CH.3 Respiratory System Flashcards
1
Q
Pectoral Muscle, Breast tissue shadows and Nipple shadow are all part of _____ of the chest.
A
Soft Tissue
2
Q
Ribs, Sternum, and T-spine are all____ of the chest.
A
Bony Structures
3
Q
This contains all the thoracic organs (heart, thyroid and thymus glands, and lymphatic tissue) except the lungs.
A
Mediastinum
4
Q
What are the 3 sections of the mediastinum?
A
Anterior, Middle, Posterior
5
Q
Anterior Mediastinal Masses arise from?
A
Thyroid and Thymus gland, and lymphatic tissue
6
Q
Middle mediastinal masses arise from what?
A
Lymphatic Tissue
7
Q
Posterior mediastinal masses arise from?
A
Nervous and Bony Tissues
8
Q
This occurs when there has been a disruption in the esophagus or airway and air is trapped in the mediastinum.
A
Mediastinal Emphysema
9
Q
What is another name for mediastinal emphysema and what can cause this?
A
Pneumomediastinum
caused by: trauma, endoscopy, violent vomitting
10
Q
Results from extensive pneumomediastinum where air passes from the mediastinum into the subcutaneous tissues of the chest and neck is known as?
A
Subcutaneous Emphysema
Visualized as air bubbles in the skin of the chest or neck
11
Q
How can glandular enlargments of the thyroid be detected on a radiograph?
A
By a displacement or narrowing of the trachea
AKA ectopic thyroid gland
12
Q
This tube is inserted through the patients nose or mouth and the tip is placed above the carina.
A
Endotracheal tube (ET)
13
Q
This tube is inserted into the chest wall between the ribs.
A
Chest Tube
14
Q
A chest tube placed higher up on the ribs is typically for the drainage of what?
A
air from a pneumothorax
15
Q
A chest tube placed lower in the chest wall is typically for what?
A
To drain fluids caused by pleural effusion or hemothorax
16
Q
A chest tube is often placed just below the sternum following what type of surgery?
A
Open Heart Surgery
17
Q
This type of line is insterted via the subclavian vein and ends at the distal superior vena cava just above the right atrium.
A
Central Venous Pressure Lines (CVP)
18
Q
What are central venous pressure lines used for?
A
it measures the central venous pressure, function of the right side of the heart and the fluid status
19
Q
This type of catheter is a multi-lumen catheter instered into the subclavian vein and ends at the pulmonary artery.
A
Pulmonary Artery Catheter (Swanz-Ganz)
20
Q
What does the Pulmonary Artery Catheter measure?
A
It measures the pulmonary wedge pressure which reflects the left atrial pressure.
21
Q
How does the pulmonary Artery Catheter work?
A
Inflation of a balloon at the tip allows the tube to float into a smaller pulmonary vein where the pressure is read.
22
Q
These types of catheters are inserted via subclavian vein and are open to the outside of the body with just the tip in the SCV.
A
Hickman Catheter
23
Q
This type of catheter is inserted via the subclavian vein right under the skin?
A
Port-O-Cath
24
Q
What are the benefits of Port-O-Caths?
A
There is a less chance of infection and require little maintenance.
25
This is a specialized catheter inserted after surgery or percutansously. The pump is syncronized to the pt's cardiac cycle to provide mechanical support of the left ventricle.
Intraaortic Balloon Pump (IABP) Catheter
26
Where are IABP's placed?
Below the subclavian artery and above the renal arteries
27
Another term for ventricle pacing electrode is what?
Pacemaker
28
This type of pacemaker is inserted via anticubital vein and into the right ventricle. It provides electrode pacing for bradycardia and is also used as a precaution for arrythmias after open heart surgery.
Temporary ventricular pacing electrode/ Pacemaker
29
This type of pacemaker is inserted under the skin below the clavicle where electrodes are placed into the right ventricle.
Permanent pacemaker
30
This is a lack of respiratory function/ lack of oxygen to carbon dioxide exchange.
Respiratory Failure
31
What are the 2 levels of respiratory failure?
1. Hypoxia
2. Hypercapnia
32
Describe hypoxia.
Low O2 levels within the arterial blood.
Caused by: toxic gas, smoke inhalation, high altitudes, hypoventilation, impaired diffusion
33
Describe Hypercapnia.
The inability to move air into and out of the lungs
34
Patients with respiratory failure typically exhibit what signs?
tachypnea, tachycardia, irregular/gasping, paradoxic abdominal motion
35
What is used to detect repsiratory failure?
Arterial blood gas measurements
36
This is the most common genetic defect of white children affecting the function of the exocrine glands.
Cystic Fibrosis
37
How is pulmonary damage initiated in patients with cystic fibrosis?
By gradually increasing secretions from hypertrophy of bronchial glands leading to obstruction of the bronchial system.
38
What are the signs and symptoms of cystic fibrosis?
chronic cough, wheezing, chronic/ recurrent pulmonart infections.
39
What is seen on an xray of a pt with cystic fibrosis?
Increased lung volume, air trapping, irregular aeration with cystic and nodular densities.
40
Respiratory distress syndrome is also known as what?
Hyaline Membrane Disease
41
What is Hyaline Membrane Disease?
incomplete maturation of the surfactant producing system of the lungs in infants born at less than 37 weeks gestation which causes unstable alveoli.
42
What are signs and symptoms of respiratory distress syndrome?
rapid and labored breathing, atelactasis and respiratory failure
43
What appears radiographically on an image of a pt with hyaline membrane disease (RDS)?
Severe atelectasis, bronchi surrounded by non aerated alveoli, "ground glass" lung appearance
44
This is the most frequent type of lung infection causeing inflammation of the lung and compromised pulmonary function. It is the 6th leading cause of death in the U.S
Pneumonia
45
What are the main causes of Pneumonia?
- Bacteria
- Viruses
- Mycoplasmas
46
Inflammation caused by pneumonia can affect which areas of the lungs?
- Entire Lobe
- Segments of Lungs
- Bronchi and Alveoli
- Interstitial Lung Tissue
47
This is the most common form of bacterial pneumonia since the bacteria is usually present in healthy throats. The bacteria works its way into the lungs and inflames alveoli of an entire lobe of lung.
Pneumococcal (Lobar) Pneumonia
48
What are the signs and symptoms of Pneumococcal Pneumonia? What is often preceded by this?
chills, cough, fever, often preceded by an upper respiratory infection
49
What does a radiograph of lobar pneumonia typically look like?
collections of fluid in one ormore lobes. the lateral chest shows the degree od segmental involvement.
50
This type of pneumonia occurs sporadically except during epidemics of infulenza when secondary infections with staphylicocci is common.
Staphylococcal Pneumonia
51
What does staphylococcol pneumonia look like on a radiograph?
patchy areas in or around the bronchi with pneumatoceles as a characteristic lesion.
52
What is a pneumatocele?
Thin walled, air-filled cyst
53
This is the rarest form of pneumonia. 1% of all hospital admissions are from this type of inflammation.
Streptococcal Pneumonia
54
Strepococcal pneumonia looks like what on a radiograph?
Localized around bronchi usually lower lobes
55
This type of pneumonia outbreaks in large buildings such as hotels due to a bacteria L. pneumophila that thrives in warm moist places and is transmitted through heat-cooling systems.
Legionnaires Disease
56
What are signs and symptoms of Legionnaires Disease?
- Mailaise
- Muscular Aches
- Chest Pain
- Non productive cough
- Vomitting and Diarrhea
57
This type of pneumonia is common is older children and young adults and is caused by mycoplasmas that have both virus and bacterial characteristics.
Mycoplasma Pneumonia
58
What does mycoplasmic pneumonia look like radiographically?
It can mimic TB, and appear as fine reticular pattern
59
Pneumonia caused by acid vomitus aspirated into the lower respiratory tract following anesthesia, alchohol intoxication, and stroke therefore causing a loss of cough reflex is known as which type of pneumonia?
Aspiration (Chemical) Pneumonia
60
What does Aspiration Pneumonia look like radiographically?
Shows edema produced by irritaion of air passages as well as densities in one or both hila.
61
Pneumonia caused by various viruses most commonly influenza A and B and is spread by infected individuals to a non-immune individual with minimal findings radiographically.
Viral (Interstitial) Pneumonia
62
What are some complications associated with viral pneumonia?
secondary bacterial infections termed superinfections that are brought on by the inflammatory response to the virus
63
This is a permanent abnormal dialation of 1 or more large bronchi as a result of destruction of the elastic and muscular compnents of the bronchial wall.
Bronchiectasis
64
What does Bronchiectasis look like radiographically?
- There are increased bronchovascular markings and // lines outlining dilated bronchi
- Sometimes looks like honeycombing
65
What is the best modality in detecting Bronchiectasis?
CT
66
This is an infection caused by inhalation of myobacterium tuberculosis.
Pulmonary Tuberculosis (TB)
67
TB generally affects the lungs but what other systems can it affect?
- Genitourninary
- Skeletal
- Central Nervous System
68
How is TB detected if it is asymptomatic 90-95% of the time?
Via skin test
69
What does pulmonary tuberculosis look like radiograhically?
Nodules/Lesions will appear in the apices of the lungs.
70
Which projection is best to identify TB in the lungs?
Apical Lordodic
71
This only occurs when the bloodstream picks up TB and large numbers of bacteria are carried throughout the body.
Miliary Tuberculosis
72
What precautions should be taken with patients diagnosed with TB?
They should be in respiratory isolation since the disease is spread through sputnum and airborne droplets expelled upon coughing.
73
What does COPD stand for?
Chronic Obstructive Pulmonary Disease
74
This is a group of disorders causing chronic airway obstruction with the most common forms being bronchitis and emphysema. it is an irreversible disease causing limited airflow and decreased elastic recoil of the alveoli.
Chronic Obstructive Pulmonary Disease
75
What has happened with the mortality rate in the last 20 years for patients with COPD?
It has increased. COPD is the 5th most common cause of death in the U.S
76
This is irritation of the mucous lining of the bronchial tree and increases in suseptibility to both viral and bacterial infections.
Chronic Bronchitis
77
Chronic Bronchitis can lead to what 3 things in the lungs?
1. Hyperplasia of the mucous glands
2. Hypertrophy of the smooth muscle
3. Thickening of brochial walls
78
What are common symptoms associated with Chronic Bronchitis??
- Persistant cough
- Expectoration
- Arterial Hypoxia
- Wheezing
- SOB
79
What are the results of Chronic Bronhcitis?
Develops over months-years and results in brochial obstruction from excess mucous secretions.
80
What does Chronic Bronchitis look like radiographically?
The lungs are chronically inflated because more air is inhaled than exhaled.
81
This is a condition in which the lungs alveoli become disteneded with an increase in the sir spaes distal to the terminal broncioles with destruction to the alveolar walls.
Emphysema
82
What is a common symptom of Emphysema?
Dyspnea
83
What does Emphysema look like radiographically?
- Hyperinflated lungs
- AP diameter of chest is increased
- Depressed/flattened diaphragm
- Increased retrosternal sir space.
84
This is a category of occupational diseases in which inhalation of foreign inorganic dust from particular work environments result in pulmonary fibrosis.
Pneumoconosis
85
Another name for Pneumoconiosis is?
Occupational Lung Disease
86
The type of Pneumoconiosis depends on what 3 things?
1. physical and chemical property of dust
2. Dose of agent
3. Site of deposition within bronchial tree
87
What are the 3 Primary types of Pneumoconiosis?
1. Silicosis
2. Anthracosis
3. Asbestosis
88
This pneumoconiosis is an inhalation of silica dust common among miners, grinders, and sandblasters. It is the most widespread and serious pneumoconiosis following 10-30yrs exposure.
Silicosis
89
What does Silicosis look like on an x-ray?
Mutiple rounded opaque nodules in lngs from the creation of fibrous tissues aka "eggshell calcifications" pg80
90
This type of pneumoconiosis is inhalation of coal dust over 20 yrs where coal dust deposits in the lungs and develops around bronchioles causing dilation.
Anthracosis
91
What is another name for Anthracosis?
Black Lung Disease
92
True/False: Anthracosis does not affect alveoli or airflow or impair lung function drastically.
True.
93
This type of pneumoconiosis is inhalation of asbestos dust causing chronic injury to the lungs with pleural thickening.
Asbestosis
94
What does Asbestosis look like radiographically?
- Sm. irregular or linear opacities in lower lungs
- Diaphragmatic pleural calcifications.
95
Asbestosis can develop into what 15 years after high exposure takes place?
Mesothelioma
96
These are a severe fungal infection entering a compromised host.
Opportunistic Fungi
97
Who is more likely to contract fungi?
Those in therapy with corticosteroids or immunosuppresents as well as-
- AIDS
- Diabetes
- Bronchitis
- Emphysema
- TB
- Lymphona
- Leukemia
- Serious Burns
98
This is a fungal infection of the lungs.
Pulmonary Mycosis
99
What are the 2 types of pulmonary mycosis?
- Histoplasmosis
- Coccidioidomycosis
100
This type of pulmonary mycosis is endemic to the Ohio and Mississippi River valleys and most cases are classified as acute and are so mild they go undiagnosed. It is fueld by the fungus of bird or bat excreta causing single or multiple pulmonary infiltrates called "popcorn effect".
Histoplasmosis
101
What are some symptoms of Histoplasmosis and how is it treated?
- Fever, cough, and general malaise
- Treated with antibiotics and antifungals
102
The "popcorn effect" of healed histoplasmosis can show what on a radiographic image?
calcified granulomas
103
This type of Pulmonary Mycosis in common in the southwest US and northern Mexico, where infective spores in the soil become airborne from winds, digging, and other disruptions. Agriculture and construction worlers are particularly at risk.
Coccidioidomycosis
104
How do most coccidioidmycosis infections present?
mild, self limited and my go unrecognized much like histoplasmosas
105
What does coccidioidomycosis look like radiographically?
- Small areas of pulmonary consolidation
- Lesions that can simulate malignacies and need biopsied
- Can resemble TB
106
What is the typical treatment for patients with coccidioidomycosis?
- Bed rest
- Progressive forms can lead to menigitis if not treated
107
What is another name for Coccidioidmycosis?
Valley Fever
108
This is a localized area of dead pulmonary paryenchyma surrounded by inflammatory debris containing puslike material.
Lung Abscess
109
A lung abcsess in more likely to occur in the right lung, Why?
Becuase of the verticle orientation of the rt. main bronchus.
110
What are some common symptoms of a lung abscess?
- Fever
- Cough
- Expectorant of pus
- Foul sputum
111
What will an x-ray of a lung abscess appear like?
- Lobar and segmental consolidations becoming globular in shape as pus accumulates.
- Poor peripheral lung definition, caverness type of effect.
112
What is pus within the pleural cavity called?
Empyemas
113
What is the most common cause of lung abscesses?
Aspiration
114
This is inflammation of the pleura.
Pleurisy
115
Pleurisy can be indicative of what pathologies?
- Pneumonia
- TB
- Malignant Disease
116
Where is pain most often associated in pleurisy?
Along the intercoastal nerve roots
117
What will an x-ray of pleurisy show?
Mostly pleural fluid associated with pleurisy
118
This is excess fluid collected in the pleural cavity usually pulmonary or cardiac in origin and is a sign of underlying condtions.
Pleural Effusion
119
These are a type of pleural effusion involving fluid filtered from the circulatory system from inflammation, pleurisy, pulmonary emboli, and neoplasms.
Exudates
120
This type of pleural effusion involves extravascular fluid with low proteins and low specific gravity and result from microvascular changes, heart failure, ascites.
Transudates
121
This type of effusion contains blood.
Hemothorax
122
What appears on an x-ray of a patient with a pleural effusion?
-Blunting of the costaphrenic angles
123
What procedure is typically performed for a pleural effusion?
Thorocentesis- removal of chest fluid
124
This is a lung cancer that is typically benign but considered a cancer because they can metastasize to the lymph nodes.
Bronchial Carcinoid
125
What does an xray image look like of a patient with bronchial carcinoids?
- Bronchial narrowing/obstruction
- collapse of affected segment of lung
126
This is the most common fatal primary malignancy in the U.S. It arises in major bronchi near the hilar region and metastasizes to lymph nodes, bloodstream, or both.
Bronchogenic Carcinoma
127
What are the 4 histologic types of Bronchogenic Carcinoma?
1. Squamous cell
2. Undifferentiated small cell (oat)
3. Undifferentiated large cell
4. Adenocarcinoma
128
What appears on an xray of a patient with Bronchogenic Carcinoma?
- airway obstruction due to unilater hilar mass (coin lesion)
- mass must be larger than 6mm to see on a CXR
129
What are some secondary effects of Bronchogenic Carcinoma?
- Occluded bronchitis
- Atelectasis
- Pneumonitis
130
