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302 MEDIMAGE > 4a. Thorax Radiology - Congenital Pathologies > Flashcards

4a. Thorax Radiology - Congenital Pathologies Flashcards

1
Q

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

A

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

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2
Q

what is atrial septal defect/patent foramen ovale in terms of anatomy

A

communication/hole between right atrium and left atrium

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3
Q

what happens in atrial septal defect/patent foramen ovale

in terms of abnormal blood flow in heart

A

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

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4
Q

what does atrial septal defect case

x 3 things

A

right side heart failure
pulmonary hypertension
risk of stroke

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5
Q

why does atrial septal defect cause right sided heart failure

A

high volume of blood going into right side

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6
Q

why does atrial septal defect cause pulmonary hypertension

A

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)

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7
Q

why does atrial septal defect increase risk of stroke

A

communication between right and left heart so thrombosis could go into systemic circulation or lung causing stroke

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8
Q

what is ventricular septal defect in terms of anatomy

A

hole in septum between right and left ventricle

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9
Q

what is ventricular septal defect in terms of physiology

A

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

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10
Q

what does ventricular septal defect cause x 4 things

A

heart failure
pulmonary hypertension
valve disease
rhythm disorders

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11
Q

why does ventricular septal defect cause valve disease

A

associated with mitral and tricuspid valve

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12
Q

what is coarctation of aorta

in terms of anatomy and physiology

A

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

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13
Q

what does coarctation do to the pressure in body upper and lower

A

increases pressure to brain and arms

lower pressure going into legs

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14
Q

what does coarctation of the aorta cause x 4 things

A

hypertension
aneurism
risk of stroke
heart failure

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15
Q

why does coarctation of aorta cause hypertension

A

blood going to kidney - kidney regulates pressure - is low pressure so kidney sends signal to increase pressure

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16
Q

why does coarctation of aorta cause heart failure

A

heart does more work to get blood into descending aorta

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17
Q

how do you fix coarctation of the aorta

A

catheter into aorta and pass it up

wire across narrowing and blow up balloon in the narrowing and put stent over balloon

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18
Q

what is the ductus arteriosus and what does it do

A

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

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19
Q

what happens to the ductus arteriosus after youre born

A

it closes down and normal adult configuration from right ventricle to pulmonary artery and doesnt go into aorta

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20
Q

what happens if the ductus arteriosus is left open after birth

A

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

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21
Q

what are the 3 things that patent ductus arteriosus cause

A

pulmonary hypertension
endocarditis
heart failure

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22
Q

what is bicuspid aortic valve

A

instead of 3 valve leaflets for the bicuspid valve there are 2 leaflets

23
Q

what is cystic fibrosis

A

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

24
Q

how do you treat cystic fibrosis

A

gene therapy, antibiotics, lung transplant

25
Q

what is seen in CT for cystic fibrosis

A

fluid in CT lungs as stagnant pus that patient cant cough up

26
Q

what is alpha antitrypsin deficiency

A

alpha antitrypsin in lungs stops lungs from autoingesting itself so deficiency means you destroy your own lungs

27
Q

what does alpha antitrypsin deficiency look like on images

A

not very many lung markings on dead lung

28
Q

what do you do with alpha antitrypsin deficiency

A

remove dead lung so rest of lungs can work better and can plan surgery with CT images

29
Q

what is oesophageal atresia

A

can be partial, complete or blocked sometimes communicates with bronchus

blocked oesophagus

30
Q

what does oesophageal atresia look like in a in utero US image

A

sagittal view of baby shows no bright amniotic fluid in babys gut as it cant swallow fluid

31
Q

what is achalasia of the oesophagus

A

blockage of oesophagus

distal end of oesophagus there is spasms prevents content of oesophagus from going into stomach

32
Q

what does achalasia of the oesophagus look like on CT images

A

dilated sac of oesophagus is full of old food unable to pass gastro-oesophageal junction

33
Q

why is achalasia of the oesophagus associated with pneumonia

A

when patient goes to sleep the content of oesophagus gets aspirated into lungs while asleep

34
Q

what is a broncho-pleural fistula

A

communication between pleural space and bronchi/lungs - usually pneumothorax

35
Q

what will you see on a CT image for a broncho-pleural fistula

A

pneumothorax

36
Q

what is a tracheo-esophageal fistula

A

communication between airways and oesophagus

37
Q

what is tracheo-esophageal fistula often caused by

A

bronchial carcinoma or cancer

38
Q

what is diaphragmatic hernia

A

heart pushed into right side of chest and chest has loops of bowels dur to hole in diaphragm

39
Q

what is hiatus hernia

A

abnormality of oesophagus where fundus of stomach slides through oesophageal hiatus into chest

stomach pulled through chest

40
Q

what does hiatus hernia look like on xray and CT

A

fluid levels behind heart on erect xray film

fiscus too wide to be oesophagus and fluid levels

41
Q

is artial septal defect/patent foramen ovale a congenital disease in infants or adults

A

infancy

42
Q

is ventricular septal defect/patent foramen ovale a congenital disease in infants or adults

A

infancy

43
Q

is coarctation a congenital disease in infants or adults

A

infancy

44
Q

is patent ductus arteriosus a congenital disease in infants or adults

A

infancy

45
Q

is bicuspid valves a congenital disease in infants or adults

A

adults

46
Q

is cystic fibrosis a congenital disease in infants or adults

A

infancy

47
Q

is alpha 1 antitrypsin deficiency a congenital disease in infants or adults

A

adults

48
Q

is atresia/hypoplasia a congenital disease in infants or adults

A

infancy

49
Q

is achalasia a congenital disease in infants or adults

A

adults

50
Q

is fistulas (broncho-pleura) a congenital disease in infants or adults

A

adults

51
Q

is fistulas (tracheo-oesophageal) a congenital disease in infants or adults

A

adults

52
Q

are hernias (diaphragmatic) a congenital disease in infants or adults

A

adults

53
Q

are hernias (hiatus hernia) a congenital disease in infants or adults

A

adults

302 MEDIMAGE (20 decks)

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