Book 4 - Self Instructional Manual for Cancer Registrars - SEER ...

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A tumor specified as "subareolar" is coded to the central portion of the breast (C50.1) indicatingthat the tumor is located directly under the nipple.Extending outward from the nipple and areola and covering the entire surface of the breast is alayer of skin. Skin changes are significant in the clinical evaluation of breast cancer and indicateinvolvement of parenchymal tissue as well as invasion of the skin itself. Changes such as dimpling,tethering, and nipple retraction are presumed to be due to tension on Cooper's ligaments and notto actual skin involvement; adherence, attachment, fixation, induration, and,thickening are usuall),dueto extension of tumor to the skin or subcutaneous tissue. Edema, peau d orange, 1 en cuirasse _, andulceration clinically indicate extensive skin involvement.The blood supply to the breast is from both the internal thoracic (subclavian) and the lateralthoracic (axillary) arteries. The veins <strong>for</strong>m both superficial and deep plexuses and correspond ingeneral to the arterial pattern.Regional Lymph NodesThe lymph nodes of the breast may be divided into the following categories:Axillary lymph nodes (ipsilaterai)Low axiUary(Level I): area adjacent to the tail of the breastMid axillary (Level II): central, interpectoral (Rotter's node)High axillary (Level III): apex of the axilla including those designated assubclavicular, infraclavicular, and apical nodesInternal mammary (parasternal) lymph nodes (ipsilateral): in the intercostal spaces alongthe edge of the sternum in the endothoracic fasciaNodules of cancer cells found in the axillary fat which are not specifically identified as lymph nodesare considered to be nodes which have lost their architectural configuration or to be intransitmetastases in the lymphatics.Contralateral or bilateral involvement of any of the above lymph nodes is considered distant lymphnode metastasis.All other lymph node metastases are coded as distant metastases, including any supraclavicular,scalene, and cervical lymph nodes.lpeau d'orange--a dimpled skin condition resembling the skin of an orange.2en cuirasse--an inflammatory process in which skin involvement resembles armor plate.302
Q22One of the first and most frequent areas of nodal metastasis in breast cancer patientsis thelymph nodes.Q23Match the axillary lymph node levels on the left with the descriptions on the right.1. Low a. Area next to the tail of the breast2. Mid b. Apex of the axillaQ243. High c. Area under the pectoralis minor musclesWhat are the most frequently involved distant lymph nodes <strong>for</strong> breast cancer?303
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SEER ProgramSelf Instructional Manu
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CONTENTSBOOK 4: HUMAN ANATOMY AS RE
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ILLUSTRATIONS(Figures 1-82, cont'd)
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ACKNOWLEDGEMENTSPortions of Book 4
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SECTIONAOBJECTIVES AND CONTENT OF B
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BSECTIONBTERMS USED TO INDICATE BOD
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Directional Planes of the BodySagit
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Relative Positional and Directional
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Figure 3. ANATOMIC DIVISIONSOF THE
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Answers to Practical ExerciseNote t
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SECTIONCTHE INTEGUMENTARYSYSTEM19
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EpidermisThe epidermis (Figure 4A)
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Q1a. What are the two primary layer
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Epidermis is epithelial tissue deri
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Answer:Q2The three glands of the sk
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Q3Q4Accessory skin organs are found
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Benign TumorsThere is a large group
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Q5 Match the malignant tumors of th
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MalignantMelanomaMalignant melanoma
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The description of the level 1 of i
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Q9"Clark's Classification" of malig
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Lymphatic Drainage of the SkinThe l
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Q10Match the regions of the skin on
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SECTIONTHE LYMPHATICDSYSTEM51
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T-Cells Versus B-CeilsThe two princ
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Answer:Q1The lymphatic system colle
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Figures 8A-8B. LYMPHATIC DRAINAGE O
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Answer:Q3The lymphatic system colle
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Lymph nodes accomplish two separate
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Q6The lymph nodes have two main fun
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SpleenThe spleen, the largest lymph
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Q9Match each lymphatic organ or tis
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LymphaticDrainageLymph nodes, most
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Answer:QllLymphatics tend to parall
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Q14A general term for lymph nodes l
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Lymph Nodes of the ThoraxThe lymph
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Answer:Q18Lymph nodes of the thorax
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Q20Lymph nodes of the abdomen may a
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Lymph Nodes of Upper and Lower Extr
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Answer:Q22c 1. Popliteal Heela 2. A
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Hodgkin's disease. The histologic c
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Answer:Q23Benign tumors of lymphoid
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Extralymphatic/ExtranodalSitesLymph
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Answer:Q27Non-Hodgkin's lymphomas m
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TilE CARDIOVASCULAR SYSTEMIonatod
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CIRCULATORY SYSTEMFigure 14D. BLOOD
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Answer:Q1The cardiovascular system
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The heart lies in a loose-fitting s
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106
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Answer:Q5The heart has four chamber
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Answer:QIODeoxygenated blood from t
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Portal System (portal circulation)V
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Answer:QllThe three kinds of blood
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Answer:QlgThe three main types of b
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120
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Answer:Q18White blood cells which a
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DEVELOPMENTOF WHITE BLOOD CELLSStem
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Answer:Q20Malignant diseases of the
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Answer:Q25b 1. Leukemia An uncontro
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130
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132
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Answer:Q1The parts of the respirato
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136
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Answer:Q41. Serves as a passageway
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140
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Answer:Q7The pharynx can be divided
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The larynx can be divided into thre
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146
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Answer:Q10The three single cartilag
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150
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Answer:Q14The windpipe or trachea s
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The lungs provide a place where lar
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Answer:Q16The main bronchus, pulmon
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Clinical ManifestationsClinical man
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Answer:Q19The interpleural space ma
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Answer:Q24_g_ 1. Exchange of oxygen
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DIGESTIVE SYSTEM: Esophagus-RectumP
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The organs of the digestive system
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Answer:Q1The main organs of the dig
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• Lips. The lips form the upper a
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Answer:Q5The lip consists of an exp
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Malignant TumorsMalignant lesions a
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Answer:Q8The tongue is composed of
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• Gums (gingiva). The gums are fo
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Answer:Qllb__ 1. GumMucosal coverin
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182
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Answer:Q12The palate is the roof of
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186
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Answer:Q18The major salivary glands
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190
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Answer:Q21c 1. Gum Retropharyngeala
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Oropharynx. The air and food passag
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196
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Answer:Q23Another name for the hypo
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Answer:Q25a__ 1. HypopharynxServes
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Answer:Q28a. Tonsillar pillar - Oro
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Figure 31. MEASUREMENTS OF THE ESOP
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206
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Answer:Q30The esophagus extends fro
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The medial border of the stomach is
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Q33The stomach lies just below thei
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Answer:Q33The stomach lies just bel
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216
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Answer:Q38The small intestine is ab
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The large intestine receives the fl
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Malignantand Benign TumorsThe usual
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224
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Answer:Q41The large intestine is ab
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Answer:Q433. The ileocolic lymph no
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Metastatic tumors involving the liv
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Answer:Q45The most common primary t
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234
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Answer: 046The function of the gall
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238
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Answer:Q48.The pancreas plays an im
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Figure 39. PRINCIPAL PARTS OF THE U
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The microscopic structure of the re
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Answer:Q1The urinary system consist
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Figure 41. A NEPHRON_ Otomes_JLus_;
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250
Page 260 and 261: Answer:Q4The blood is circulated th
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Page 264 and 265: Answer:Q8The regional lymph node dr
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Page 268 and 269: Answer:Q12The tube which carries ur
Page 270 and 271: URINARY BLADDER, RENAL PELVIS AND U
Page 272 and 273: Malignant TumorsBladder cancer is t
Page 274 and 275: Answer:Q14The urinary bladder is a
Page 276 and 277: Q18Theis a membranous tube which co
Page 278 and 279: Answer:Q18The urethra is a membrano
Page 280 and 281: Figure 44.FEMALE PELVIS (frontal vi
Page 282 and 283: CORPUSUTERII I _ 'PRIMARY] ENDOMETR
Page 284 and 285: Answer:Q1The female reproductiveorg
Page 286 and 287: • Choriocarcinoma, a highly malig
Page 288 and 289: Answer:Q6For corpus uteri you might
Page 290 and 291: FallopiantubesThe fallopian tubes,
Page 292 and 293: Answer:Q7b 1. Uterus Pear-shaped mu
Page 294 and 295: Q8Name the three openings of the ut
Page 296 and 297: Answer: 08In naming the three openi
Page 298 and 299: Regional Lymph NodesThe regional ly
Page 300 and 301: 6. Vaginal orifice f. Glands that s
Page 302 and 303: Answer:Q14The vagina is situated be
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Page 308 and 309: Answer:Q19The breasts overlie the p
Page 312 and 313: Answer:Q22One of the first and most
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Page 316 and 317: ANSWERS TO REVIEW TESTd 1. Gonads i
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Page 320 and 321: Answer:Q25The male gonads consist o
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Page 324 and 325: Answer:Q27c 1. Epididymis Tube loca
Page 326 and 327: Figure 51. PROSTATE GLAND (frontal
Page 328 and 329: Answer:Q29b 1. Prostate Gland which
Page 330 and 331: RegionalLymph NodesThe regional lym
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Page 334 and 335: Answer:Q30Male hormones are produce
Page 336 and 337: Figure 53. ENDOCRINEGLANDS328
Page 338 and 339: • Prolactin (luteotrophic hormone
Page 340 and 341: Parathyroid GlandThere are four par
Page 342 and 343: Thymus GlandThe thymus gland is loc
Page 344 and 345: Q2Match the hormone on the left wit
Page 346 and 347: Answer:Q1d 1. Hormones Organic secr
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Page 350 and 351: Figure 58.AXIAL SKELETONSkuLl.342
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Page 354 and 355: Answer:Q1The skeletal system is com
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Page 358 and 359: Answer:Q4One characteristic which d
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352
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Answer:Q8The purpose of the sesamoi
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Structure of BoneEach long bone of
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Answer:QllThe numbered parts of the
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Facial bones. The facial bones are
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Figure 65. BONES OF THE THORAX Figu
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Q17Match the bones on the left with
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Figure 67. APPENDICULARSKELETON366
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Malignant TumorsBone is derived fro
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Q20Sites from which metastases to b
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Q22Match the description on the lef
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Answer:Q21c 1. Angiosarcoma A malig
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Figure 68.MUSCLE TYPES376
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Figure 69. HISTOLOGICAL COMPARISONS
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Answer:Q1The three types of muscle
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382
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Answer:Q61. True Malignant tumors o
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• Supinators turn the palm upward
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Answer:Q8The three general function
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Answer:Q11Match the muscle groups o
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392
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Figure 70.NERVE CELL (neuron)394
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Answer:Q1The central nervous system
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Figure 71.CEREBRUMCEREBRUMC_ere_etr
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400
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Figure 74 CRANIAL NERVES402
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MalignantTumorsGliomas are tumors o
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406
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Answer:Q6Match each term on the lef
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410
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412
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Answer:Q1The five major sensesof th
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416
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Answer:Q3The three layers which com
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420
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Answer:Q5The eyeball/s not a solid
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424
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Answer:Q8Name the lymph nodes which
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Figure 80. TONGUE: Areas of tasteUv
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Answer:QllReceptors for the sense o
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Malignant TumorsTumors of the nasal
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Answer:Q13The nasal fossa is divide
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Regional Lymph NodesThe lymphatics
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Answer:Q16b 1. External ear Made up
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440
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HISTOLOGIC TYPE PRIMARY SITELeukemi
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444
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DETERMINATION OF SUBSEQUENT PRIMARI
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470
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OTHER ICD-O-2 CODES TO BE CONSIDERE
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474
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SELECTED BIBLIOGRAPHY (cont'd)Paul,
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478
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Adenocarcinoma (continued)Primary s
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Arteries (see also Vessels) (contin
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Blood (see also Cardiovascular syst
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Bone tissue (osseous, vascular tiss
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Breast (mammary gland) (continued)H
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Cartilage (nonvascular tissue) (con
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Cerebrum (forebrain, telencephalon)
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Cortisol, 329, 333, 336, 338Cortiso
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Ducts (see also Endocrine system an
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Estradiol, 281Estrogen-producing ca
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Follicular adenocarcinoma, 331, 337
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Glycogen, 229Gonadotrophic hormone
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Histologic type of cancer, 439-441H
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Integumentary system (skin) (contin
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Kidney (see also Urinary system) (c
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Leukocyte (WBC),Agranular, 119B-Cel
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Luteal cell, 281Luteinizing hormone
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Lymph nodes (continued)Perivesical,
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Lymphoma (continued)Nasopharynx (ph
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Metastases (continued)Lymph node, 6
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Muscle (see also Muscular system) (
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Nervous system, Cranial (continued)
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Ovary (female gonad), 273, 281,285,
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Peripheral nervous system, 393, 396
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Prostate (continued)Urethra (prosta
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Salivary gland (see also Parotid, S
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Skull (diploe), 351, 354, 356, 359,
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Sulcus,Buccal, 178Nasolabial, 39Sup
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Tibia (shin bone), 351, 369Tumors o
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Tumor (see also specific histologic
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Urethra (female, male) (continued)L
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Vertebral cavity, 10Vertebral colum
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