Respiratory System
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| What happens if the epiglottis fails to work properly? | -food and liquid could enter the airway/possible aspiration
-cough reflex would initiate
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| Is the esophagus anterior or posterior to the trachea? | posterior
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| There is _________ _________ in the pleural cavity which lubricates the pleural surfaces. | serous fluid
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| What does the serous fluid help the lungs do? | move more freely during respiration
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| What does type 2 alveolar epithelial cells produce and how does this help the lungs? | produces pulmonary surfactant which is a lipid protein substance that reduces tension at the air-liquid interface in the alveolar spaces. This keeps the lungs from collapsing.
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| What do mucous cells found in submucosal glands secrete and how does this play a role in protecting the lungs? | secrete mucin which plays a role in protecting the lungs from pathogens and toxins
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| What is the respiratory systems first line of defense? | the mucin that is secreted by the mucous cells in submucosal glands
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| What is a normal field size for the larynx? | 5x5
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| With H&N cancer, what gender is more often affected? | men
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| With H&N cancer, what race is more often affected? | African American
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| With H&N cancer, what age is typical? | older than 40
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| Etiology of H&N cancer | -smoking
-alcohol
-betel nuts (the red coating)
-poor nutrition
-viruses (HPV and EB)
-genetic defects
-chronic irritation
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| What 2 etiological factors of H&N cancer have a synergistic effect? | smoking and drinking
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| What is the most common histology of H&N cancer? | squamous cell
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| How is staging done for H&N cancer? | based on the size of the tumor and the number or size of lymph nodes involved
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| Name the 5 risk factors involved with Oral cancer. | -tobacco use
-alcohol
-oral infection (HPV)
-sun exposure for lip cancer
-reflux (larynx cancer)
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| T or F. The cure rate is better for HPV cancers than for smoking related cancers. | True
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| There are 9 H&N cancer sites. Try to list them. | -paranasal sinuses
-buccal mucosa
-lip
-base of tongue
-tonsil
-salivary gland
-nasopharynx
-pyriform sinus
-larynx
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| Dr. Legg stated that if air can touch it, then the cell type is _________________ cell. | squamous
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| What do the sinuses do? | lighten the weight of the head, filter and warm air, function in sound resonance, serve as crumple zone in the case of facial trauma
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| Which paranasal sinus is most commonly affected by cancer? | maxillary sinuses
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| Most sinus tumors are ____________ cell carcinomas. | squamous
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| What other tumors can also be found in the sinuses, but it is not as common. | adenocarcinomas, lymphomas, sarcomas, and papillomas
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| Papillomas are usually __________. | benign
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| Maxillary sinus tumors are usually __________ and _____________. | large and invasive
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| What is the best treatment for maxillary sinus tumors? | chemo and radiation to shrink the tumor before it is surgically removed
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| Collectively, most H&N cancers start where? | in the oral cavity
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| Erythroplakia vs Leukoplakia | erythroplakia is red patchy areas on the mucosa while leukoplakia is white patchy areas on the mucosa
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| Endophytic vs Exophytic | Endophytic means it is growing into the tissue and exophytic means it is growing out of the tissue
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| Lip cancer is typically ___________ cell carcinoma. | squamous
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| What causes lip cancer? | sun exposure, smoking, chemicals, and burns
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| How do we treat lip cancer in rad therapy? | electrons (superficial)
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| Nasopharynx tumors are usually treated as what before it is caught? | vertigo bc the eustachian tubes open up into the nasopharynx and this causes balance issues
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| Tumors of the nasopharynx are related to what 2 causes? | EBV and alcohol
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| What is a normal symptom of a nasopharynx tumor? | bloody nasal discharge
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| Nasopharynx tumors are usually ______________ cell carcinoma. | squamous
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| The hypopharynx is also known as the what? | laryngopharynx
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| The hypopharynx includes what 3 things? | -piriform sinuses
-lateral and posterior pharyngeal walls
-post-cricoid region
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| Does the hypopharynx (aka laryngopharynx) house the larynx? | No
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| What part of the hypopharynx is the most common pathology site? | pyriform sinus
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| Larynx tumors are caused by what 2 things? | smoking and alcohol
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| Larynx tumors are classified as ______________ cell carcinomas. | squamous
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| List the treatment field borders for the larynx. | Superior: hyoid bone
Inferior: cricoid cartilage
Anterior: 1-1.5 cm flash
Posterior: vertebral bodies
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| Dr. Legg stated that any glandular tissue tumors are typically classified as ________________. | adenocarcinomas
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| Salivary gland tumors mostly involve the ______________ _____________. | parotid gland
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| What is the treatment option for salivary gland tumors? | surgery first and then radiation
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| Possible side effect of salivary gland tumor treatment? | dry mouth
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| What is the most common cancer in men? | prostate
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| What is the most common cancer in women? | breast
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| What is the second most common cancer among men and women? | lung cancer
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| What race is typically most affected by lung cancer? | african american male OR white female
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| What age is typically most affected by lung cancer? | 65 or older
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| What is the leading cause of death in the US? | lung cancer
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| T or F. More people in the US die from lung cancer than colon, prostate, and breast cancer combined. | True
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| There are multiple etiological factors that contribute to lung cancer. Try to list them. | -smoking (1st, 2nd, and 3rd hand)
-exposure to radon
-exposure to asbestos
-exposure to radiation
-chronic lung disease
-environmental exposures
-pollution
-family hx
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| Small cell lung cancer is also known as? | oat cell
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| Oat cell lung cancer accounts for _____% of diagnosed lung cancers. | 15%
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| Non-small cell lung cancer consists of what 4 types. | -adenocarcinomas
-squamous cell carcinoma
-large cell carcinoma
-carcinoid
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| Non-small cell lung cancer accounts for ____% of diagnosed lung cancers. | 85%
specifically, adenocarcinoma is 40%, squamous cell is 30%, large cell is 10% and carcinoid/other is 3%
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| Why is small cell lung cancer aka oat cell? | bc it looks like oats microscopically
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| What is oat cell lung cancer capable of secreting? | hormones which is not something lungs do
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| Why is it not a good thing that oat cell lung cancer has the capability of secreting hormones? | bc lungs do not secrete hormones and this could create symptoms which lead to paraneoplastic syndrome which can lead to Addison's disease
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| T or F. Oat cell lung cancer spreads quickly and is usually in several locations at the time of diagnosis. | True
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| What 2 sites is typically where oat cell lung cancer spreads? | brain (most common) and adrenal glands
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| What treatment option is oat cell lung cancer most responsive to? | chemotherapy
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| What type of lung cancer often requires prophylactic cranial irradiation (PCI)? | oat cell lung cancer
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| What is a typical PCI dose? | 2400-3000 cGy
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| Which type of lung cancer is not always related to smoking? | adenocarcinoma
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| Where does adenocarcinoma typically occur in the lungs? | glandular tissue and often located peripherally
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| What gender is adenocarcinoma more commonly affected? | women
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| Which type of lung cancer has the greatest link to smoking? | squamous cell carcinoma
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| What type of cells does squamous cell carcinoma occur in? | keratinizing cells
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| Where are the squamous cell tumors often located? | centrally
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| What is a primary symptom of squamous cell carcinoma? | hemoptysis (coughing up blood)
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| What type of lung tumor is found in the apices of the lungs and typically large in nature? | pancoast tumor
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| What anatomical site can the pancoast tumor possibly invade? | brachial plexus
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| Which type of lung cancer is associated with asbestos exposure? | mesothelioma
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| Mesothelioma affects the ________ of the lung. | pleura
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| How can mesothelioma be treated? | chemotherapy
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| What case could possibly occur as an emergency rad therapy treatment? | SVC syndrom
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| Can you lay a person with SVC syndrome flat? | No, bc they would not be able to breathe
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| Where is the esophagus located in reference to the trachea? | posterior
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| Define pulmonary edema. | excess fluid in the lungs, produces swelling and the fluid collects in the air sacs of the lungs making it difficult to breathe
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| The most common tumor arising in the esophagus is? | adenocarcinoma
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| What percent of smokers develop lung cancer? | 10-20%
*this was one on the quiz and the other statistic is that 80-85% of lung cancers are linked to smoking
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| What is the second leading cause of lung cancer? | radon exposure
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| The most common presenting symptom of lung cancer is persistent _____________. | cough
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| Hounsfield number for bone | 1000
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| Hounsfield number for water | 0
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| Hounsfield number for air | -1000
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| Is surgery a common option for SCLC? | No, bc most are caught in advanced stages of the disease
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| What kind of treatment would SVC syndrome require? | 3-4 fx of 300-400 cGy (treated through an open field) followed by a reduction for a daily dose of 180-200 cGy (treated through an open field) followed by a customized field) for a total of 4500-6000 cGy
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| SBRT lung treatments usually require how many fractions? | 1-5
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| Treatment rx for lung cancer | 180 cGy in 35 fx for a total dose of 6300 cGy
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| Treatment rx for PCI | 250 cGy in 10 fx for a total dose of 2500 cGy
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| Treatment rx for Esophageal cancer | 200 cGy in 30 fx for a total dose of 6000 cGy
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| Skin TD 5/5 | 5000
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| Esophagus TD 5/5 | 5500
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| Brachial Plexus TD 5/5 | 6000
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| Heart TD 5/5 | 4000
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| Lung TD 5/5 | 1750
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| Spinal Cord TD 5/5 | 4500
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| Larynx TD 5/5 | 4500
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