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Radiology Residency > BSAVA Thorax > Flashcards

BSAVA Thorax Flashcards

1
Q

What kV & mAs settings are best for thorax?

A

High kV, Low mAs (high mA, short exposure time)
- High kV –> low contrast image w/ wide range of grey tones

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2
Q

On which image is the sternal node more easily identified?

A

Right Lateral

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3
Q

What are 4 reasons why a right lateral image preferable over a left if only a single lateral can be obtained?

A

1) Sternal node more easily identified
2) Diaphragm obscures less of caudodorsal lungs
3) Heart in a more consistent position (due to R side cardiac notch)
4) R middle lung lobe superimposed over heart & sternum –> better cardiac detail

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4
Q

What are DV and VD views preferred for, respectively?

A

DV = cardiac related disorders (more standard heart appearance b/c less magnified & caudal vasculature more easily identified)

VD = pulmonary parenchyma

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5
Q

What is an extra pleural sign?

A

Where a lung margin is locally deviated from a mass arising from the chest wall

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6
Q

What disease process may cause septal flattening in a RPS short axis view?

A

Pulmonic stenosis (secondary to increased RV pressure)

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7
Q

MPA diameter should be _____ or ______ than the Ao.

A

Equal to or smaller than
(Increased diameter w/ normal pulmonic valves may suggest PH)

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8
Q

What are two disease processes that cause decrease radionuclide clearance from pulmonary circulation?

A

L to R shunt & L CHF (If bolus too slow, iatrogenic slow pulmonary clearance can also be simulated)

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9
Q

In a R to L shunt, what two structures fill with radionuclide simultaneously?

A

Aorta & pulmonary arteries

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10
Q

What is the embryological origin of the heart?

A

Paired endocardial tubes that arise from splanchnic mesoderm

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11
Q

The L and R main coronary arteries arise from where?

A

Root of the aorta

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12
Q

In terms of L, R, cranial, & caudal where are the LA, LV, RA, & RV located in a dog?

A

LV and LA = L and caudal aspects
RV and RA = R & cranial aspects

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13
Q

At what intercostal space is the carina normally located?

A

4th - 5th

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14
Q

What is the pericardial fat stripe?

A

Fat present between the fibrous pericardium & pericardial mediastinal pleura that may remain visible on a lateral view in patients w/ pleural effusion

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15
Q

T or F, aortic size alters in association w/ hypovolemia or volume overload?

A

False

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16
Q

What are the terminal abdominal tributaries of the CVC?

A

Hepatic veins

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17
Q

Within what structure does the CVC cross the diaphragm?

A

W/in plica vena cava on R side

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18
Q

What vessels unite to form the CrVC?

A

Axillary veins join w/ internal & external jugular veins to form the R & L brachiocephalic veins which then unite to form CrVC

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19
Q

What 3 vessels join the CrVC in the cranial mediastinum before it empties into the RA?

A

Costocervical veins
Internal thoracic veins
Azygous vein

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20
Q

What does the azygous vein form from?

A

1st lumbar veins

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21
Q

What is the location of origin & course of the thoracic duct?

A

Origin = between diaphragmatic crura
Courses cranially along right dorsal Ao border & usually enters CrVC or L jugular vein

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22
Q

Cranial pulmonary arteries and veins are best separated on which lateral projection?

A

Left lateral

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23
Q

Explain concentric versus eccentric cardiac hypertrophy?

A

Concentric hypertrophy results from inc systolic pressure (pressure overload) –> thickened ventricular wall w/ normal or reduced luminal size
Eccentric hypertrophy results from increased diastolic pressure & volume (volume overload) –> normal ventricular wall six w/ inc luminal size

24
Q

Rotation of the cardiac apex caudodorsally away from sternum is a sensitive sign of what?

A

RV enlargement

25
Q

Enlargement of which structures cause ventral and dorsal displacement of the caudal mainstream bronchi, respectively?

A

Ventral = tracheobronchial lymphadenopathy
Dorsal = LAE

26
Q

What are 2 ddx for enlargement of the entire aortic arch?

A

SAS & age-related changes in cats

27
Q

What disease causes enlargement of the descending portion of the aortic arch?

A

PDA

28
Q

What are 3 things that can cause a redundant aorta?

A

Aged related changes in cats
Brachycephalic dogs
Congenital hypothyroidism

29
Q

What are 6 disease processes that can cause calcification/mineralization of the Ao?

A

Primary or secondary hyperparathyroidism
Lymphoma
Spirocera lupi
Hypervitaminosis D
Hyperadrenocorticism
Arteriosclerosis

30
Q

What vascular dissension occurs secondary to segmental aplasia of the CVC?

A

Marked enlargement of the azygous vein

31
Q

What are 4 causes of an enlarged MPA?

A

Pulmonic stenosis (post-stenotic dilation)
Inc circulating volume (PDA, ASD, VSD_
Pulmonary hypertension
Severe HWD or Angiostrongylosis

32
Q

T or F, R CHF is a rare cause of feline pleural effusion?

A

True

33
Q

Screens increase or decrease patient dose? Explain the mechanism.

A

Decrease. Ability to convert few absorbed xray photons into light.

34
Q

What screen is the most efficient type?

A

Rare earth screens

35
Q

The faster the screen has what effect of exposure and detail?

A

Faster exposure, but less detail.

36
Q

What are the 3 effects of high kV that lead to it’s contrast level? And what sort of contrast on the image does it result in?

A

High kV –> low contrast with many grey tones
3 factors that cause low contrast =
1) high amount of undesirable scatter
2) Predominance of Compton effects
3) High penetration of beam energy

37
Q

What are two benefits and one negative of grids?

A

Benefits:
- Decrease scatter
- Improve contrast

Con:
- Increase patient dose (because must use higher exposure factors since some of primary beam absorbed)

38
Q

To better assess for small volumes of pleural effusion or gas, radiographs should be taken at what point during the respiratory cycle?

A

End of expiration

39
Q

What are 2 advantages of a DV projection?

A

1) Cardiac silhouette is less magnified & adopts a more standard appearance
2) Caudal pulmonary arteries & veins better identified due to surrounding gas-filled lung

40
Q

What are 3 scenarios to consider a decubitus/horizontal beam VD/DV?

A

1) Small volume pleural effusion
2) Small volume pneumothorax
3) Skyline view for thoracic wall lesions

41
Q

Film-screen radiographs have better ________ _________ than digital images?

A

Spatial resolution

42
Q

What weight/volume percentage of barium sulphate suspension should be administered for esophageal studies?

A

60%

43
Q

What are 3 cons of barium sulphate suspension in esophageal studies?

A

1) May not distend a dilated esophagus
2) May not show a stricture
3) Does not adhere well to mucosa

44
Q

True or false, barium aspiration will result in permanently altered lung function ?

A

False, but may result in permanent visualization

45
Q

What are 2 rare complications of barium aspiration?

A

Granulomatous pulmonary reactions and aspiration pneumonia

46
Q

If you are suspicious for what 2 disease processes/lesions then barium should NOT be orally administered?

A

Esophageal perforation or bronchoesophageal fistula (may result in mediastinal granuloma & adhesion formation)

47
Q

If you cannot use orally administered barium due to concern for esophageal perforation, then what medium should be used?
What are the potential negative side effects of this contrast media?

A

Non-ionic iodinated contrast

2 possible S/E:
1) Pulmonary edema
2) Death

48
Q

How can you improve visibility of the thoracic inlet on a lateral projection?

A

Move one thoracic limb cranially & the other caudally

49
Q

At what age does the thymus reach its maximal size?

A

4 mos

50
Q

What effect does emaciation have on the opacity of the lung fields?

A

Makes them hyperlucent. (Decrease exposure factors to compensate for this)

51
Q

A sharply marginated cardiac silhouette may be indicative of what disease process?

A

Pericardial effusion. (Normally the margins should be slightly hazy from respiratory motion)

52
Q

Caudal vena cava merges with which crus of the diaphragm?

A

Right crus

53
Q

On which lateral view is it easier to distinguish between cranial pulmonary arteries & veins?

A

Left lateral

54
Q

Which view gives a “3 humped” appearance to the diaphragm?

A

VD

55
Q

Discuss the differences between VD and DV projections for the assessment of pulmonary parenchyma?

A

VD - ventral lung fields better evaluated & accessory lobe better visualized (due to cranial position of the heart)

DV - dorsal lung fields better evaluated & accessory lobe LESS aerated due to cranial position of mid-diaphragm

Radiology Residency (21 decks)

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