Chest - Alveoli Flashcards
Another name for tuberculosis
PT or the consumption
What is Gon’s Focus?
Small granuloid pockets that are typically located at the top of the chest.
Radiographic signs of TB
Granuloid masses in apex of lungs (gons focus)
Patient presentation for TB
dry cough
What is a Gon’s complex?
When GOns focus gets into the lymph and retained.
Imaging pathways for TB
PA and lat followed by a lordotic view if gons is supsected
positioning for a lordotic view
AP and angle beam 20-30 degrees. OR
AP and instruct patient to take a step forwards and lean their back into bucky whilst hips stay still
lower back and bottom shouldnt touch IR.
Make sure beam still perpendicular to anatomy.
Purpose of lordotic view
to push clavicles out of lung fields
Another name for COPD or COAL
CAL
What does CAL stand for?
Chronic Airways limitation
What causes CAL?
Smoking causes a fibrotic change and a loss of elasticity…
pressure of cough will pop the alveoli wall creating one large alveoli and a broken alveoli wall (loss of surface area).
Gas exchanges is reduced and alveoli have to work harder causing more to pop.
healthy alveoli try to get bigger to deal with lack of oxygen.
These enlarged alveoli will push and flatten the diagram as well as pushing anteropostero causing a barrel chest.
What does a patient with CAL try to do to increase oxygen intake
purse their lips to breath,
doesnt actually cause more oxygen to inhale but the pressure makes them feel like it does,
Technical changes for a CAL
Less surface tension and more air in lung field so lessen exposure.
What is a bullous ephysema?
Lung alveoli becomes MASSIVE
Alveoli becomes so large it can be seen on CXR.
Can be linked with CAL.. patient may be on a oxygen tank. they will have less oxygen to the brain and less energy.
Multiple bullae can occur
TAA
Thoracic Aorta Aneurysm
What is cardiomegaly?
enlarged heart.
Hypertrophy of the heart chambers
LVF
left ventricular failure
When does LVF occur
when patient cant push blood around body.
Left ventricle enlarges to try and push more blood.
Extra fluid can be from renal failure.
What shape is the heart typically during LVF
Boot shaped and near touching thoracic wall
How to differentiate cardiamegaly and LVF
Look at CARDIAC WAIST
Cmegaly has a straight line from left atria to left ventricle , whereas LVF has a waist/ inpouching
Acute
Pulmonary
Oedema
Meaning
Acute: small time frame
Pulmonary: pertaining to the lungs
odema: build up of fluid.
How does acute pulm odema occur?
Pathogen causes body to be unable to expose fluid.
body STORES FLUID IN CELLS whilst trying to expell it.
Alveoli get full and gas exchange is very poor.
lung cells particularly full.
basically drowning.
treatment for Acute pulm odema
Dialysis
Exposure parameters for Acute pulm odema
More fluid so higher dose is needed to push through it.
USE GRID
Patient presentations for Acute pulm Odema
Gargly voice
Sweaty (trying to expose fluid)
Acute pulm odeam radiographic appearance
whiteout throughout the lungs
How to best visulise a puml emboli?
CT w/ contrast during pulmonary phase and look for filling defects.
What is Pneumoconiosis
Breathing in of fine particles
it is a group of pathologies.
Links of pneumoconiosis and birds?
mites under feathers can be inhaled . known as Bird fanciers lung
What occurs during pneumoconiosis
Body tries to encapsulate and insulate FB. through a calcific change,
What can asbestos cause?
fibrosis and pneumoconiosis and mesophelioma
Radiographic appearance of asbestos
Fibrosis near diaphragm and throughout lung
pleural plaques in lung
Mesothelioma apperance
masses on periphery of thorax
What is anthracosis
a form of pneumoconiosis.
coal miners lung/ black lung
common in Newcastle and can have whole days of CXRs when coal miner clinics open.
Anthracosis appearance
calcifications and pleural plaques, fibrotic chanegs … TYPICALLY IN UPPER AREAS OF LUNGS
how are pneumoconiosis differnitatied?
patients clinical history and occupational history
What life style factor does lung cancer have a strong connection with?
CAL
lung cancer appearance
opacities in lung
what are coin lesions
smaller and multiple cancer masses that appear rounded and slightly radiopaque
What does FNAB stand for?
Fine needle Aspiration biopsy.
What is a pathology caused by medical intervention known as?
Iatrogenic
What can be a risk of FNAB?
Iatrogenic pneumothorax
