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5.2.2. Main stage:

Brief guidelines for the work of students on practical zanya t ones.

In classrooms called theme, the general and specific objectives classes. In kladach and conducts test control entry-level knowledge.

More students in torakal Mr. department HOKOD or surgical breath and Lenny HIMR conduct independent curation of patients with lung cancer and mediastinal tumor and us, alternatively, under the supervision of a teacher. To evaluate correctly at STI test constantly engaged other students., Pay attention to an mnez and patients familiar with the methods and results of laboratory studies and researches and findings are entered in workbooks.

Curator, based on the data, making the sick. I considered giving the question of etiology, pathogenesis, classification TNM lung cancer and tumor and mediastinal us, stops on the role of factors that contribute to the development of the disease is given at first.

More students together with the teacher to discuss the findings, clinical manifestations, stage of disease, differential diagnosis and modern methods l and forging and prevention of lung cancer and mediastinal tumors.

At the end of class, the instructor controls the final level of knowledge, and more confused est. knowledge and skills of students through tasks, tests, leads pi d bag sessions.

Incidence in Ukraine 44.6 in Kharkiv region - 37.1 per 100 thousand people (2001). In the structure of morbidity takes first place in the men (23.07%) and eighth place in the women (4.95%).

Risk groups

1.         Malicious smokers.

2.         Patients X O ZL (chronic bronchitis, fibrosis, asthma).

3.         Patients with tuberculosis (lung cancer grows scar tissue).

4.         Hazardous industries (refining, paint manufacturing, smelting and metal processing, manufacture of asbestos cement, welders).

5.         Genetic predisposition - persons who have or have tumors other home network and zatsyy.

Clinical and anatomic classification by AI Savitsky:

1.    Central (80%) - the main growing epithelium partially ce d mentarnyh bronchi, while there is atelectasis of part or all l f gene:

- Perybronhy ​​cial and (seemingly bronchus) - эndobronhyaln j (эkzofytnaya form) - branched (creeping along the wall of the bronchus).

2.         Peripheral (about 20%) - growing epithelium bronchioles ATE lektazu no: pnevmonyepodobna form; abdominal form; Penkosta cancer (cancer of the lung apex).

3.    Al and pychn and forms 2-3% (manifested clinic hematogenic metastases):

bone, brain, liver, medyastynalna, miliary kartsynoz.

Histological forms:

1.    Ploskokl and hospitable cancer (VC and dermoydnyy) - 40 - 45% 2. Adenocarcinoma (with a lizystyy cancer) - 20% 3. Small cell - 25 - 30% .4. Krupnokl and Tina cancer 5 - 10% 5. Carcinomas and Dr.

Central Clinic cancer caused tumor growth in the lumen of the bronchus is lykoho and atelectasis:

1.       Chest pain - caused by tumor growth in the lumen of the bronchus and germination of nerve endings in the bronchial tubes.

2.       Cough - due to the growth of the tumor into the lumen of the bronchus and irritation of nerve endings (in the type of th a foreign object).

3.       Hemoptysis - the collapse of the tumor and the allocation of sputum streaks of blood.

4.       Shortness of breath - obstruction of the bronchus tumor off the act of breathing and gas exchange at major areas of pulmonary parenchyma.

5.       Hyperthermia - obstruction of bronchial tumor, g and poventylyatsyya, development and p rakankroznoy pneumonia (pneumonia that accompanies cancer).

Clinic peripheral cancer very poorly, the tumor is often found in Prospect at fohlyadah by fluorography, possible symptoms:

1. Pain in the chest only during germination pleura or bronchi, as in the lung parenchyma are no nerve endings.

2. Cough - germination bronchus.

3. Hemoptysis - germination bronchus.

Metastasis of cancer lung:

1.         L and mfohenne: bronchopulmonary and l and IFI UZL s, lymph nodes root of the lung - N 1, mediastinal lymph nodes of the lesion (paratrahealn and would Furko and HH nd c and f couple zofahealn etc.), N 2 lymph in and UZL seredostynnya from the opposite side, over-and subclavian l and IFI UZL s - N 3.

2.         Hematogenous: liver, brain, bones, pleura - lung parenchyma, and retroperitoneal l IFI UZL s.

TNM Classification 7 edition, 2007

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