CHEST 1 Flashcards
LOBE ANATOMY
1–UPPER LOBES ARE ANTERIOR
2–LOWER LOBES ARE POSTERIOR
3–Right middle lobe and lingula lingula are ________
4–HEART , ascending aorta and aortic arch are
considered ________
5– Diaphragms are ___________
anterior
anterior
posterior
BASIC CONCEPTS OF CHEST PATHOLOGY INTERPRETATION
1–The Silhouette Sign
– When two similar similar _______ ______________ are in contact with one another, the visible border between between the two structures structures is lost.
– Helpful in localizing pathology.
radiographic densities
BASIC CONCEPTS OF CHEST PATHOLOGY
INTERPRETATION
2–Lobes involved and structure silhouetted:
- RUL (anterior): (anterior): Ascending Ascending aorta
- RML (medial): (medial): Right heart border
- RLL: Right hemidiaphragm
- LUL (apical‐posterior): Aortic knob
- LUL (anterior): (anterior): Pulmonary Pulmonary trunk
- LUL (lingula): (lingula): (lingula): Left heart border
- LLL (superior): (superior): Descending Descending aorta
- LLL: Left hemidiaphragm
know
BASIC CONCEPTS OF CHEST PATHOLOGY
INTERPRETATION
3–Air Bronchogram
– Visualization of AIR in the BRONCHI due to surrounding lung tissue (alveoli) filling with ______OR_______
– Bronchi should NOT normally be seen
4–Extra‐pleural sign
– ________ of the pleura from a chest wall or
mediastinal mass
– If the edges form an OBTUSE > 90º angle
= EXTRA‐pleural or PARIETAL pleural lesion
– If the edges form an ACUTE
fluid or cells
Tenting
OBTUSE = EP
OBTUSE COST EXTRA P!
ACUTE = LV
IF IT’S ACUTE..I LV IT!!
AIR SPACE PATHOLOGY
1—EMPHYSEMA
Lung overinflation = destruction of the acinar walls leading leading to air trapping
– little or no fibrosis fibrosis
– _____= small, usually peripheral, interstitial interstitial collection collection of air
– _____ = large parenchymal collection of air
Types 1--– centrilobular • upper lobes 2--– panacinar 3– distal acinar 4--- irregular
*******BARREL CHEST
bleb
bulla
AIR SPACE PATHOLOGY
2—PNEUMONIA
A–Inflammation of the alveolar ___________
B–____________ of lung tissue
C-Causes
-___________ IS MOST COMMON
–chemical inhalation
– chest wall TRAUMA
D–Classification
–– by causative agent = viral, bacterial,mycoplasmal,
yeast, fungal
—radiographic appearance
• lobar, LOBULAR, bronchostitial, interstitial, spherical, round.
—etiology
• community‐acquired,__________, immunosuppressed trauma , aspiration
parenchyma
Consolidation
-INFECTION
nosocomial
AIR SPACE PATHOLOGY
3–ATELECTASIS
A–Definition: = incomplete incomplete air filling and
UNDER EXPANSION
B–Can involve:– entire lung, lobe, segment segment
or subsegment
C–can diplace NORMAL anatomy
D—Always caused by __________ _________
– Atelectasis is a SIGN
TYPES A--– \_\_\_\_\_\_\_\_\_\_ / Resorptive • most common cause • INtrinsic or EXtrinsic B--– Passive – Cicatrization, scarring – Compressive – Adhesive
underlying pathology
Obstructive
ATELECTASIS 1-- Volume LOSS 2--Associated ipsilateral shift 3-- Linear, wedge‐shaped 4--Apex at \_\_\_\_\_\_\_\_
VS
PNEUMONIA
1–Normal or ____________ volume
2– No shift, or if a shift is present present
it is contralateral
3–Consolidation or filling of air space
4– NOT HILAR centered
Air bronchograms can occur in either condition
hilum
increased
AIR SPACE PATHOLOGY
4–GRANULOMA
A–Well‐defined calcified LESION
B–Ghon tubercle–– parenchymal granuloma associated with ____
C–Usually associated with slow growing ________
D–Tuberculosis is the most COMMON
E– Ranke complex– a Ghon tubercle and HILAR lymph node _____________
TB
infection
calcification
AIR SPACE PATHOLOGY
5–MASS‐ TUMOR
A--Pulmonary radiopacities GREATER THAN 3CM B--If less than 3cm = \_\_\_\_\_\_\_ C--Bronchogenic carcinoma --may have FUZZY or lobulated border – may have peripheral \_\_\_\_\_\_\_\_\_ D--Pancoast tumor = masses in the superior sulcus or upper lung region (APEX) --usually \_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_ type – can show RIB destruction E--Some causes of pulmonary MASSES --– abscess, arteriovenous --malformation, bronchial carcinoid tumors
nodule
calcification
squamoous cell
PLEURAL PATHOLOGY
1–PLEURAL EFFUSION
A--Large collection of transudate, exudate, blood or chyle B--Radiographic– costophrenic blunting C--hemithorax opacification D--Nonspecific sign of underlying pathology E-CAUSES: --abdominal disease --collagen diseases -- CHF --renal disease -- disease -- trauma -- tuberculosis
S
PLEURAL PATHOLOGY
2—PNEUMOTHORAX
A–Collection of air in the ________ _______
B–Traumatic
C–Spontaneous
–PRIMARY = RUPTURE OF A BLEB
—SECONDARY = CHEST DISEASES WITH CYSTS
E–Radiographic = _____-________ radiolucent shadow between between the lung and chest wall
–absence of lung markings
– thin pleural line
—–best seen on full _________, standing chest x‐ray
PLEURAL SPACE
crescent ‐shaped
expiration
