Chest Pathology Flashcards
how do you work out the cardiothoracic ratio and what should it be
width of the heart/width of the thoracic cavity
< 50%
Name the lobes of the right lung and the fissures
RUL RML RLL minor fissure between RML & RUL major fissure separating from other lobes
Name the lobes of the left lung and the fissures
LUL
LLL
major fissure separating the two
Aetiology (causes) of Cardiomegaly
Valve Disease - MVD/AVD/TVD Hypertension cardiomyopathy CAD myocarditis trauma/surgery
what are the 2 types of heart valve disease
aortic or mitral
what can valves be?
stenosed (narrowed) or incompetent (regurgitation)
what happens in heart valve disease?
increase in pulmonary and right heart pressures leading to a pulmonary oedema
what are the radiographic appearances for mitral’s valve disease? - 4 points
‘moghuls’
aortic knuckle
left pulmonary artery
left atrium
what is the equation to identify hypertension
BP = HR + SVR
Blood Pressure = Heart Rate + Systemic Vascular Resistance
what are the contributing factors for hypertension? - 8 points
Family History Smoking Obesity Diabetes Kidney Diseases High alcohol intake Lack of exercise Certain medicines (steriods)
what can hypertension lead to ?
heart failure
what would happen if the right half of the heart failed (right ventricular failure)?
general body vein pressure would increase and fluid would accumulate in the body, especially in tissues of the legs and abdominal organs (liver most likely to be affected)
what would happen if the left half of the heart failed?
it would cause failure of the right ventricle causing biventricular failure
name and describe the 3 types of cardiomyopathy?
dilated - enlarged heart with dilation of all 4 chambers
hypertrophic - assymetrical hypertrophy (enlargement) of the ventricular septum (HOCM)
restrictive - loss of ventricular compliance. Can have normal heart size, but ventricular cavities markedly obliterated by extensive endocardial thickening
what are 4 common things resulting from hypertension cardiomyopathy
angina pectoris (chest pain)
syncope (fainting)
cardiac failure
sudden death
what is Coronary Heart Disease and what can it result in
atherosclerosis
can lead to a Myocardial Infarction and injury and irreversible damage to the myocardium
what is myocarditis?
what may causes the inflammation?
inflammation of the heart muscle
a viral or bacterial infection, rheumatic fever, or a toxic reaction to a drug
what can myocarditis do? - 3 points
cause damage to the heart muscle
affect the heart’s pumping action
a degree of heart failure
what is cardiac tamponade?
compression of the heart by an accumulation of fluid in the pericardial sac
what is left ventricular failure called?
what is right ventricular failure called?
what is biventricular failure called?
pulmonary oedema - fluid will build up in the lungs due to congestion of the veins of the lungs
limb and abdominal oedema - general body vein pressure will increase and fluid will accumulate in the body, especially the tissues of the legs and abdominal organs (of these, the liver is the organ most likely to be affected).
congestive cardiac failure (CCF)
what are the signs and symptoms of LVF?
Orthopnea Dyspnea/Tachypnea Restlessness/insomnia Cynosis Cough Tachycardia Fatigue Weakness Anorexia Diaphoresis
what are the signs and symptoms of RVF?
Weight gain Ascites Abdominal Distention Oedema Dilated peripheral veins G.I. distress – nausea, vomiting, jaundice Hepato/splenomegaly Fatigue Weakness Anorexia Diaphoresis Smelly, Profund Sweat
what is the treatment for heart failure?
what is the treatment for acute heart failure?
After patients are administered diuretics what must be done?
bed rest
diuretics such as Frusemide
medications such as Digoxin - increases the heart’s effectiveness at pumping blood
treatment is commenced with diuretics and drugs called nitrates that reduce the strain of the heart.
Patients’ fluid input and output is monitored regularly to make sure that the patient is not becoming dehydrated
What is Acute Respiratory Distress Syndrome (ARDS)? - 2 points
who is usually affected?
‘shock lung’
sudden damage to alveoli - oedematous changes
Usually acutely ill patients – trauma, post surgery, infection
what are the 4 types of lung cancer
small cell
non-small cell (NSCLC)
Mesothelioma
Metasases
what are the 4 types of NSCLC
squamous cell
adenocarcinoma
large cell
bronchoalveolar cell carcinoma
give 4 components of SCLC
strongly associated with smoking
v aggressive
metastises v early
central tumour = main bronchus
NSCLC - prognosis and treatment
when is surgery best chance of cure?
what do patients who don’t have surgery undergo?
varies depending on stage
stages 1 or 2 - 20-25% of patients
radiotherapy / chemotherapy
what are the survival rates for NSCLC at stage 1a and stage 4
stage 1a - 82% 5 yr survival
stage 4 - 10% 1 yr survival
what is mesothelioma
a rare form of cancer, is a disease in which malignant cells are found in the pleura, or peritoneum
what is reported in 70-80% of all cases of mesothelioma
a history of asbestos exposure
where are areas frequented by metastases
how does it present
Breast Testicular Colon Sarcoma Bladder Prostate
cachexic
