4a. Thorax Radiology - Congenital Pathologies Flashcards
what is the normal path of blood through the heart and what are the relative pressures in the left and right halves of the heart
IVC and SVC drain into right atrium and through tricuspid valves
right atrium to ventricle and pulmonary valve into pulmonary artery into lungs
lungs to pulmonary arteries through mitral valve and to left atrium
pressure in left heart is higher than right heart
what is atrial septal defect/patent foramen ovale in terms of anatomy
communication/hole between right atrium and left atrium
what happens in atrial septal defect/patent foramen ovale
in terms of abnormal blood flow in heart
pressure in left is higher than right side so blood goes from left atrium into right atrium - path of least resistance - into right ventricle and into lungs back into right atrium and some goes back to right ventricle of heart
blood flow to lungs higher than blood flow to body and body is starved of blood and lungs get too much plod volume per beat
what does atrial septal defect case
x 3 things
right side heart failure
pulmonary hypertension
risk of stroke
why does atrial septal defect cause right sided heart failure
high volume of blood going into right side
why does atrial septal defect cause pulmonary hypertension
lungs arent meant to have lots of blood through them so they increase resistance to try stop as much blood entering them (path of least resistance principle)
why does atrial septal defect increase risk of stroke
communication between right and left heart so thrombosis could go into systemic circulation or lung causing stroke
what is ventricular septal defect in terms of anatomy
hole in septum between right and left ventricle
what is ventricular septal defect in terms of physiology
high pressure in left ventricle and less resistance going into right side than into aorta so blood goes into right heart rather than aorta from left ventricle
what does ventricular septal defect cause x 4 things
heart failure
pulmonary hypertension
valve disease
rhythm disorders
why does ventricular septal defect cause valve disease
associated with mitral and tricuspid valve
what is coarctation of aorta
in terms of anatomy and physiology
ascending aorta goes up and beyond that where branches are there is a tight stenosis so blood on ascending side have higher pressure than descending side
what does coarctation do to the pressure in body upper and lower
increases pressure to brain and arms
lower pressure going into legs
what does coarctation of the aorta cause x 4 things
hypertension
aneurism
risk of stroke
heart failure
why does coarctation of aorta cause hypertension
blood going to kidney - kidney regulates pressure - is low pressure so kidney sends signal to increase pressure
why does coarctation of aorta cause heart failure
heart does more work to get blood into descending aorta
how do you fix coarctation of the aorta
catheter into aorta and pass it up
wire across narrowing and blow up balloon in the narrowing and put stent over balloon
what is the ductus arteriosus and what does it do
its the communication between the pulmonary artery and aorta as there is no point in blood going to lungs as they are not oxygenated so mostly blood bypasses lungs and go straight into aorta
this is because resistance in lungs is very high so blood goes where resistance is lowest which is where aorta is
what happens to the ductus arteriosus after youre born
it closes down and normal adult configuration from right ventricle to pulmonary artery and doesnt go into aorta
what happens if the ductus arteriosus is left open after birth
blood from aorta can go back into pulmonary artery as pressure is pulmonary is lower than pressure in aorta and gets increased blood flow through lungs
what are the 3 things that patent ductus arteriosus cause
pulmonary hypertension
endocarditis
heart failure
what is bicuspid aortic valve
instead of 3 valve leaflets for the bicuspid valve there are 2 leaflets
what is cystic fibrosis
autosomal recessive disease where mucus in lungs is sticky and cant be coughed up so stays in lungs and cant clear bacteria and dust from lungs
bacteria stay in lungs and fester destroying lungs and there is pus in lungs
how do you treat cystic fibrosis
gene therapy, antibiotics, lung transplant
what is seen in CT for cystic fibrosis
fluid in CT lungs as stagnant pus that patient cant cough up
what is alpha antitrypsin deficiency
alpha antitrypsin in lungs stops lungs from autoingesting itself so deficiency means you destroy your own lungs
what does alpha antitrypsin deficiency look like on images
not very many lung markings on dead lung
what do you do with alpha antitrypsin deficiency
remove dead lung so rest of lungs can work better and can plan surgery with CT images
what is oesophageal atresia
can be partial, complete or blocked sometimes communicates with bronchus
blocked oesophagus
what does oesophageal atresia look like in a in utero US image
sagittal view of baby shows no bright amniotic fluid in babys gut as it cant swallow fluid
what is achalasia of the oesophagus
blockage of oesophagus
distal end of oesophagus there is spasms prevents content of oesophagus from going into stomach
what does achalasia of the oesophagus look like on CT images
dilated sac of oesophagus is full of old food unable to pass gastro-oesophageal junction
why is achalasia of the oesophagus associated with pneumonia
when patient goes to sleep the content of oesophagus gets aspirated into lungs while asleep
what is a broncho-pleural fistula
communication between pleural space and bronchi/lungs - usually pneumothorax
what will you see on a CT image for a broncho-pleural fistula
pneumothorax
what is a tracheo-esophageal fistula
communication between airways and oesophagus
what is tracheo-esophageal fistula often caused by
bronchial carcinoma or cancer
what is diaphragmatic hernia
heart pushed into right side of chest and chest has loops of bowels dur to hole in diaphragm
what is hiatus hernia
abnormality of oesophagus where fundus of stomach slides through oesophageal hiatus into chest
stomach pulled through chest
what does hiatus hernia look like on xray and CT
fluid levels behind heart on erect xray film
fiscus too wide to be oesophagus and fluid levels
is artial septal defect/patent foramen ovale a congenital disease in infants or adults
infancy
is ventricular septal defect/patent foramen ovale a congenital disease in infants or adults
infancy
is coarctation a congenital disease in infants or adults
infancy
is patent ductus arteriosus a congenital disease in infants or adults
infancy
is bicuspid valves a congenital disease in infants or adults
adults
is cystic fibrosis a congenital disease in infants or adults
infancy
is alpha 1 antitrypsin deficiency a congenital disease in infants or adults
adults
is atresia/hypoplasia a congenital disease in infants or adults
infancy
is achalasia a congenital disease in infants or adults
adults
is fistulas (broncho-pleura) a congenital disease in infants or adults
adults
is fistulas (tracheo-oesophageal) a congenital disease in infants or adults
adults
are hernias (diaphragmatic) a congenital disease in infants or adults
adults
are hernias (hiatus hernia) a congenital disease in infants or adults
adults
