Functional anatomy

From Oncology for Medical Students
Ideal oncology curriculum > Functional anatomy

Objective 2.1

At graduation, the student should be able to demonstrate an understanding of the anatomical basis of cancer assessment such as: vascular supply (e.g. liver); lymphatic drainage patterns (e.g. breast); and anatomical relationships of relevance to oncology (e.g. pelvis).

Prerequisite knowledge

  • General anatomy

Representative questions that suggest the required depth of knowledge

1. Describe the modes of potential spread of breast cancer in the upper outer quadrant of the left breast.

Essential in answer:

  • Direct extension – skin, chest wall
  • Lymphatic spread – axillary nodes, internal mammary nodes, supraclavicular nodes
  • Haematogenous spread – bone marrow, lung, liver, brain

2. A patient has a squamous cell carcinoma of the apex of the left lung (Pancoast tumour). Describe the possible structures involved in local progression, and their effects.

Essential in answer:

  • Brachial plexus (lower roots; C8/T1) – pain, weakness in small muscles of hand
  • Cervical ganglion (sympathetic nerve) – Horner’s Syndrome
  • Chest wall invasion – pain, mass
  • Supraclavicular extension – pain, mass