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Anna Burant IV > Chest > Flashcards

Chest Flashcards

1
Q

Flat band of muscle and connective tissue that completes the posterior aspect of the trachea

A

Posterior tracheal membrane

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2
Q

Tracheal mucosa are composed of _____

A

Pseudostratified ciliated columnar epithelium
W/c contains scattered neuroendocrine(APUD) cells

*submucosa contains cartilage,smooth muscle and seromucous glands

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3
Q

Composed of the right lateral tracheal wall, a small amount of mediastinal fat, paratracheal lymph nodes, and the visceral and parietal pleural layers of the right upper lobe

-interface of the RUL with the right lateral tracheal wall

A

Right paratracheal stripe

  • should be uniformly smooth,should not exceed 4mm in width
  • thickness or nodularity reflects disease in any of the component tissues, including medial tracking pleural effusion
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4
Q

Normal TRACHEA approximate measurements:
A.length in adults
B. Upper limit of normal coronal diameter in men? In women?
C. Coronal-to-Sagittal diameter ratio

A

A. 12 cm.
B. 25 mm(men); 21 mm(women)
C. 0.6:1.0

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5
Q

A narrowing of the tracheal coronal diameter producing a coronal-to-Sagittal ratio of <0.6 is termed a _____

A

Saber sheath trachea

*seen in patients with COPD

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6
Q

Normal or abnormal?

Slight tracheal deviation to right after entering the thorax

A

Normal

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7
Q
  • represents the combined thickness of the tracheal and esophageal walls and intervening fat
  • produced by the presence of air in the esophagus
A

Tracheoesophageal stripe

  • should measure less than 5mm
  • thickening is commonly seen with esophageal ca
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8
Q

Bronchi gradually lose their cartilaginous support between generations ___ and _____

A

1;12 to 15

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9
Q

1-3mm airways

A

Bronchioles

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10
Q

Bronchioles bearing alveoli on their walls

A

Respiratory bronchioles

*divide into alveolar ducts and sacs

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11
Q

The airway just before the first respiratory bronchiole

-smallest bronchiole without respiratory exchange structures

A

Terminal bronchiole

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12
Q

Divides the lungs; invaginations of the visceral pleura

A

Interlobar fissures

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13
Q

Arises from the truncus anterior

A

Upper lobe bronchus and its artery

*3 segmental branches: anterior, apical, posterior

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14
Q

Arises from the intermediate bronchus

-supplied by a branch of the right interlobar pulmonary artery

A

Middle lobe bronchus

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15
Q

4 segments of the LUL

A

Anterior, apicoposterior(supplied by the upper division of the left main pulmonary artery), superior and inferior lingula segments

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16
Q

Gas exchanging units of the Lung

A

Alveolar ducts and alveolar sacs

*pulmonary alveolus is lined by type 1 (squamous) and type 2 (cuboidal) pneumocytes

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17
Q

The major and minor fissures are best visualized on _____ radiographs

A

Lateral

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18
Q

Left major fissure begins more ______ and has a slightly more ______ course than the right major fissure

A

Superiorly; vertical

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19
Q

Projects at the level of the right 4th rib and is seen as a thin undulating line on frontal radiographs in approx. 50% of individuals

A

Minor fissure

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20
Q

Most common accessory fissure ; approx 10% to 20% of individuals
-separates the medial basal from the remaining basal segments of the lower lobe, is often incomplete

A

Inferior accessory fissure

*a small triangle of extrapleural fat at its point of insertion in the diaphragm is a clue for identification

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21
Q

This is seen in 0.5% of individuals

  • composed of 4 layers of pleura (2 viscera and 2 parietal)
  • represents an invagination of the right apical pleura by the azygos vein
A

Azygos fissure

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22
Q

Separates the superior segment from the basal segments of the lower lobe
-distinguished from the minor fissure on lateral radiographs because it extends posteriorly from the major fissure to the chest wall

A

Superior accessory fissure (rare)

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23
Q

Separates the lingula from the remaining portions of the upper lobe

A

Left minor fissure

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24
Q

A sheet of connective tissue that extends from the hilum superiorly to a level at or just above the hemidiaphragm

  • contains the inferior pulmonary vein superiorly and a variable number of lymph nodes
  • accounts for the media, location and triangular appearance of lower lobe collapse
A

Inferior pulmonary ligament

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25
Q
  • mistaken for the inferior pulmonary ligament

- a linear structure seen on CT near the inferior pulmonary ligament extending into the lung from mediastinal pleura

A

Sublobar septum

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26
Q

A triangular density extending toward the lung that is seen along the posterior aspect of the right heart border on lung windows on chest ct

-represents a reflection of pleura over the inferior portion of the phrenic nerve and pericardiophrenic vessels

A

Pericardiophrenic ligament

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27
Q

The right interlobar artery course ANTEROLATERAL to the bronchus

A

EPIARTERIAL

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28
Q

…the LLL ARTERY over the left hilar bronchi

***page 332-333

A

HYPOARTERIAL bronchus

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29
Q

Primary nutrient vessels of the lung

A

Bronchial arteries

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30
Q

Usually arise from the POSTEROlateral wall of the aorta in common with an intercostal artery as an intercostobronchial trunk

A

Right bronchial artery

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31
Q

Arise individually from the ANTEROLATERAL aorta or rarely from an intercostal artery

A

Left bronchial arteries

32
Q

Arise within the interlobular septa from the alveolar and visceral pleural capillaries

A

Pulmonary veins

33
Q

When distended by fluid, these account for the radiographic appearance of Kerley A lines

A

Perivenous lymphatics and their surrounding connective tissue

34
Q

Scaffolding of the lung , provides support for the airways and pulmonary vessels

A

Pulmonary interstitium

  • axial interstitium(extends from the mediastinum and envelopes the bronchovascular bundles)
  • centrilobular interstitium(provide support for the air-exchanging portions of the lung)
  • peripheral interstitium(divides secondary pulmonary lobules,contains subpleural interstitium and interlobular septa)
35
Q

Interstitium where pulmonary veins and lymphatics lie

A

Peripheral interstitium

36
Q

A thin network of fibers that bridges the gap between the centrilobular and peripheral compartments

A

Intralobular interstitium

37
Q

Edema involving the axial interstitium is recognized radiographically as ________

A

Peribronchial cuffing

38
Q

Edema of the peripheral and subpleural interstitium accounts for ____

A

Kerley b lines and thickened fissures

39
Q

Seen as sharp edges where the lung and adjacent pleura reflect off of various mediastinal structures

A

Lung-mediastinal interfaces

40
Q

Relate directly to the space available in 3 regions viewed on the lateral film: retrosternal space, retrotracheal triangle, retrocardiac space

A

Lung-lung interfaces

41
Q

An inferior extension of the upper lobe reflections off the inominate veins
-obliquely oriented from right superior to left inferior; extends from upper sternum to base of heart

A

Anterior junction line

42
Q

A.Small retrotracheal triangle—–

B.Large retrotracheal triangle—–

A

A. Right paraesophageal interface
B. Posterior junction line (vertically oriented in the midline; extends from upper thoracic spine to level of azygos and aortic arches)

43
Q

Large retrocardiac space—–

A

Inferior posterior junction line

44
Q

Separates the right paraesophageal from the upper azygos esophageal space

A

Arch of the azygos vein

*measurement should be made thru the midpoint of the azygos arch perpendicular to the right main bronchus a diameter of greater than 10mm on a PA view should raise poss.of mass,adenopathy,or dilated arch of the azygos vein

45
Q

2 conditions that will increase azygos venous diameter

A
  1. Supine positioning

2. Performance of the Muller maneuver (forced inspiration against a closed glottis)

46
Q

Aortic nipple

-normally measures <5mm

A

Left superior intercostal vein

47
Q

A vertically oriented interface overlying thoracic spine

A

Azygoesophageal recess interface

48
Q

A line produced when air is present in the distal portion of the esophagus and the azygoesophageal recess interfaces with the right lateral wall of the esophagus

A

Right inferior esophagopleural stripe

49
Q

A straight vertical interface extending the length of the right hemithorax and represents contact of the right lung with a small amount of tissue lateral to the thoracic spine

A

Paraspinal interface

50
Q

Interface immediately inferior to the aortic arch

A

Aortopulmonary window

51
Q

Immediately inferior to the Aortopulmonary window

A

Left lateral border of the main pulmonary artery

52
Q

A reflection of the LLL with the esophagus anterior to the descending aorta,extending vertically from the undersurface of the aortic knob a variable distance toward the diaphragm

A

Preaortic recess interface

53
Q

Represents the reflection of the left lung off the Paraspinal soft tissues

A

Left paraspinal interface

54
Q

Forms a concave interface immediately below the main pulmonary artery

A

Left atrial appendage

55
Q

Comprises most of the left heart border

A

Left ventricle

56
Q

Fat adjacent to the cardiac apex

A

Epipericardial fat pad

57
Q

The apex of the right hemidiaphragm typically lies at the level of the ________

A

6th anterior rib

*approx. 1/2 interspace above the apex of the left hemidiaphragm

58
Q

Borders of the retrotracheal (or Raider) triangle

A

Posterior border of the trachea/esophagus, anterior border of the spine, top of the aortic arch

59
Q

Impression on the anterior surface of the lingula

A

Cardiac incisura

60
Q

Contains central cardiovascular, tracheobronchial structures, and esophagus enveloped in fat with intermixed lymph nodes

A

Mediastinum

61
Q

A line drawn thru the _______anteriorly and __________ posteriorly divides the mediastinum into superior and inferior compartments

A

Sternal angle; 4th thoracic intervertebral space

62
Q

A triangular or bilobed structure that is maximal in size at puberty and then undergoes gradual fatty involution

A

Thymus

63
Q

Space seen between the trachea posteriorly and the posterior margin of the ascending aorta anteriorly and is contiguous with the precariously space inferiorly

A

Pretracheal space

64
Q

4 contents of the Aortopulmonary window

A

Fat, lymph nodes, ligamentum arteriosum, left recurrent laryngeal nerve

65
Q

Represents the junction of the lung with the mediastinum and is composed of upper lobe pulmonary veins and branches of the pulmonary artery and corresponding bronchi

A

Hilum

66
Q

In more than 90% of individuals, the left hilar shadow is _______ than the right

A

Higher

67
Q

The avascular aspect of the composite hilar shadow , inferior to the shadow of the right pulmonary arteries and veins and anterior to the descending left pulmonary artery and left superior vein

A

Inferior hilar window

68
Q

A serosal membrane that envelopes the lung and lines the costal surface, diaphragm and mediastinum

A

Pleura

69
Q

A potential space between the two pleural layers and normally contains a small amount of fluid (<5mL) that reduces friction during breathing

A

Pleural space

70
Q

Diaphragmatic opening that lies in the midline, immediately behind the diaphragmatic crura and anterior to the 12th thoracic vertebral body

A

Aortic hiatus

71
Q

Diaphragmatic opening that usually lies slightly to the left of midline, cephalad to the aortic hiatus

A

Esophageal hiatus

*transmits the esophagus and vagus nerves

72
Q

Diaphragmatic opening that pierces the central tendon of the diaphragm at the level of the 8th thoracic intervertebral disk space

A

Inferior vena cava

73
Q

Triangular gaps in the muscles of the anteromedial diaphragm

-site of potential intrathoracic herniation of abdominal contents

A

Foramina of Morgagni

74
Q

Defects in the closure of the POSTEROlateral diaphragm at the junction of the pleuroperitoneal membrane with the transverse septum

A

Foramina of Bochdalek

75
Q

Lines the ribs and endothoracic muscles

A

Endothoracic fascia

Anna Burant IV (7 decks)

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