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Hi, everyone. We'll uh we'll make a start. Could I get uh, just a thumbs up or something that you can hear me? Mhm. Not seeing anything coming. Could someone just send a, a thumbs up just confirming, you can hear us in the chat? I can hear you. But um yeah, I'm gonna send a message in case. Ok, perfect, great. Ok, we'll make a start. So, um, hello everyone. Thank you for joining us today. Uh, so my name's Luke, I'm one of the education directors at SUTA. Um, and this week we're focusing on cardiothoracic surgery. Um, so we're excited to have you all with us and thank you for joining. Um, so today I'm joined by Esther Sleigh. Um, who will give you, um kind of a, an overview of the topic of lung cancer. Um, Esther is a medical student from the University of Nottingham um to make this, this session as engaging as possible. Uh, we will be releasing polls throughout. Um, so these are completely anonymous. Um, and we encourage you to participate actively. Um, if you do have any questions during the session, please put them in the chat and we'll do our best to address them at the end of the session, we'll share a feedback form. Um And if you complete this, you will receive a certificate of attendance and exclusive discount codes for teaching me surgery and pass the MRC S. Additionally, the session is being recorded. Um And the recording and slides will be shared on our meal page a couple of hours after the session. Uh So keep an eye out for that. We are also excited to share that an exclusive question bank and other resources will be available on our learning portal. Um So check out our website to access them. Er if you create a free membership account with us, you'll also um receive a discount code for 10% off the geek medics, anatomy flashcards, surgery flashcards and knowledge bundle. We also have an exciting opportunity for all our attendees. So two lucky people will win free access to the GKI medics surgical flashcards and the GKI Medics aus stations to enter simply complete the Google form um which will be sent at the end of the session and enter the unique code that we'll provide the more sessions you attend the higher the chances of winning. So be sure to stay until the end of the session and attend as many of our sessions as well. And finally, just before we begin, uh we'd like to thank our partners, the Royal College of Surgeons England, geeky medics, the ND U more than skin deep meal will teach me surgery and pass the MRC S. So without further ado, I will hand over to Esther. Thanks Luke. That's great. So, hi, everyone. Um So yeah, I, I'm one of the final years at Nottingham. Um and today we're just gonna be talking about lung cancer. Um go through a bit of anatomy and like the clinical relevance. Um So as Luke said, like, thank you to our partners. Um and just to start off with going through the learning objectives. So there's quite a few. So these are the anatomy ones. Um I'm not gonna read them all out and then there's also the clinical um objectives of lung cancer. So I'll just be going through the different types um how to diagnose the symptoms. Um and then some little bit of a surgical relevance at the end. Um as it's a surgical, it's a surgical talk. So stay tuned for that. Um So to start off with some anatomy, so as you all probably know, the thorax is subdivided into four parts. Um So you've got um on here, the diagram at the side, you can see the superior and the inferior and then the inferior is divided into the anterior, middle and posterior. Um and that border is at the sternal angle. So I'm just gonna go through kind of each uh each subdivision um to start off with just so everyone's aware of what anatomy is in which part. So the superior mediastinum um and its contents. So you get the great vessels. So you've got the arch of the aorta and the three branches that you can see on the um diagram at the side. Then you've also got the superior vena cava and the four drainage into the superior vena cava. You've got the nerves. So the vagus nerve, the left recurrent laryngeal, the phrenic nerve, the cardiac nerves and the sympathetic trunk and then some others that kind of pop in and out of the superior and inferior. You've got the thymus gland, the trachea, esophagus, thoracic duct and muscles, the anterior mein. Um So this is probably the smallest uh area of the thorax and its main contents is the thymus gland, which you can see this is a cross section at the side. Um It does usually shrink as you get older. Um the branches of the internal thoracic vessels and also the sterno sternopericardial ligaments and the l like loose connective tissue. So that's everything that's in front of the heart, but behind the rib cage and sternum. So the middle media spinum, you've got the main content is the heart and pericardium and then behind the heart and pericardium, you've got the tracheal bifurcation and the left and right, main bronchi. Um There's the vessels as well. So it's the origin of all the great vessels as obviously your heart is in the middle. Um So you've got the ascending aorta pulmonary trunk SBC IVC, um your nerves, you've got the cardiac plexus, the, and the phrenic nerves, the left and right and then the lymphatics, which, which are the tracheobronchial lymph nodes. Um and these are important um for clinical relevance and when you find abnormalities with them. So, just have a think um what conditions, what certain lung pathologies might have, um enlarged lymph nodes just, just have a think what might cause it. So the posterior media um is right at the back. Um So it's the, and the posterior thoracic wall. So you've got your rib cage at the back and your vertebrae and then in front of that, you've got your thoracic aorta and its branches, the esophagus, the thoracic duct system and your sympathetic trunks. Also, if you have any questions at all throughout the session, please just put your messages in the chart. OK. So, moving on um sinum, we're gonna look at the anatomy of um the airways and the lungs itself. So it's kind of split into the upper and lower airways. So your upper airways, you've got your nasal cavity, your nasopharynx, oropharynx, larynx. So that'll be mostly at the top here. And then your lower airway is from the trichia downwards. So the trachea, the bronchi bronchioles alveoli and then right at the bottom, you've got the diaphragm, which is not really the airway, but it, it makes up part of the anatomy. So the trichia, uh she's uh c shaped carcinogen rings arising at the lower border of the cricoid cartilage and it bifurcates at the sternal angle. So, and why is this relevant? Why like why you know, why do we care about what way the um bronchia placed or anything like this? Because the right main bronchi uh bronchus is shorter, wider and more straight. So often when Children inhale foreign bodies, the foreign body will sit in the right main bronchus. So it's important as that's where you should, you should look first if you, if you ever have to go in to try and remove the foreign body. Um As that's where it's most likely going to sit, obviously, there's exceptions to everything. Um but that's the most likely place. So going further down now to the bronchial tree. So you've got the, the main bronchus, the lobar, bronchi, segmental, bronchi, tonal bronchioles and then the alveoli and each of the lung and its bronchus are s they're in segments. So, on the right, you've got the three lobes and 10 segments and on the left, you've got the two lobes and 10 segments. So there's still 10 segments on both sides. Um And there's some, like there's some variation of diagrams as some segments are kind of squished together a little bit on the left. Um And I'm not sure if you need to know this for your exams or not. I mean, it might be helpful later down your career, but these are the different um these are the names of the each segment. So you can remember the right ones that a palm makes another list. So the apical posterior, anterior, lateral, medial, superior, medial, anterior, lateral, posterior. So uh basically as you just go down, it's apical posterior, anterior or lateral needle. Um and then on the left, um you can remember as a alps. Um So you can read it there as the poster which can be split in two, the anterior superior lingua lingular, the inferior lingular, superior or apical, the anterior medial, which can also be split into two and then the lateral and posterior. So you can kinda see on the diagram how it all uh