Airways disease and emphysema Flashcards
normal pattern of tracheal branching in pigs, consists of an accessory bronchus to all or a portion of the right upper lobe that arises from the lateral tracheal wall within 2cm of tracheal carina
tracheal bronchus or bronchus suis
tracheal bronchus most often supplies what lung segment
right upper lobe
characterized by atresia of a segmental or subsegmental bronchus with a normal distal airway
bronchial atresia
caused by congenital or acquired abnormalities of the elastic membrane or cartilaginous rings of the trachea
focal tracheal dilatation
aka paratracheal air cysts, which may be congenital or acquired
tracheoceles
tracheoceles occur almost exclusively in the______ trachea because the pressure gradient from the extrathoracic trachea to the atmosphere with the Valsalva maneuver favors their formation in this region
cervical
circular lucencies along the right posterolateral trachea at the thoracic inlet in CT may represent
tracheoceles
most common cause of extrinsic mass effect on the trachea is a
tortuous or dilated aortic arch or brachiocephalic artery
Presents as a typical hourglass deformity of trachea on frontal radiography
Tracheal stenosis
Patients with extrathoracic tracheomalacia, most often at the site of a prior tracheostomy, demonstrate tracheal narrowing on inspiration or expiration?
Inspiration
Patients with intrathoracic tracheomalacia usually from prior endotracheal intubation, have tracheal narrowing on inspiration or expiration?
Expiration
This entity can produce a necrotizing granulomatous inflammation of the tracheal and central bronchi, leading to focal cervical narrowing, or in advanced disease, narrowing of the entire length of trachea. Its diagnosis is made by radiographic demonstration of tracheal narrowing in association with upper airway and renal involvment and characteristic findings on biopsy
Granulomatosis with polyangitis
Endotracheal and endobronchial tb are usually associated with
Cavitary tb
tracheal scleroma is a chronic granulomatous disorder caused by infection with
Klebsiella rhinoscleromatis
5 diffuse tracheal narrowing may be seen with what tracheal conditions
saber-shealth trachea, amyloidosis, tracheobronchopathia, osteochondroplastica, relapsing polychondritis, GPA or tracheal scleroma
can cause diffuse tracheal narrowing but is mostly seen in the cervical trachea
GPA or tracheal scleroma
rare condition in which there is incomplete septation of the cartilage rings, producing a long segment tracheal narrowing or “napkin ring” trachea
congenital tracheal stenosis
congenital tracheal stenosis is often associated with other congenital cardiovascular anomalies in particular,
anomalous origin of left PA from right PA (PA sling)
a fixed deformity of the intrathoracic trachea in which the coronal diameter is diminished to less than 2/3 of the sagittal diameter
saber-sheath trachea
saber sheath trachea commonly affects
older men with COPD
causes mass-like circumferential deposits that irregularly narrow the tracheal lumen seen in CT. It is characterized by deposition of a fibrillar protein polysaccharide complex in various organs
amyloidosis
rare disorder characterized by the presence of multiple submucosal osseous and cartilaginous deposits within the trachea abd central bronchi or elderly men. the lesions arise as enchondromas from the tracheal and bronchial cartilage, and then project internally to produce nodular submucosal deposits that irregularly narrow the tracheal tumen and have a characteristic appearance and feel on bronchoscopy
tracheobronchopathia osteochondroplastica
helpful feature in tracheobronchopathia osteochondroplastica that distinguishes this from tracheobronchial amyloid
calcified plaques that can be seen involving the anterior and lateral walls of trachea, with sparing of membranous posterior walls of the trachea which lacks cartilage
common associated finding in saber-sheath trachea
upper lobe emphysema
systemic autoimmune disorder that commonly affects the cartilage of the earlobes, nose, larynx, tracheobronchial tree, joints and large elastic arteries
relapsing polychondritis
early in the disease, tracheal wall inflammation associated with cartilage destruction leads to an abnormally compliant and dilated trachea. Later in the disease, fibrosis leads to diffuse fixed narrowing of trachal lumen
relapsing polychondritis
diagnosis is made by noting recurrent inflammation at two or more cartilaginous sites, most commonly the pinnae of the ear (producing cauliflower ears) and the bridge of the nose (producing saddle nose deformity)
relapsing polychondritis
congenital disorder of the elastic and smooth muscle components of the tracheal wall
tracheobronchomegaly (Mounier-Kuhn syndrome)
tracheobronchomegaly is associated with
ehler-danlos syndrome
In tracheobronchomegaly, trachea and central bronchi meaures
Greater than 3.0 and 2.5 cm respectively in coronal diameter
Congenital or acquired defect of tracheal cartilage causing softness of tracheal cartilage rings and a tendency for airway collapse
Tracheobronchomalacia
3 Congenital disorders most often associated with tracheobronchomalacia
- Relapsing polychondritis,
- ehler danlos syndrome,
- mucopolysaccharidosis
May result from prolonged intubation, prior tracheostomy and extrinsic tracheal compression by mediastinal masses and vascular anomalies
Tracheobronchomegaly
Excessive airway collapse of trachea on expiration, seen best on dynamic expiratory CT using low dose CT acquisition performed during forced expiratory maneuver are imaging features of
Tracheobronchomegaly
A reduction in the cross-sectional area of the trachea exceeding 50% on the expiratory CT, particularly if there is a crescentic “frown-like” configuration to the trachea in cross section should suggest what diagnosis
Tracheobronchomegaly
“Lunate”-shaped trachea, in which the coronal diameter of the trachea exceeds the sagittal diameter on axial CT obtained at normal inspiration
Tracheobronchomegaly
Tracheal and bronchial fractures generally involve what part of bronchial tree
Proximal main bronchi (80%) or distal trachea (15%) within 2cm from the carina