Exam 1, Ch. 3, Respiratory Pathologies Flashcards
Hyaline Membrane Disease (definition and cause)
Occurs primarily in premature infants. Lack of surfactant and immature lungs causes underaeration of the lungs.
Hyaline Membrane Disease (on an image)
lack of aeration in lung; granular appearance of lung parenchyma
Cystic Fibrosis (definition and cause)
Hereditary disease characterized by secretion of excessively viscous (thick) mucous by all exocrine glands. 90% of morbidity and mortality related to resp. involvement. Mucous secreted by mucosa blocks air passages.
Cystic Fibrosis (on an image)
thickening of linear markings of the lung, with lung hyperinflation
Croup (definition and cause)
viral infection of young children; inflammatory obstructive swelling localized to the subglottic portion of the trachea
Croup (on an image)
tightening of the trachea; hourglass appearance; seen well on AP soft tissue neck
Epiglottitis (definition and cause)
common in 6-7 year olds; thickening of epiglottic tissue and surrounding pharyngeal structures
Epiglottitis (on an image)
Epiglottic shadow appears as large as an adult thumb. Normally appears as adult little finger. Best seen on lateral projections
Tuberculosis (overview)
TB can affect the GI, GU, and skeletal systems, but is primarily a resp. system infection. Mycobacteria are surrounded by inflammatory cells in lung forming a visible mass called a tubercle. In a healthy individual, scar tissue replaces the mass.
Where is the tuberculous scar typically found?
posterior lung apices
Primary Tuberculosis (who it affects; on an image)
- affects children and young adults
- segmental/lobar, homogeneous consolidation; typically in lung apex
- enlargement of hilar or mediastinal lymph nodes
- causing the “primary complex” the Ghon lesion
- unilateral pleural effusion
Secondary (Reactivation) Tuberculosis (characteristics)
- may remain inactive for many years
- often reactivates when immune system is down
- usually affects upper lobes
- new lesions have thick, ill-defined walls
Secondary Tuberculosis (on an image)
- hilum is elevated
- non-specific, hazy, poorly marginated alveolar infiltrate
- radiating outward from hilum
Tuberculoma (definition and on an image)
- sharply circumscribed (filled circle) parenchymal nodule
- single or multiple pulmonary nodules, 1-3 cm in diameter
Histoplasmosis (definition and cause)
- caused by fungus (commonly found in Ohio River)
- numerous, small calcifications seen develop in lung
- can cause fibrosis in mediastinum
- normally benign but can be serious
- can cause calcification in spleen, liver, and lymph nodes
Histoplasmosis (on an image)
- hilar lymph node enlargement
- multiple dense calcifications in lung (commonly in lower lung)
Emphysema (definition and cause)
- obstructive and destructive changes in the small airways (acini)
- commonly caused by smoking and can be caused by air pollution, chronic bronchitis, and resp. irritants
- cause injury to cilia
Emphysema (on an image)
- overinflation of lungs
- flattening of domes of diaphragm
- on lateral image: increase in size and lucency of retrosternal airspace
- one bulla can fill an entire hemithorax
Asthma (definition and cause)
widespread swelling of mucous membranes of bronchi due to increased responsiveness to stimuli
-can be extrinsic asthma (caused by outside source like pollen, dust, certain foods) or intrinsic asthma (exercise, stress, heat/cold)
Asthma (on an image)
- expiration becomes difficult
- during an acute asthmatic attack lungs overinflate causing radiolucency and flattening of hemidiaphragms
- repeated episodes cause permanent bronchial wall thickening
Bronchiectasis (definition and cause)
- permanent abnormal dilation of one or more large bronchi
- caused by bacterial infection
Bronchiectasis (on an image)
- coarseness and loss of definition of interstitial markings
- in advanced cases, cystic dilations form (2 cm in diameter)
- in very severe cases, a honeycomb pattern may appear
Silicosis (definition and cause)
- caused by inhalation of silicon dioxide
- fibroblast-stimulating factor causes extensive fibrosis
Silicosis (on an image)
- multiple nodular shadows of uniform density scattered in lungs
- nodules may become calcified
- some nodules increase in size and coalesce, usually bilaterally
- hilar lymph node enlargement is common
Asbestosis (definition and cause)
- asbestos deposits at alveolar bifurcation
- causes fibrosis
- mesothelioma is a major complication
Asbestosis (on an image)
- hallmark - involvement of pleura
- pleural thickening (linear plaques of opacification)
- curvilinear densities conforming to upper surfaces of diaphragm bilaterally
Anthracosis (definition, cause, and image)
- caused by working with anthracite (hard coal)
- anthracite collects in walls of the bronchioles
- leads to weakened musculature and dilation
- image - initially, multiple, small opacities form in lungs; similar to solicosis but less defined
- advanced stage - pattern of progressive fibrosis
Pleural Effusion (definition and cause)
- fluid in the pleural space
- caused by variety of pathological processes
- congestive heart failure, PE, infection, connective tissue disorders
- can also be caused by abdominal trauma or disease
Pleural Effusion (on an image)
- early on - a blunting of costophrenic angle and upward concave border of fluid level
- best seen on lateral projections b/c costophrenic angles run deeper posteriorly
- massive effusions may displace the heart and mediastinum to opposite side
Alveolar Pneumonia (definition and cause)
- inflammatory exudate replaces in air in alveoli
- caused by virus or bacteria
- can spread from one alveolus to the next
- can affect entire lobe
Alveolar Pneumonia (on an image)
- inflamed alveolus or lobe are radiopaque
- causes air-filled bronchial tree to be seen on airless lung parenchyma
Interstitial Pneumonia (definition and cause)
- caused by virus or fungus
- inflammatory process involves interstitial structures supporting lining of lung, the “alveoli septum”
Interstitial Pneumonia (on an image)
- causes a reticular (net-like) pattern in lungs
- left untreated, this can cause a honeycomb appearance in lungs
Pulmonary Edema (definition and cause)
- abnormal accumulation of fluid in extravascular pulmonary tissues
- caused by increased pressure of pulmonary veins
- increased pressure caused by left-sided heart failure or pulmonary venous obstruction
Pulmonary Edema (on an image)
- edema fluid in interstitial space causes a loss of normal sharp definition of pulmonary vasculature
- perihilar haze
Congestive Heart Failure (definition and cause)
- inability of heart to propel blood at a rate and volume sufficient to supply all tissues
- caused by intrinsic cardiac abnormality, hypertension, and/or obstructive process that increases the resistance of blood flow
Congestive Heart Failure (on an image)
- left-sided failure: enlarged heart and superior pulmonary veins, and interstitial and alveolar edema
- right-sided failure: dilation of right ventricle/atrium and SVC, and widening of right superior mediastinum
