Lecture 1 Thorax Flashcards
Left lateral at inspiration diaphragmatic crura:
at expiration:
come back to T12/T13
Caudal dorsal vasculature visible, and visible radioluscent triangle of accesory lung lobe.
T11
Right lateral at inspiration diaphragmatic crura:
At expiration:
Come back to T13 / L1
T11 / T12
Appearance of viscera in R lateral recumbency in cats and small breed dogs:
Heart: Egg-shaped, pointed apex
Diaphragmatic crura: parallel each other
Cranial lobar pulmonary vasculature crisscross
Will see pathology from L side better (opposite from down side)
Left Lateral radiograph visceral orientation:
Heart: more oval
Diaphragmatic crura diverge
Caudal vena cava seen passing by dependant crus
Cranial lung lobe vasculatrue (R and L) are parallel
Ventral dorsal radiograph visceral orientation
Heart enlongated
Gap between apex of heart and diaphragmatic cuppula
Dorsal ventral radiograph visceral orientation:
Overlap between heart and diapragm
Spondelosis deformans
ventral and lateral osseous proliferation which is a degenerative change of intervertebral disk space,
anatomic variance
perioarticular osteophytes common at
Caudal portion of glenohumoral joint
costochondral changes
oval shape mineral opacities
Brachyocephalic breeds commonly have
Vertebral abnormalities, fusions, spina bifida, transitional segments
Pleural changes
Pleural thickening = fibrosis
Pleural fissure line along cardiac silhouette in left lateral recumbancy
Cats frequently get
Right middle lung lobe
Usually associated with asthma
Batwing something….
Age related anatomic variance in cats
cardiac silhouette lays down along sternum (lazy heart syndrome)
Aortic arch may become elongated and creatate a knob next to heart
Enlargement of pulmonary arteries
Chondrodystrophic dogs and pleural signs
Added soft tissue opacity medial to pleural space on DV or VD rads
Costochondral junction juts into thorax
Analyzing pleural signs
Is it:
Normal anatomic variant?
Secondary to pathological change?
Young animals
Thymus (Sail sign VD) in front of heart in lateral
Open physes
Dorsal aspect of mediastinum:
Ventral aspect of mediastinum:
Dorsal: all our structures: esophagus, trachea, etc
Ventral: Thymus and Sternal lymph nodes
Fat deposition dog:
Fissure between right cranial and right middle lung lobes
Widening of cranial mediastinum
Ventrally in pleural space
Fat deposition in cats:
Subpericardial and pleural position (different opacity of heart still can distinguish except with lypoma I think)
Geriatric canine changes
Osteomas / osseous metaplasia in subparietal places (also common in shelties and collies)
Pulmonary fibrosis
Bronchial wall changes: airways mineralized and easy to see (age or cushings related)
Plate-like Atelectasis
Sub lumbar fissures, lateral recumbency
Not clinically relevant
Focal area of atelectasis
Esophageal changes
Gas: brachiocephalics and sharpes (comma shaped gas patterned ventral to trachea) - called a reductant esophagus
Usually esophagus is not seen in rads
Hiatal hernia
Hiatuses
Aortic: most dorsal
Esophagus: in middle, usually not seen
Caval: most ventral
Trachea variants
- hump with neck flexed
- redundant dorsal tracheal membrane
Humanoid position
To see cranial lung fields better
Pneumoperitoneum
Gas behind the diaphragm
Radioluscent spots
Also able to see caudal aspect of diaphragm
Means rupture of hollow viscous = sx emergency
Indication of wonkiness in abdomen
enlargement of the sternal lympth nodes
Traumatic diaphragmatic rupture
Hyperinflation / lower airway trapping
Aggressive osseous lesions
Dont forget scapula
Look for lysis, zone of transition, cortical continuity
Discospondelytis
Narrowing, lysis and sclerosis
Seen with systemic aspergillis (german shepherds)
Also possible in endosternebral disk spaces
Pleural space
Between parietal pleura and visceral pleura
Pleural space not seen radiographically
Fluid, gas, masses, diaphragmatic rupture, extrapleural sign….?
Pleural effusion
abnormal accumulation of fluid in pleural space
Radiopaqueness displacing lungs
Large volume causes border effacement
Pneumothorax
Raduioluscency displacing lungs and creeping into fissures
Retraction of cardiac silhouette
Be wary of skin folds and overexposure…can fake a pneumo
abnormalities to asses (big questions):
- Pneumoperitoneum?
- Abnormalities associated with the stomach or liver?
- Any osseous aggressive lesions?
- Soft tissues (neck)?
- Rib lesions? Easiest to miss.
- Pleural effusions
- Pleural mass
- Plueral gas
- Diaphragmatic rupture
- Is there an extra pleural sign?
Caudal Vena Cava goes into
Right diaphragmatic crus
Moderate Pleural effusion
Border effacement
Pleural fissures lines-specific locations
Retraction of lung lobes by fluid
Triangular appearance to the lung lobes
Pleural effusion more opaque than the lung lobes
Severe Effusion
Border effacement
More severe retraction of the lung lobes
Atelectasis of lung lobes
Widening of pleural fissures
Pleural effusion Etiologies
Transudate-low cells and protein
Modified translated-mild to moderate elevation in cells or protein
Exudate-elevation in cell numbers and protein
Repeat radiographs after therapeutic and dx thoracocentesis
Chronic effusions
Chylothorax, neoplastic effusion, diaphragmatic rupture, lung lobe torsion
Rounding of lung lobe
Pleural peel
