Blo201, CaseStudyl,Tissues andBone - Word References Mailings Review View Help T

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Blo201, CaseStudyl,Tissues andBone - Word References Mailings Review View Help Tell me what you want to do 5. Even one second past the deadime of Will resuli in automaic50% reduction ofl score. No wnltm assignments will be accepted after Case Study A.Epithelial Tissue and Cancer Chief Complaint: 68-year-old man with a cough and dyspnea ("shortness of breath") for the past week. History: Daniel McDonald, a 68-year-old white male with a 40-pack-year smoking history suffered from chronic bronchitis for which he had been on antibiotics for several months. Two weeks ago, he began coughing up a bloody sputum ("hemoptysis"). In the past week he's become increasingly short of breath. A routine chest X-ray revealed two silver dollar-sized opacities on the right side of the carina. Bronchoscopic examination revealed a tumor that was nearly occluding the right mainstem bronchus. A bronchial biopsy revealed the diagnosis: bronchogenic carcinoma 1. Define the terms and describe where in the body each term is: a bronchogenic carcinoma, b. hemoptysis, c. opacities; d. carina a. bronchogenic carcinoma: b. hemoptysis: c. opacities: d. carina: 2. Most cancers arise from epithelial tissue. Why do you suppose this is? 3 0

Explanation / Answer

1)

a.) Brochogenic carcinoma: It is the medical term for lung cancer. It is characterized by uncontrolled cell growth in tissues of the lung. If left untreated, the growth could spread beyond the lung in a process called metastasis into nearby tissue or other parts of the body.

b.) Hemoptysis: It is the presence of blood or blood-stained mucus while coughing. This occurs from respiratory tract especially from lungs.

c.) Opacities: The state of a body that obstructs the absorption or reflection of the X-rays light which makes it impervious to the rays of light. This occurs where the internal blood is clotted or a cough or any foreign particle is present.

d.) Carina: It is a cartilage which divides the two main bronchi.It is formed at the lowermost end of the trachea (usually at the level of the 4th thoracic vertebra) This ridge lies to the left of the midline and runs anteroposteriorly i.e front to back.

2.) Epithelial tissue is particularly prone to carcinogenesis, possibly for the following reasons:
this tissue lines all body surfaces, inside and out, and is thus the first tissue that carcinogenic (cancer-causing) agents strike upon entry into the body, most types of epithelium divide fairly rapidly under normal circumstances, and thus may be more susceptible to the intracellular triggers of uncontrolled cell division.

3.) The epithelium lining of bronchi is ciliated, pseudostratified, columnar epithelium. This single layer of ciliated, column-shaped cells has nuclei that appear at varying distances from the underlying basement membrane, giving the false appearance of a multi-layered epithelium (i.e. "pseudostratified"). The epithelium contains mucus-producing goblet cells and mucous glands. This mucus is secreted onto the surface of the epithelium.

4.) The chronic irritation of the bronchial epithelium by cigarette smoke exposure causes a mild inflammatory response (bronchitis) which can impair the cleansing function of the cilia. Irritation of the lining causes excessive mucus production, which, in turn, is difficult to clear because of poor cilia function. Mucus begins to clog pool in the bronchial tree, and Daniel develops the familiar "smoker's cough," an attempt to clear his airways of this mucus. The pooling mucus provides a nutrient-rich medium for invading bacteria. Daniel is thus likely to develop infections of the bronchi.

5.)Severe infectious bronchitis may occasionally cause blood to appear in the sputum. The hemoptysis may also be due to a bronchogenic carcinoma. Cancerous growths often have a rich blood supply, and they frequently bleed into neighboring tissues. In addition, cancer that is rapidly enlarging can damage already existing blood vessels. Since Daniel's cancer is near the bronchial surface, blood may spill into the bronchial tree and be coughed upward (i.e. hemoptysis).

Daniel's 40-pack a year smoking history places him at increased risk of developing emphysema. In emphysema, there is slow, gradual destruction of alveolar walls, and thus a loss of surface area for the respiratory membrane. Furthermore, there is a destruction of elastic connective tissue around the bronchioles, making them more likely to collapse and block airflow. Both chronic bronchitis and emphysema are part of the clinical syndrome called chronic obstructive pulmonary disease

6.) The appearance of the cancerous tissue would vary depending upon the specific type of bronchogenic carcinoma Daniel has. In squamous cell ("epidermoid") cancer, the cells are flattened and produce an abundance of keratin, looking like epidermal cells of the skin (hence, the term "epidermoid" cancer). In small cell cancer, the cancer cells are oval-shaped and small with little or no cytoplasm visible. In large cell cancer, the cells are larger and very poorly differentiated (i.e. immature in appearance), with large nuclei. Finally, in adenocarcinoma, cells may range from well-differentiated, glandular cells producing mucus to poorly differentiated cells packed more tightly together.

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