Chest: Musculoskeletal Pathology

Question 1

Agenisis

Answer 1

Structure hasnt been developed or created

Question 2

What is subcutanenous emphysema

Answer 2

ait trapped under the skin

Question 3

What can a hiatus hernia lead to?

Answer 3

GORD

Question 4

What is an abscess?

Answer 4

A cavity containing/ trapping dead materials. THrough liquidfication necrosis

Question 5

How can a lung abscess commonly occur?

Answer 5

breathing in foreign microbes

e.g. aspirated anaesthetic , people who tend to have a low level of consciousness and people with tooth decay

Question 6

Radiographic appearance of abscess

Answer 6

Circle with white surrounding … typically a flat fluid level within

Question 7

What is the white lung?

Answer 7

it is a whiteout of the lung space.

definitive with a pneumoectomy

Possibly due to 
atelectasis
pleural effusion
empyema
pneumonia

and unlikely due to

bronchiectasis
cystic fibrosis

Question 8

What are the radiographic signs of a pneumoectomy

Answer 8

Whiteout

Crowding of ribs (smaller IC space)
Removed ribs where lung has been removed
Mediastinal structures moving into empty space

Remaining lung will enlarge

Question 9

Describe the process behind atelactasis

Answer 9

Blockage from food, cancer, mucous .. block the air ways and prevent oxygen from getting to alveoli.

However capillary beds around alveoli continually leach remaining air from alveoli… alveoli deflate… very painful.

Question 10

What demographic is atelectatis common with

Answer 10

Kids due to aspirated FB

Question 11

Radiographic appearance of atelectasis?

Answer 11

Tension created by shrunk alveoli pulls mediastinum over to that side (complete)

Partial: FB blocks at bronchiole or smaller, caused whiteout in that area.. tends to have well defined margins

Question 12

What is a Pleural Effusion

Answer 12

Fluid build up in the pleural space

Question 13

Radiographic appearance of a pleural effusion

Answer 13

A thick fluid will take longer to move and sticks… will appear as fluid on lungs

Thin fluid will take a while to sit so patient needs to be stood up for a while before doing a HV PA CXR

If fluid sat on diaphragm it may appear to be below on a PA but its actually sitting on the posterior aspect of diaphragm which sits lower than the anterior aspect.

LATERAL IS USEFUL

Question 14

WHat is a pleural effusion sometimes referred to?

Answer 14

water on the lungs

Question 15

Causes of pleural effusion?

Answer 15

Pneumonia , cancer

Question 16

How can you differentiate a pleural effusion from an atelectasis ?

Answer 16

Pleural effusion will PUSH the mediastinum away from it.

atelectasis will PULL mediastinum towards it.

Question 17

What is empyema?

Answer 17

Infected purelant layer which can sit in lung field.

Will be filled with puss and has a fuzzy border

Question 18

What is Pneumonia?

Answer 18

Very common and can lead to death.

It is an infection in the lung leading to a inflammatory response …. bacteria and fluid build up in alveoli and gas exchange is diminished.

Question 19

Common causes and demographic for pneumonia?

Answer 19

Viral
Bacterial
Fungal
ASPIRATION

elderly with poor movement, people with decreased level of consciousness, drug users, alcoholics, people prone to fainting.

Be wary that it can be viral.. distance, protect yourself.

Question 20

Radiographic appearance of pneumonia?

Answer 20

Alveoli may be blocked but AIRWAYS ARE STILL OPEN…

will see air filled bronchi surrounding by lung whiteout due to windowing .. essentially a bronchiogram.

Whiteout typically has a patchy edge and the WHITER (opaque) the whiteout is the more it has spread anetropostero.

Question 21

Can a bacterial and viral pneumonia occur at same time?

Answer 21

yes

Question 22

-ectasis

Answer 22

Dilation or widening

Question 23

What is bronchiectasis?

Answer 23

Mucousa in air ways (often due to lung infection)

irritation occurs and forced coughing is common.

forced cough leads to damaged airways .. healing and scarring occur but mucousa gets trapped in lining.

causing more forced coughing .. scarring causes dilation, loss of elasticity and widening of airways.

Very similar mechanism to cystic fibrosis.

Question 24

RAdiographic appearance of bronchiectasis

Answer 24

numerous small tiny circles and super dilated airways

Question 25

Radiographic appearance of bronchiectasis and cystic fibrosis?

Answer 25

Very similar but CF is more aggressive and widespread.