Chest Lecture 3

Question 1

Acquired valvular disease is secondary to what diseases?

Answer 1

Rheumatic fever
HTN
Atherosclerosis

Question 2

Valvular disease manifests how on a chest film?

Answer 2

Changes in heart sizes

Question 3

Aortic aneurysm occurs in what locations what % of the time?

Answer 3

Ascending aorta 25%
Aortic arch 25%
Descending thoracic aorta 50%

Question 4

How does an aortic aneurysm appear on film?

Answer 4

Mass following the contour of the vessel
Mediastinal widening
Displacement of calcified wall plaques

Question 5

MC congenital heart malformation

Answer 5

Atrial septal defect

Question 6

Tetralogy of Fallot

Answer 6

Aortic coarctation
VSD
Right ventricular hypertrophy
Overriding aorta

Question 7

Congestive heart failure appearance

Answer 7

Enlarged heart (left ventricle and atrium)
Cephalization of blood flow
Enlarged SVC
Kerley's lines
Pulmonary edema (ie batwing)

Question 8

What is pleural effusion?

Answer 8

Free or loculated collections of transudate, exudate, blood, or chyle in the pleural space

Question 9

What is pulmonary edema?

Answer 9

Fluid accumulation in the extravascular space of the lungs

Question 10

Pulmonary edema appears as _______ pattern early and _______ pattern late

Answer 10

Interstitial

Air-space

Question 11

Causes of pulmonary edema include?

Answer 11

Left-sided heart disease
Capillary permeability
Renal failure
Obstructed lymph vessels

Question 12

How does pulmonary edema appear?

Answer 12

Septal lines
Hilar haze
Peribronchovascular haze - (loss of bronchi definition)
Subpleural edema - (fluid accumulation)

Question 13

What are Kerley’s lines?

Answer 13

Excess pulmonary fluid that distends the interstitial markings of the lung field

Question 14

Where do Kerley’s A lines appear?

Answer 14

Long lines in the upper lung parenchyma

Question 15

Where do Kerley’s B lines appear?

Answer 15

Short lines in the lower periphery of the lung, perpendicular to the pleural surface

Question 16

Where do Kerley’s C lines appear?

Answer 16

Fine interlacing lines in the central areas of the lung

Question 17

Pulmonary edema of the alveola appears in what pattern?

Answer 17

butterfly/sunburst/bat-wing shape

Question 18

Where do emboli arise from?

Answer 18

Venous circulation, bone marrow, amniotic fluid

Question 19

Most emboli arise from where?

Answer 19

Deep veins of the lower extremity

Question 20

What happens to most pulmonary emboli?

Answer 20

They resolve

Question 21

What percent of emboli result in infarct?

Answer 21

15%

Question 22

Emboli usually affect what lobes?

Answer 22

Lower

Question 23

Although not sensitive, what are the radiographic findings of thromboembolism?

Answer 23

Large pulmonary arteries
Westermark’s sign
Pleural-based radiodensity
Fleischner’s lines