07 - mediastinal and pleural

Question 1

(mediastinal shift of the cardiac silhouette)

1-2. what two causes?

Answer 1

1. volume loss of lung (atelectasis): heart shifts towards affected side
2. vol increase cause by intrathoaracic or pulmonary mass -> heart shifts away from affected side

Question 2

(mediatstinal masses)

1. most common cause?

Answer 2

1. lymph node enlargement (2° to lymphoma, neoplasia, fungal dz)

Question 3

Question 4

(pleural effusion)

1-3. what three main things are seen?

4. possible fluids?
5. what are 5 causes?

Answer 4

1. ^ thoracic opacity
2. pleural fissure lines between lung lobes
3. separation of lung from thoracic wall with fluid opacity in the pleural space
4. transudates, modified-transudates, exudates
5. right sided heart failure, chylous effusion, pyothorax, hemorrhage, neoplastic effusion

Question 5

(pneumothorax)

1. air in the pleural space -> results in what?
2. if lung lobes collapsed what is this called?

Answer 5

1. separation of lungs from thoracic wall, heart dorsally elevated
2. tension pneumothorax (emergency!!!)

Question 6

(thoracic wall)

1. masses may be neoplastic or infectious, hemorrhage secondary to trauma is generally more diffuse
2. rib fractures commonly overlooked