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Thrall > Chapter 30 - Mediastinum > Flashcards

Chapter 30 - Mediastinum Flashcards

1
Q

What are the different types of parietal pleural?

A

Parietal: costal, diaphragmatic, mediastinal

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2
Q

What are the different types of parietal pleural?

A

Parietal: costal, diaphragmatic, mediastinal

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3
Q

Describe the pareital and visceral pleura and how it borders the mediastinum?

A

There is a parietal mediastinal layer on the medial aspect of both (right and left) pleural sacs.

Cranially and caudally, there is a reflection of the mediastinum that can be seen radiographically. At this reflection, the parietal reflects onto the surface of the lungs (visceral pleura)

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4
Q

What is the difference between parietal and visceral pleura?

A

Parietal - borders everything outside of the lung.

Visceral - lies on top of the lungs

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5
Q

Where are the mediastinal reflections seen radiographically on the lateral view?

A

Cranioventral - ‘bubble’ present in the cranioventral thorax.
This is due to the right cranial lung pushing across midline twoards the left - pushing the cranial mediastinal reflection towards the left side

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6
Q

Where is the mediastinal reflection seen on the DV/VD view?

A

Cranioventral reflection - separation between right and left. Curvilinear line extending from the cranial aspect of the left heart towards midline. Off of midline due to the right cranial lung.

Caudoventral - extension from the caudolateral aspect of the heart on the left side towards the diaphragm. Displaced off of midline due to the accessory lung lobe.

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7
Q

What structures make up the caudoventral mediastinal reflection?

A

visceral pleura of the accessory lobe
mediastinal parietal pleura of the right pleural sac
mediastinal parietal pleura of the left pleural sac
visceral pleura of the left caudal lobe

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8
Q

How wide should the cranial mediastinum be on the VD view?

A
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9
Q

3 types of mediastinal abnormalities?

A

mediastinal shift
mediastinal mass
pneumomediastinum

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10
Q

Most common cause of mediastinal shift?

A

atelectasis/decreased lung volume

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11
Q

True/false

Pneumomediastinum can progress to a pneumothorax?

A

TRUE

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12
Q

True/false

Pneumothorax can progress to pneumomediastinum?

A

FALSE

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13
Q

What is it called when alveolar rupture leads to dissection of gas into the mediastinal space?

A

Macklin effect

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14
Q

Difference between sternal lymphadenopathy and mediastinal cyst?

A

Sternal lymphadenopathy - more cranially located

Mediastinal cyst - incidental findings

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15
Q

What does the sternal lymph node drain?

A

abdominal structures including peritoneal space, abdominal wall, mammary glands

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16
Q

Differentials for a cranioventral mediastinal mass?

A 
mediastinal lymphadenopathy
sternal lymphadenopathy
thymoma
mediastinal cyst (branchial cyst) 
ectopic thyroid tumor
mediastinal abscess
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17
Q

Differentials for a craniodorsal mass?

A

Esophageal mass/enlargement (vascular ring, myasthenia, foreign body)
Neurogenic tumor
paraspinal tumor

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18
Q

Differentials for a caudodorsal mediastinal mass?

A 
spirocerca lupi
caudal esophageal mass/foreign body
hiatal hernia
tracheobronchial lymphadenopathy
**always take three views to help differentiate between caudodorsal mediastinal mass and a lung mass
19
Q

What do the cranial mediastinal lymph nodes drain?

A

muscles of the neck, thorax and abdomen, the last cervical vertebrae, thoracic vertebrae, ribs, trachea, esophagus, thyroid, thymus, mediastinum, heart and aorta

20
Q

Enlarged tracheobronchial lymph nodes cause ___ displacement of the tracheal carina

A

cranioventral

21
Q

Differentials for a caudoventral mediastinal mass?

A

Something associated with the diaphragm: hernia

22
Q

Dfiferentials for pneumomediastinum?

A

Trauma - bite wound from neck, blunt thoracic trauma with rupture of alveoli and Macklin effect
Iatrogenic - overinflation of ET cuff, PPV
Esophageal or tracheal rupture - trauma, foreign body, inflammation, neoplasia
Infection by gas producing bacteria

23
Q

Describe the pareital and visceral pleura and how it borders the mediastinum?

A

There is a parietal mediastinal layer on the medial aspect of both (right and left) pleural sacs.

Cranially and caudally, there is a reflection of the mediastinum that can be seen radiographically. At this reflection, the parietal reflects onto the surface of the lungs (visceral pleura)

24
Q

What is the difference between parietal and visceral pleura?

A

Parietal - borders everything outside of the lung.

Visceral - lies on top of the lungs

25
Q

Where are the mediastinal reflections seen radiographically on the lateral view?

A

Cranioventral - ‘bubble’ present in the cranioventral thorax.
This is due to the right cranial lung pushing across midline twoards the left - pushing the cranial mediastinal reflection towards the left side

26
Q

Where is the mediastinal reflection seen on the DV/VD view?

A

Cranioventral reflection - separation between right and left. Curvilinear line extending from the cranial aspect of the left heart towards midline. Off of midline due to the right cranial lung.

Caudoventral - extension from the caudolateral aspect of the heart on the left side towards the diaphragm. Displaced off of midline due to the accessory lung lobe.

27
Q

What structures make up the caudoventral mediastinal reflection?

A

visceral pleura of the accessory lobe
mediastinal parietal pleura of the right pleural sac
mediastinal parietal pleura of the left pleural sac
visceral pleura of the left caudal lobe

28
Q

How wide should the cranial mediastinum be on the VD view?

A

Less than 2 times the width of the vertebral column

29
Q

3 types of mediastinal abnormalities?

A

mediastinal shift
mediastinal mass
pneumomediastinum

30
Q

Most common cause of mediastinal shift?

A

atelectasis/decreased lung volume

31
Q

True/false

Pneumomediastinum can progress to a pneumothorax?

A

TRUE

32
Q

True/false

Pneumothorax can progress to pneumomediastinum?

A

FALSE

33
Q

What is it called when alveolar rupture leads to dissection of gas into the mediastinal space?

A

Macklin effect

34
Q

Difference between sternal lymphadenopathy and mediastinal cyst?

A

Sternal lymphadenopathy - more cranially located

Mediastinal cyst - incidental findings

35
Q

What does the sternal lymph node drain?

A

abdominal structures including peritoneal space, abdominal wall, mammary glands

36
Q

Differentials for a cranioventral mediastinal mass?

A 
mediastinal lymphadenopathy
sternal lymphadenopathy
thymoma
mediastinal cyst (branchial cyst) 
ectopic thyroid tumor
mediastinal abscess
37
Q

Differentials for a craniodorsal mass?

A

Esophageal mass/enlargement (vascular ring, myasthenia, foreign body)
Neurogenic tumor
paraspinal tumor

38
Q

Differentials for a caudodorsal mediastinal mass?

A 
spirocerca lupi
caudal esophageal mass/foreign body
hiatal hernia
tracheobronchial lymphadenopathy
**always take three views to help differentiate between caudodorsal mediastinal mass and a lung mass
39
Q

What do the cranial mediastinal lymph nodes drain?

A

muscles of the neck, thorax and abdomen, the last cervical vertebrae, thoracic vertebrae, ribs, trachea, esophagus, thyroid, thymus, mediastinum, heart and aorta

40
Q

Enlarged tracheobronchial lymph nodes cause ___ displacement of the tracheal carina

A

cranioventral

41
Q

Differentials for a caudoventral mediastinal mass?

A

Something associated with the diaphragm: hernia

42
Q

What do the tracheobronchial lymph nodes drain

A

lungs and bronchi primarily (smaller contributions from aorta, esophagus, trachea, heart)

43
Q

Dfiferentials for pneumomediastinum?

A

Trauma - bite wound from neck, blunt thoracic trauma with rupture of alveoli and Macklin effect
Iatrogenic - overinflation of ET cuff, PPV
Esophageal or tracheal rupture - trauma, foreign body, inflammation, neoplasia
Gas producing bacteria

Thrall (4 decks)

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