Diseases of the Heart Flashcards
What do you call an upper lobe vessel that became equal to or larger than the size of the lower lobe vessels in pulmonary venous hypertension?
Cephalization
Right descending pulmonary artery diamter.
<17 mm
T/F lower lobe vessels are larger than the upper lobe vessels
True
T/F upper lobe vessels are thicker and larger compared to the lower lobe vessels
False (thinner and smaller)
T/F vessels from central to peripheral gradually tapers off
True
Rapid cut off in size of peripheral vessels relative to size of central vessels
Pulmonary arterial hypertension
Central vessel appear too large for size of peripheral vessels which come from them = ?
Prunning
Main pulmonary artery projects beyond tangent line
Pulmonary arterial hypertension
What are seen in increased flow to the lungs?
More blood vessels than normal
Enlarged RDPA and prominent peripheral vessels
5 states of pulmonary vasculature
Normal Pulmonary venous hypertension Pulmonary arterial hypertension Increased flow Decreased flow
Mostly unrecognizable even when it’s present
Decreased flow
Suggestive for the diagnosis of CHF
kerley lines
Kerley lines is also useful in what non cardiax conditions?
Pulmonary fibrosis
Carcinomatosis
Heavy metal interstitial deposition
What are the causes of pulmonary chronic kerley lines?
Fibrosis or hemosiderin deposition and pulmonary edema
This line is never seen without kerley b or c lines also present
Kerley a
Lines that are seen in CHF and interstitial fibrosis
Kerley B
These are longer (at least 2 cm) unbranching lines coursing diagonally from the periphery toward the hila in the inner half of the lungs
Kerley A
They may represent thickening of anastomotic lymphatics or superimposition of many kerley B
Kerley C
They may be seen in any zone but more frequently observed in lung bases at the costophrenic angles on the PA radiograph, and in the substernal region on lateral radiographs
Kerley B
These lines represent interlobular septa, which are usually less than 1 cm in length and parallel to one another at right angles to the pleura.
Kerley B
Short, fine lines throughout the lungs, with a reticular space
Kerley c
What are the chamber prominence in mitral stenosis?
Left atrium and right ventricle
Cardiomegaly. Mitral stenosis or regurgitation?
Mitral regurgitation
Chamber prominence in mitral regurgitation
Left atrium and right ventricle
Presence of left ventricular hypetrophh
Aortic stenosis
Presence of dilated aorta and aortic arch
Aortic regurgitation
+/- pulmonary venous hypertension and calcification
Aortic stenosis
ABCD of lung assessment.
enlarged left Atrium?
Big or bulbous main pulmonary artery
Concave main pulmonary artery?
Dilated or delta shaped heary?
(+) enlarged left atrium
Normal pulmonary vasculature
Mitral regurgitation
(+) enlarged left atrium
(+) pulmonary venous hypertension
Mitral stenosis
L myxoma
(+) enlarged left atrium
Increaased pulmonary vasculature
VSD, PDA
(+) dilated or delta-shaped heart
Cardiomyopathy
Pericardial effusion
Multiple valve disease
(+) concave main pulmonary artery
Normal aorta
Cardiomyopathy
(+) concave main pulmonary artery
Ascending dilated aorta
Aortic stenosis
(+) concave main pulmonary artery
Whole dilated aorta
Aortic regurgitation
HBD
(+) big or bulbous main pulmonary artery
Normal pulmonary vasculature
Pulmonic stenosis
(+) big or bulbous main pulmonary artery
Increased pulmonary vasculature
ASD (VSD)
(+) big or bulbous main pulmonary artery
Pulmonary hypertension
Idiopathic secondary to lung disease
Radiologic signs of cardiac disease
Increased lung density
Decreased lung density
Pleural abnormalities
Atelectasis
Diseases that cause increased lung density
Air space disease
Interstitial disease
Combined air space interstitial disease
Masses and nodules
Diseases that cause decreased lung disease
Emphysema
Bullae
Blebs
Cavities
Replacement of gas within air spaces by liquid, cells or combination of the two
Parenchymal consodilation (air-space disease)
Different patterns of interstitial disease
Septal Reticular Nodular Reticulonodular Ground-glass
Measurement of nodule and mass
Nodule:<3cm
Mass: >/= 3 cm
Diminished gas within lung associated with reduced lung volume
Atelectasis
Lateral decubitus can detect how many ml of lung fluid
Minimum of 10ml
PA view can detect how many ml of lung fluid which is necessary to cause blunting of lateral sulcus
Pleural effusion
