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ICA > Air space disease > Flashcards

Air space disease Flashcards

1
Q

The lingular section of the left lung is homologue to what ?

A

the right middle lobe

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2
Q

what is the azygous fissure/ lobe?

A

it is created by downward migration of the azygous vein. as it migrates, it takes a portion of the parietal/ visceral pleura of the upper right lobe. this separates a fraction of the lung into a new lobe

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3
Q

What is another name for the anterior mediastinum?

A

cardiac

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4
Q

What is another name for the middle mediastinum?

A

the vascular & lymphadenopathy of the hilar area

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5
Q

What is another name for the posterior mediastinum?

A

neurogenic

neurofibromas

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6
Q

What are the 2 patterns of disease seen in the lung & what are examples of each?

A
  1. interstitial space disease: AS or RA

2. air space disease: MC pneumonia

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7
Q

Where is the primary lobule located and what is its purpose?

A

Aka: acinus
located distal to the respiratory bronchiole
it is the functional unit of respiration

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8
Q

Where is the secondary lobule located and what is it comprised of ?

A

located distal to the terminal bronchile

comprised of 4-5 primary lobules, 1-2 cm

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9
Q

How do alveoli communicate?

A

with each other via Pores of Kohn

with distal bronchioles via Canals of Lambert

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10
Q

What is interstitium and what are the 3 spaces of it?

A

it is the connective tissue support network within the lung

  1. axial
  2. parenchymal
  3. peripheral
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11
Q

Where is the axial space of the interstitium?

A

surrounds the primary bronchi and pulmonary artery

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12
Q

Where is the parenchymal space of the interstitium?

A

surrounds the alveoli

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13
Q

Where is the peripheral space of the interstitum?

A

between visceral pleura and lung parenchyma

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14
Q

What is the pattern of interstitial lung disease seen on film?

A

“toothpick” pattern

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15
Q

What is the pattern of alveolar/ airspace lung disease seen on film?

A

“cloud-like” pattern

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16
Q

What causes the “cloud-like” pattern of alveolar lung disease?

A

normal radiolucent lung tissue becomes white/ radiopaque if air within acini is replaced by BEPT; this leads to consolidation which leads to loss of air in alveolar space without loss in lung volume

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17
Q

What type of epithelial cells most commonly line the alveoli?

A

90% are type I squamous pneumocytes that lack the ability of mitosis

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18
Q

What is pnemocystic carinii?

A

a mix of airspace and interstitial
MC infx in HIV+
caused by P. jiroveci fungus

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19
Q

What is the “Silhouette” sign?

A

it is a loss of radiodense border secondary to a radiodense pathology positioned continuous with normal structure

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20
Q

How is the “Silhouette” sign helpful in dx chest pathology?

A

allows the observer to determine the location or presence of abnormality in relation to normal structure

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21
Q

What does a negative Silhouette sign with a dx of pneumonia indicate?

A

that the cardiac tissues are not touching the pathology. the pathology is either in front or in back of the heart

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22
Q

What does a positive Silhouette sign with a dx of pneumonia indicate?

A

the heart shadow is not seen, this indicates that the pathology is touching the heart

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23
Q

If the right heart border is obliterated on film, where is the pathology?

A

Right middle lobe

24
Q

If the left heart border is obliterated on film, where is the pathology

A

Lingular section of upper lobe

25
Q

If the right hemidiphragm is obliterated on film, where is the pathology

A

lower RIGHT lobe

26
Q

If the left hemidiphragm is obliterated on film, where is the pathology

A

lower LEFT lobe

27
Q

If the ascending aorta is obscured, where is the pathology?

A

Right UPPER lobe

28
Q

If the aortic arch is obscured, where is the pathology?

A

LEFT upper lobe

29
Q

What is the “air bronchogram” sign?

A

air filled bronchi normally not seen because they are surrounded by air filled lung
they appear as radiolucent tubular densities if the lung is filled with water

30
Q

What is atelectasis?

A

incomplete air filling and under expansion of the lung. suggests presence of another disease

31
Q

What are the radiographic findings of atelectasis?

A
  • direct findings = displaced fissures, increased radiodensity
  • indirect findings = elevated diaphragm
32
Q

What are the 5 types of atelectasis?

A
  1. obstructive/ resorption
  2. compressive (extrapulmonary)
  3. passive (intrapulmonary)
  4. contraction/ cicatrization
  5. newborn
33
Q

What is the cause of obstructive atelectasis?

A

airway obstruction

this is the MC type

34
Q

What is the cause of compressive atelectasis

A

pulmonary mass/ SOL inside the lung

35
Q

What is the cause of passive atelectasis

A

pleural mass (pneumothorax)/ SOL external to the lung

36
Q

What is the cause of contraction/ cicatrization atelectasis

A

scarring & contracture of pulmonary tissue after infection, scleroderma, radiation, etc

37
Q

What is an acceptable diaphragm displacement difference measurement side to side?

A

2 cm

38
Q

What are the radiographic findings of atelectasis?

A

superior migration of right minor fissure and increased radiodensity of collapsed right upper lobe

39
Q

What is the Reverse “S” configuration / “S” sign of Golden?

A

collapse of right upper lobe leads to superior migration of horizontal fissure which then bulges inferiorly near hilar mass

40
Q

What are the radiographic findings of Atelecstasis of the right upper lobe?

A

high RT hemidiphragm, elevated horizontal fissure, reverse “S” configuration

41
Q

What is Bronchial Asthma?

A

widespread, REVERSIBLE, episodic narrowing of airways

42
Q

What are the 2 types of Bronchial Asthma and their causes?

A
  1. Extrinsic: due to environmental exposure

2. Intrinsic: due to immunological response (exercise or infx)

43
Q

What are the radiographic findings of acute Bronchial Asthma?

A

hyperinflation of the lung, increased radiolucency, possible diaphragm depression, barrel chest appearance

44
Q

What are the radiographic findings of chronic Bronchial Asthma?

A

normal or prominent interstitium, possible thick bronchi

45
Q

What are the S/S of Asthma?

A

wheezing, prolonged expiration, dyspnea & cough

46
Q

What is Bronchiectasis & what are the types?

A

chronic, IRREVERSIBLE dilation of bronchi

types based on appearance: cylindrical, varicose & saccular

47
Q

What are the radiographic findings of Bronchiectasis?

A

thick bronchial walls, altered lung volume, honey comb appearance

48
Q

What is a congenital bronchiogenic cyst?

A

anomalous out pouching of the primitive foregut, complete separation from the airway
80% are medialstinal

49
Q

What is a bronchopulmunary sequestration?

A

congenital malformation of the foregut resulting in separation of a portion of the lung from the bronchial tree
appears as a radiodense mass above or below diaphragm

50
Q

Where are extralobular sequestrations located?

intralobular?

A

extralobular: 90% are on the LEFT
intralobular: 60% are on the RIGHT

51
Q

What is emphysema?

A

chronic dilation of the air space distal to the terminal bronchi (secondary lobule)
characterized by acinar wall destruction, large aggregate air spaces

52
Q

How are types of emphysema based and what are they?

A

Based on region:

centriolobular, panacinar, distal acinar, irregular

53
Q

What are the radiographic features of emphysema?

A 
bilaterally flat & slanted, depressed hemidiphragm
thin heart shadow
lung over inflation / increased radiolucency
increased retrosternal space
barrel chest
increased widened intercostal spaces
prominent hilar vasculature
bullae
54
Q

What is the most reliable radiographic feature of emphysema

A

increased retrosternal space

55
Q

What is bullous emphysema?

A

damage & loss of elasticity of the bronchioles & alveolar sacs, chronic dilation that traps stale air in airspace. rupture of small capillaries causes less efficient circulation & gas exchange

56
Q

What is a characteristic radiographic feature of emphysema?

A

the heart twists and looks more narrow due to diaphragm no supporting it below
only moderate to severe forms are detectable on film

ICA (6 decks)

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