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Chest And Abdomen > Final > Flashcards

Final Flashcards

1
Q

When looking at a lateral chest film what diaphragm is which?

A

One you can see all the way is the right and one that is only half visible is the left

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2
Q

Divisions of the mediastinum

A

Anterior: anterior to heart
Middle: posterior to heart
Posterior: 1cm behind VB

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3
Q

Air space disease look

A

White cloudy ill-defined

SOL has displaced air

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4
Q

Interstitial of lung

A

CT support

Capillaries, venues, and lymph vessels

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5
Q

Interstitial disease appearance

A

Wall affected vs room affected (airspace)

Coarse white lines that can be defined
CT is white lines

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6
Q

Air space vs interstitial pattern appearance

A

Air space: cloudy/hazy

Interstitial: coarseness defined lines

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7
Q

Cervicothoracic sign

A

Finding that only structures posteriorly located are seen above the clavicles

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8
Q

Air bronchogram sign

A

If lung is filled with water based pathology (pneumonia) bronchi appear radiolucent tubular (darker) densities

Confirms air-space disease

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9
Q

Findings of atelectasis

A

Displaced fissures
Increased pulmonary radiodensity (white)

Elevated diaphragm
Approximation of the vessels, brochi and ribs
Displaced mediastinum and hilar TOWARD lesion

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10
Q

Types of atelectasis

A 
Obstructive MC!!! Ex: tumor
Compressive (mass)
Passive (pneumothorax)
Contraction (scar formation TB)
Adhesive (hyaline membrane disease-alveoli collapse)
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11
Q

S sign of golden

A

Atelectasis of RUL

Usually due to a mass

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12
Q

Two categories of bronchial asthma

A

Extrinsic: exposure to environmental triggers

Intrinsic: asthma, infection, exercise

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13
Q

Bronchiectasis

A

Damage to large airways of lung causing them to widen and thicken

Associated with cystic fibrosis and recurrent infections

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14
Q

Bronchiectasis xray

A

Ring shadows of dilated bronchi
Bilateral bc systemic
Honeycomb appearance

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15
Q

Bronchopulmonary sequestration

A

Section of lung that doesn’t develop properly and is separated

Radiodense mass above or below diaphragm

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16
Q

Emphysema

A

Chronic dilation of airspace distal to terminal bronchi

Alveolar wall destruction lead to large airspaces= Bullae

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17
Q

XRAY of emphysema

A 
Bilaterally flat depressed hemidiaphragm 
Lung overinflation
Increased radiolucency (white)
Increased retrosternal space
Kyphosis
Increased intercostal space
Prominent hilar vasculature 
Bullae (MC in apex-open circular space)
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18
Q

What may give a false appearance of cardiomegaly

A

Not taking a full breath in

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19
Q

What is normal size of heart

A

Less than width of hemothorax

Less than half width of thorax

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20
Q

What defines aneurysm

A

More than 50% dilation of aorta

Normal size is 2cm

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21
Q

True vs false aneurysm

A

True: all 3 layers involved
False: only outer layers

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22
Q

MC area of aneurysm

A

Descending thoracic aorta 50%

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23
Q

Thumbnail sign

A

Thoracic aortic aneurysm

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24
Q

MC heart defect

A

Ventricular septal defect

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25
Q

Left sided heart failsure

A

Lung edema/backflow
Dyspnea
Cyanosis
Chronic cough/pink phlegm

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26
Q

Right sided heart failure

A

JVD
Pitting edema

Frequent urination
Fatigue and weakness
Rapid heart rate
Confusion
Loss of appetite-ascites
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27
Q

Xray of CHF

A

Enlarged heart
LA/LV
Vessels appear engorged-cephalization
Enlarged superior vena cava
Kerley’s lines (interstitial disease)
Pleural effusion (blurring of costophrenic angles)
Pulmonary edema (batwing or butterfly appearance)

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28
Q

Pleural effusion

A

Fluid in pleural space

Gravity dependent so take lateral decubitus

Due to cardiopulmonary disease, inflammation, tumors and trauma

Blurred costophrenic angles

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29
Q

Pulmonary edema

A

Fluid accumulation in extra vascular space of the lungs

Interstitial or air-space looking

Due to left CHF, capillary permeability, renal failure, obstructive lymph channels

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30
Q

Interstitial pattern of pulmonary edema xray

A

Linear densities
Kerley’s lines
Nodular appearance of lungs
Subpleural edema

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31
Q

Kerley lines

A

Seen with excess pulmonary fluid

Pulmonary edema

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32
Q

Airspace/alveolar pattern of pulmonary edema

A 
Homogenous radiodensity
Bilateral radiodense shadows extending laterally from hila:
Butterfly
Sunburst
Batswing

Air-bronchogram sign

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33
Q

Pulmonary thromboembolism xray

A

15% show Xray changes
Large arteries
Wedge shaped pleural based radiodensity= infarct
HAMPTONS HUMP

Resolves over time= melting sign
Residual adhesions (Fhleischner’s lines)
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34
Q

What is the single most important diagnostic modality for detecting PE

A

V/Q
Ventilation perfusion scanning

Shows air and blowflow in the lungs

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35
Q

Pneumonia xray

A

Lung consolidation
Pleural effusion
Air bronchogram sign

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36
Q

Methods do acquisition of pneumonia

A

Community acquired
Nosocomial (hospital)
Immunosuppressed
Aspiration (alcoholics)

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37
Q

Pneumonia radiographic types

A

Broncho(lobar)…large airways and bronchi central to peripheral
Lobar-distal bronchioles…peripheral to central pattern
Interstitial (rare)
Aspiration (RARE)

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38
Q

Pneumonia causative agents

A

Streptococcus pneumoniae

MC community acquired agent. Lobar distribution

Haemophilus influenzae…C disease patients, alcogholics

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39
Q

Bat wing pattern

A

Pulmonary edema

Pneumonia

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40
Q

Taking PA chest xray

A

High kVp
14x17
72”
Inhale and hold

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41
Q

the parietal pleura is external to the visceral pleura

A

True

42
Q

Largest to smallest pulmonary anatomy

A

Lung, lobe, bronchopulmonary segment, secondary lobule, primary lobule

43
Q

Where is the heart located according to the roentgenometric/surgical and anatomical divisions

A

Middle mediastinum using anatomical divisions

Anterior mediastinum using surgical divisions

44
Q

Air bronchogram sign confirms

A

Air-space pattern of pulmonary disease

Confirms surrounding alveoli are filled with water based pathology

45
Q

What disease is described by chronic dilation, thickening and widening of bronchi

A

Bronchiectasis

46
Q

What is the most likely presentation of atelectasis in chiropractic practice

A

Obstructive secondary to bronchial tumor

47
Q

What finding can be used to distinguish lobar atelectasis from other presentations of air-space disease such as pneumonia or pulmonary edema

A

Significant volume loss and migration of the horizontal fissure

48
Q

Which chamber of the heart creates the right cardiac silhouette in the PA projection and the left?

A

Right atrium

Left ventricle

49
Q

Which chambers of the heart form the anterior and posterior silhouettes of the heart in the lateral projection

A

Right ventricle = anterior

Left atrium = posterior

50
Q

What disease is stages for severity using the measure of forced expiratory volume in one second and the GOLD system criteria

A

Emphysema

51
Q

What region of the thoracic aorta is MC to demonstrate and aneurysm

A

Descending aorta

52
Q

What are the established causes of pulmonary edema

A

Capillary permeability
Renal failure
Congestive heart failure

53
Q

Kerley lines are an example of what chest Xray pattern

A

Interstitial

54
Q

Bilateral radiodense shadows extending laterally from the hila represent what and are associated with what

A

Bat wing or sunburst pattern of pulmonary edema

55
Q

What is the next best step for a patient who you think has a PE

A

Refer patient for VQ scan of the lungs

56
Q

Infections of the bronchi and lungs are termed

A

Lower respiratory tract infections

57
Q

What radiographic pattern of pneumonia involved distal bronchioles and surrounding alveoli of the periphery of the lungs

A

Lobar pneumonia

58
Q

What causative agent (s) is MC responsible for community acquired pneumonia that is likely to appear in your future practice

A

Streptococcus pneumonia
Tuberculosis

Globally mycpbacterial pneumonia is TB but in the US strep is MC

59
Q

A Ranke complex describes what

A

Matched hilar and parenchymal primary infections of TB

60
Q

What radiographic pattern of pneumonia is MC to present in your future practice

A

Lobar (broncho) pneumonia

61
Q

Which tumor is known to secrete hormones causing the patient symptoms to mimic Cushing’s syndrome

A

Bronchial carcinoid

Uncommon

62
Q

What is the most suggestive of malignant etiology for a SPN

A

15 year history of heavy smoking

63
Q

What is the MC cause of a SPN presenting in your future practice

A

Pulmonary granuloma

64
Q

What are predictors of a benign SPN

A

Nodule completely calcified
Stability over time
Younger age <35

65
Q

M vs F MC lung cancer?

A

Women

66
Q

What have thick walls adn what have thin walls

A

Thick:cavities
Thin: malignant or infective or cysts

67
Q

What is associated with pancoast tumor

A

Mass in superior sulcus
Destruction of upper ribs
Drooping eyelid on ipsilateral side
Tracheal deviation away from involved side

68
Q

Fluid accumulation in the distal pulmonary tissues secondary to capillary permeability that results from drug abuse and smoke inhalation is termed

A

ARDS

Adult respiratory distress syndrome

69
Q

What occupational pulmonary disease is associated with working around moldy hay

A

Farmers lung

70
Q

What disease is nicknamed black lung

A

Coal workers pneumoconiosis

71
Q

Which term describes the complication of slow growing, large, pulmonary fibrotic masses that seem to migrate toward the hilar over time

A

Progressive massive fibrosis

Classically develop as a complication to coal worker’s pneumoconiosis and silicosis

72
Q

Pneumothorax is what

A

Air between the visceral and parietal pleura

73
Q

Which term describes a group of pulmonary disease which develop secondary to excessive inorganic dust inhalation

A

Pneumoconiosis

74
Q

Bladder calculi are MCin who

A

Elderly men

Associated with unable to fully void the bladder

75
Q

What is true of renal stones

A

Small stones spontaneously pass through urinary symptoms without dramatic s/s
Flank pain is a common symptom
Renal stones typically contain enough calcium to be visible on plain film
Most stones are in the renal pelvis

76
Q

Where are more renal stones located

A

Renal pelvis

77
Q

What is used to image renal calculi

A

Intravenous pyelography

78
Q

What percent of gallstones contain enough calcium to see them on plain film

A

0-25%

79
Q

Where are gallstones usually seen

A

RUQ

80
Q

What are some s/s of colorectal carcinoma

A

Change in frequency or other aspects of bowel
Presence of blood in the stool
Rectal bleeding

81
Q

What is the MC type of hiatal hernia

A

Sliding

82
Q

Mc primary lung tumor in patients under 16

A

Bronchial carcinoid

83
Q

Bronchiogenic carcinoma

A

Leading cause of cancer related death in the US (20%)
Urban, industrial, cigarettes, inhalants

Small cell (oat)
Non-small cell
84
Q

Nodule and determining whether malignant

A

Increases with age, 3+cm, no calcification, fast growing

Solid, central, laminated, stippled = BENIGN
Anything not those are treated as no Ca++ and malignant till proven otherwise

85
Q

Peripheral lung cancer lesions concerned to be where

A

Lateral to hilum

Better prognosis than central

86
Q

Hamartoma

A

Focal tissue malformation at the organ level
MC benign lung tumor
25-75% stippled pattern

87
Q

Mediastinal widening in a 20-40 year old patient

A

Lymphadenopathy= lymphoma

88
Q

With metastatic bone disease nodules to lungs be calcified or not?

A

Not

89
Q

Pleural mesothelioma

A

Benign local form
Malignant diffuse form (asbestos)
Rarely calcified

90
Q

Tear to a location and appearance on xray

A

Anterior mediastinum with peripheral Ca++

91
Q

Pneumoconiosis vs extrinsic allergic alveolitis

A

Pneumo: lung inflammation due to inhalation of inorganic agents-interstitial bilateral

Due to organic agents (dusts or animals etc)
As symmetrical appears similar to airspace though

92
Q

Unilateral hilar enlargement

A

Bronchiogenic carcinoma

93
Q

Sarcoidosis

A

Bilateral hilar enlargement

94
Q

Where are gallstones seen in the AP and lateral projections

A

AP in RUQ
Anterior to spine in lateral
Only 10-15% have enough ca+ to visualize on xray

95
Q

Pancreatic lithiasis

A

Calculus formation secondary to duct obstruction

MC due to alcohol

Small irregular scattered densities at L1/2 level

96
Q

Hydatid disease

A

Infestation of echinococcus granulosus from sheep, cattle, deer etc. cysts are slow growing

97
Q

Normal structures that calcify

A

Costal cartilage
Pelvic vein thrombosis (phleboliths)
Prostate

98
Q

Calcification of these indicate pathology

A

Pancreases
Vascular
Mesenteric lymph nodes

99
Q

Calcification of these ARE pathology

A 
Renal calculi
Appendix oil this
Bladder calculi
Tear to a
Uterine fibroids
100
Q

tar love or arachnoid cyst

A

Dilations of subarachnoid space surrounding a spinal NR

Chest And Abdomen (1 decks)

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