

which CN is facial palsy linked with

7th facial nerve

81

which CN is disturbances of taste linked with

7th facial nerve

82

which CN is disturbance of balance linked with

8th vestibulocochlear

83

which CN is odd facial sensation linked with

5th trigeminal nerve

84

which CN is difficulty swallowing linked with

10th vagus nerve

85

what does the vestibulocochlear CN control

balancing & hearing

86

what is the ringing noise in ears associated with acoustic neuroma

tinnitus

87

what do you need in order to localise sound

two ears

88

which other CN also goes through the internal auditory meatus, as well as the 8th CN

the 7th facial CN

89

what happens as a cause of damage to the 7th facial CN

it effects muscle tone which looses so that side of the face droops down

90

how is the disturbance of taste linked to damage to the 7th facial CN

the 7th facial CN is also a sensory nerve of the front 1/3rd of the tongue

91

what is the 5th trigeminal CN involved with

facial sensation

92

what is the 10th vagus CN involved with

swallowing

93

what is the cause of the ataxia from the acoustic neuroma

the tumour squashes the cerebellum, which controls sensory, motor and coordination
e.g. can't walk through a door

94

what is raised intracranial pressure due to the blockage of

blocked cerebellopontine angle

95

list the series of production and drainage of CSF

- CSF is produced by choroid plexus in the lateral ventricles
- it passes through the foramen of monro into the 3rd ventricles
- through the aquaduct of sylvius into the 4th ventricle
- passage through foramina of luschka and megendie into subarachnoid space
- absorption into venous system by arachnoid villi

96

so what does a acoustic neuroma block

the drainage of CSF hence pressure builds up in cranium

97

what is placed in order to drain the CSF which is built up in the cranium

ventriculoperitoneal shunt

98

what is the tube of the ventriculoperitoneal shunt placed into

the lateral ventricle

99

what is the CSF drained through and into

drained through the tube and into the gut

100

where does the catheter lie

underneath the skin

101

which muscle raises the upper eyelid and which CN

the levator palpebrae
3rd CN oculomotor

102

which are the two smooth muscles (muscles of muller)

- superior tarsal muscle
- inferior tarsal muscle

103

which muscle is the eye closed by and which CN is that associated with

orbicularis oculi
7th facial CN

104

what happens if the orbicularis oculi muscle is damaged

cannot shut the eye

105

list the ocular symptoms of acoustic neuroma

- inability to lower the eyelid
- lower eyelid ectropion
- epiphora
- reduced tear secretion
- loss of corneal sensation
- loss of stability of the surface of the cornea
- affect on lateral rectus

106

list the ways of how to alleviate symptoms of lack of eyelid closure

- ointment, taping at night
- surgical tarsorrhaphy (sewing eye shut)
- botulinum toxin tarsorrhaphy (inject botox into elevator palpebrae)
- insertion of weight into upper eyelid

107

how does inserting a weight into the upper eyelid work

inserted onto upper tarsal plate which pulls the eyelid down and patient can learn to contract elevator palpebrae to open the eye, so the patient can use the 3rd oculomotor CN

108

what is the cause of lower lid ectropion

due to loss of innervation by 7th facial CN

109

what is lower eyelid ectropion

lower lid falls down

110

how is an ectropion alleviated

a teflon plate is placed in the lower eyelid to keep it in place

111

what is the danger of ectropion

cornea is exposed as eyelid cannot sit completely

112

what is epiphora

watering of the eyes due to ectropion tears pool in the eyelid and then splash out

113

what is the cause of reduced tear secretion

tears not distributed as the eye cannot blink due to damage of the 7th facial CN

114

damage to which CN causes the loss of corneal sensation

5th trigeminal CN

115

what can loss of corneal sensation cause

a damaged tear film

116

damage to which CN causes an effect on the lateral rectus muscle

6th abducens nerve

117

what does an effect on the lateral rectus muscle cause

inability of the eye to turn out

118

what % of intracranial tumours are pituitary adenomas

10-12%

119

where is the pituitary gland located

below the optic chiasm

120

which way does a pituitary tumour grow and why

upwards, as the pituitary sits on a bony saddle/sella, which impacts the chiasm

121

which fibres will a pituitary tumour compress

fibres originating from the nasal inferior retina of both retinae

122

what type of field defect will a pituitary tumour cause

bitemporal superior field defect

123

which fibres will a pituitary adenoma compress

fibres of the ventral surface of the chiasm causing bilateral superior scotomas

124

which part of the chiasm does a chromophobe adenoma push up

infront of the chiasm

125

which fibres are most vulnerable from a pituitary tumour

duscussating fibres

126

list the things which can be done about a non-functional 7th facial CN

- 7th CN often regenerates
- a nerve graft to connect the functional 7th CN on the side of the face to the muscles on the non-functional side (using the leg's sural nerve)
- facelift eg
gold weight in upper eyelid
teflon plate in lower eyelid
attachment of mouth to ear

127

what does the length of the optic nerve effect the relative position of

the chiasm and seller structures

128

list the three types of relative positioning of the optic chiasm and seller structures due to optic nerve head

- prefixed chiasm - short optic nerve
- normal chiasm
- postfixed chiasm - long optic nerve

129

Which type of neoplasm is generally primary and why

Benign as they stay where they originated

130

Which type of neoplasms are secondary and metastatic

Malignant

131

list from first to last, which cranial nerves get effected by an acoustic neuroma (i.e. from small to large)

- 8th CN vestibulo cochlea
loss of hearing
disturbance of balance
- 7th CN facial nerve
facial palsy
disturbance of taste
- 5th CN trigeminal nerve
odd facial sensation
- 10th CN vagus nerve
difficulty swallowing