Katz - Respiratory Tract Imaging Flashcards
Identify
Streptococcus pneumoniae
Identify
Staphylococcus aureus
Identify
Klebsiella Pneumonia
Bulging fissure sign
Identify
Aspiration pneumonia
When recumbent (alcoholic) aspiration usually occurs into the superior segments of the lower lobes or the posterior segment of the upper lobes.
Right side is more often effected.
Identify
Interstitial pneumonia
Viral pneumonia - Mycoplasms pneumoniae and Pneumocystic jiroveci (PCP - old name)
Identify
Mycoplasma Pneumonia
Identify
Cavitary pneumonia
Mycobacterium tuberculosis
Reactivation tuberculosis
Cavities in upper lobes, thin walled and no air-fluid level
Identify
Ghon lesion
Calcified tuberculous granuloma
Identify
Ranke complex
When associated with a calcified ipsilateral hilar node
Identify
Pneumothorax
Air enters the pleural space
Lung collapses
thin white line outlined by air on both sides
Identify
Upper Lobe Bullous emphysema
Identify
Scapula
Identify
Tension pneumothorax
Loss of air into the pleural space
May cause a shift of the heart and mediastinal structures away from the side of the pneumothorax
Identify
Right pneumothorax
Causes: spontaneous - rupture from bleb
Traumatic
Diseases that stiffen the lung
Identify
Spontaneous pneumothorax
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RDS Pneumothorax
Respiratory Distress Syndrome
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Trauma pneumothorax
Identify
Pneumomediastinum
Newborn
Presence of extraluminal gas within the mediastinum
Identify
Pneumopericardium
Adults - penetrating injury or surgery
Pediatrics - not related to penetrating injury; genetic
Identify
Subcutaneous Emphysema
Air expands into the soft tissue of the neck, chest and abdominal walls.
Identify
Pneumomediastinum with subcutaneous emphysema
Retrosternal chest pain and Hx of bronchial asthma
Identify
Which lobe?
Adenocarcinoma
LUL?
Distinguish between a nodule and a mass.
Nodule is usually less than 3 cm while a mass is greater than 3 cm.
Identify
Granuloma
Identify
Cavitary Bronchogenic carcinoma
Squamous cell CA
(84 year old with chronic cough)
Identify
Adenocarcinoma
Usually peripheral location
Includes bronchoalveolar cell carcinoma
Identify
Squamous Cell Carcinoma
Usually central location
Identify
Small Cell Carcinoma
Usually central location (like Squamous)
Identify
Pancoast Tumor
Horner Syndrome
Meiosis
Ptosis
Anhydrosis
Identify
Adenocarcinoma of the lung with mets
Hilar lymphadenopathy
Identify
Large right pleural effusion
Malignant effusion
Identify
Metastatic Neoplasm of the lung
Lymphangitic spread
Unilateral
Identify
Metastatic Neoplasms of the Lung
Hematogenous
Multiple nodules
Traveled through the bloodstream from distant primary site
Ex) Colorectal, renal, breast
Identify
Anterior Compartment (note how anterior curves up)
Middle Compartment
Posterior Compartment
Identify
Substernal Thyroid Mass
Only one that displaces the trachea
Identify
Lymphoma
Multiple lobulated masses
May be in other compartments
Identify
Thymoma
Associated with Myasthenia Gravis
Identify
Teratoma
Contains fat, cartilage and possibly bone on CT
Identify
Middle mediastinal lymphadenopathy
Contains the heart, the origins of the great vessels, trachea, and main bronchi
Most common mass in this compartment
Middle Mediastinal Masses
Identify
Neurofibroma
Tumors of Neural origin
Posterior Mediastinal Mass
Identify
Lung Abscess
Thick cavity wall
Smooth inner margin
Air Fluid level
Identify
Normal Endotracheal Tubes
Tip should be 3-5 cm above carina
Between clavicles and carin
Carina at T4
Balloon should never extend tracheal walls
Where is the most common misplacement for an endotracheal tube?
Right mainstem bronchus
Leads to atelectasis
Can damage vocal chords or cause aspiration
Identify
Overinflated cuff on an Endotracheal Tube
Balloon should never distend walls
Identify
High endotracheal tube
Tip should be 3-5 cm above carina
Between clavicles and carina
Carina at T4
Identify
Tracheostomy
Tip half-way between stoma and carina
T3
Not affected by flexion or extension
2/3 width of trachea
Long term : tracheal stenosis
Identify
Normal Central Venous Catheter
Tip should be in SVC (malpositioned in RA or Int Jug)
Subclavian joins brachiocephalic vein behind edial end of clavicle
Catheter should reach this point before descending
Catheter should descend lateral to spine
Identify
Central Venous Catheter
Internal jugular malplacement
Identify
Central Venous Catheter
Complication: Arterial placement
- suggested by pulsatile flow
Identify
PICC line
Right Atrial Malplacement
Should be in SVC
Identify
Pulmonary Artery Catheter
Swan-Ganz catheter
Same appearance of central venous lines but longer
2cm from hilum
Aid in differentiating cardiac from non-cardiac pulmonary edema
Identify
Abnormal Position of Swan-Ganz
Tip too peripheral toward the right pulmonary artery
Should lie within 2 cm of hilar shadow
Identify
Pleural drainage tubes
Anterosuperior for pneumothorax
Posteriorinferior for effusion
*None of the sideholes should lie outside the thoracic wall*
Identify
Abnormal Pleural drainage tube
Side hole outside thoracic wall
Identify
Correctly positioned pacemaker
Tip positioned at apex of right ventricle
Should have gentle curves
Identify
Fractured pacemaker lead
Identify
Nasogastric tube
Should extend into the stomach and be at least 10 cm into the EG junctions
Identify
Feeding tube
- should lie in region of duodenal bulb
Ideally in duodenum
Where is the desired position of the ETT?
Tip 3-5 cm from carina
Where is the desired position of the Tracheostomy tube tip?
Half way between stoma and carina
Where is the desired position of the central venous catheter?
Tip in SVC
Where is the desired position of the PICC line?
Tip in SVC
Where is the desired position of the Swan-Ganz catheter?
Tip in proximal R or L pulmonary artery
Where is the desired position of the Pleural drainage tube?
Anterosuperior for PTX
Posteriorinferior for effusion
Where is the desired position of the Pacemaker?
Tip at apex of r ventricle
Where is the desired position of the NG?
Tip in stomach
