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Radiology > Lecture 3 thorax > Flashcards

Lecture 3 thorax Flashcards

1
Q

Vetebral heart scale

A

Measure widest and longest part and count vertebral bodies

Normal Dog: 9.7 +/- 0.5

Normal Cat: 7.5 +/- 0.3

Grey hounds and boxers: large hearts 11.6 +/- 0.6

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2
Q

Two primary branches off aortic arch

A
  1. Left subclavian
  2. brachiocephalic trunk
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3
Q

Lazy heart / redundant aortic knob or angular aorta

A
  1. 2 features of geriatric feline thorax
  2. Don’t mistake for lung mass in L. Cranial lung lobe
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4
Q

Interpretation paradigm for cardiac silhouette

A
  1. Is there cardiac enlargement? L, R, or both sides
  2. Is there radiographic evidence of right (pleural effusion) or left sided (pulmonary edema) cardiac failure
  3. Are the peripheral pulmonary arteries or veins enlarged? PA enlarged? PV enlarged? Both?
  4. Are there any lumps or bumps in area of the great vessels on the VD/DV projection (must be straight for accurate interpretation)
  5. Other Roentgen abnormalities associated with the cardiac silhouette?
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5
Q

Left Heart Failure

Pulmonary Edema

A

Dogs

  1. Pulmonary venous enlargement >> unstructured interstitial to alveolar (hilar to caudodorsal distribution)
  2. Both caudal lung lobes or right caudal lung lobe (eccentric mitral valve regurgitant jet)

Cats

  1. Multifocal and asymmetric w/o a specific lung lobe distribution
  2. Unstructured interstitial >> alveolar (same dz but different pattern)
  3. Enlarged pulmonary arteries and veins
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6
Q

Veins

A

Central and ventral

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7
Q

Caudo dorsal distribution of inc opacity

A

Pulmonary edema

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8
Q

Pleural effusion look for

A

Retraction of lung lobes

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9
Q

Falciform ligament

A

Fat on the abdominal side of the diaphragm

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10
Q

Right Atrium and ventrical enlargement

A
  1. Can happen independently
  2. Best viewed on VD
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11
Q

Reverse D (bottom left)

A

Right ventricular enlargement

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12
Q

Right atrial enlargement typical

A

Tricuspid disease

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13
Q

Right ventrical enlargement typical of

A

Pulmonic stenosis

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14
Q

Left atrial enlargement

A
  1. Backpack signs (backpack on top of heart)
  2. Signs of compression of left caudal mainstream bronchus
  3. TRACHEAL ELEVATION
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15
Q

Left to right patent ductus arteriosus: Roentgen signs

A
  1. Left sided cardiomegaly with left atrial and ventricular enlargement
  2. Pulmonary overcirculation with enlargement of both pulmonary arteries and veins
  3. Enlargement of the descending thoracic aorta (= ductus diverticulum)
  4. Enlargement of the main pulmonary artery (+/-)
  5. Left heart failure = pulmonary edema
  6. Tree knuckle sign on VD = classic finding
    - enlargement of the MPA descending thoracic aorta and left auricle
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16
Q

Sub aortic stenosis

A
  1. Often no sig changes
  2. Widening of cranial mediastinum on VD
  3. Elongation of the left ventricle and cardiac apex on VD image (left ventricular hypertrophy
  4. Can get concomittent left atrial enlargement seconadry to mitral valve insufficiency
  5. Left heart failure: Pulmonary Edema
  6. Arrythmias common
  7. Predisposed to bacterial endocarditis of aortic valve
17
Q

Tracheal elevation

A

Left atrial enlargment

18
Q

Pulmonic stenosis

A
  1. Right sided cardiomegaly with right ventricular enlargement
  2. Pulmonary circulation: normal to undercirculated with small pulmonary arteries and veins
  3. Enlargement of the main pulmonary artery (+/-)
  4. Righ heart failure = pleural effusion
  5. Can have normal thoracic rads if mild/moderate stenosis and valvular gradient is not considered significant
19
Q

Peritoneal Pericardial diaphragmatic hernia

A
  1. Generalized cardiomegaly with unusual shape and contour
  2. Normal pulmonary circulation
  3. No enlargement of descending thoracic aorta or main pulmonary artery
  4. Do not present in heart failure
  5. Differential opacities in the cardiac silhouette (fat/gas due to intestinal contents)
  6. Lack of abdomial viscera in cranil abdomen
  7. Dorsal peritoneopericardial mesothelial remnant seen ventral to cauda vena cava in cats
20
Q

Mitral valve degenerative disease

A

Backpack signs and in severe cases dorsal displacement of trachea

  1. L sided cardiomegaly w/ L atrial and ventricular enlargement
    - enlarged main body of left atrium = bowlegged cowboy sign on VD
  2. Left heart failure = pulmonary edema
  3. Enlargement of left auricle when left atrium is moderately enlarged
  4. MV and TV result in generalized cardiomegaly
  5. MPA can be enlarged in cases of chronic elevated pulmonary veins and arteries
21
Q

Dilated cardiomyopathy

A
  1. Left sided cardiomegaly with left atrial and ventricular enlargement
  2. Left heart failure = pulmonary edema
    - can also have pleural effusion. This will effect right ventricle
  3. Enlargement of left auricle when left atrium is moderately enlarged
  4. MV and TV insufficiency can result from annular dilation
  5. In Dobermans, the pulmonary edema can be seen in the accesory lung lobe
    - WIll wipe out the caudal venal cava
    - unstructured interstitial pulmonary pattern to an alveolar pulmonary pattern
22
Q

Heartworm Disease

A
  1. Peripheral pulmonary artery disease (where HWs live)
  2. Enlarged, tortuous, blunted pulmonary arteries; right caudal lung lobe effected first
  3. After pulmonary hypertension => main pulmonary artery and right ventricular enlargement
  4. Enlarged caudal vena cava

=>caval syndrome

  1. RIght heart failure-pleural effusion
23
Q

Pericardial Effusions / Heartbase Tumors

A
  1. Generalized cardiomegaly with ‘globoid’ cardial silhouette on VD/DV
  2. Righ heart failure - pleural effusion and ascites when in cardiac tamponade
  3. Most common cause in dogs is secondary to neoplasia
  4. Right auricular hemangiosarcoma or heartbase chemodectoma are most common tumor types
  5. Pulmonary metastatic disease from these tumor types are possible
24
Q

Cardiomyopathies in cats

Valentine shape heart on VD/DV

A
  1. Change in cardiac shape
    - Particularly caudal border of cardiac silhouette with a ‘bulge’
    - looks like a jalapena pepper vs normal almond
  2. Vantine heart shape on VD/DV consistent with either left atrial or both right and left atrial enlargement
  3. Enlargement of the left ventricle
  4. Pulmonary edema and/or pleural effusion present
  5. Pulmonary edema pattern is multifocal unstructured interstitial to alveolar
25
Q

Hypertrophic cardiomyopathy in cats

extra notes

A
  1. Hypertrophic and restrictive
  2. Alveolar pattern and unstructured pulmonary pattern
  3. Lots of edema
  4. Pulmonary edema in a random multi-focal distribution
    - NOT CAUDODORSAL
  5. heart size can be 3X intercoastal space
26
Q

Microcardia

A
  1. Heart less than 2 intercostal spaces on both lateral and radographs
  2. Widest point of cardiac silhouette on VD less than 40% pleural to pleural diameter at T8
  3. Small pulmonary vasculature
  4. Small caudal vena cava
  5. Seondary to Addison’s dz or any cause of hypovolemia
27
Q

Diseases causing microcardia

A
  1. Addisons
  2. Hit by car
  3. Internal bleeding
  4. Hemangiosarcoma of spleen
28
Q

Decreased lung opacity

A

Hypovolemia

29
Q
A

Canine L heart

30
Q
A

Right heart

31
Q
A

Right sided heart failure

Pleural effusion

33
Q
A

Left to right patent ductus arteriosus

Left sided cardiomegaly with L atrial and ventricular enlargement

Pulmonary overcirculation

  • enlargement of both pulmonary arteries and veins

Enlargement of descending thoracic aorta

  • ductus diverticulum

Classic finding is 3 knuckle sign

34
Q
A

Sub aortic stenosis

often no significa thoracic findings

widening of cranial mediastinum

elongation of the left ventricle and cardiac apex on the ventrodorsal image

35
Q
A

Pulmonic stenosis

Right sided cardiomegaly with right ventricular enlargement

36
Q
A

Peritoneal Pericardial Diaphragmatic hernia

37
Q
A

Dilated cardiomyopathy

Left sided cardiomegaly with left atrial and ventricular enlargement

Left heart failure = pulmonary edema

Radiology (7 decks)

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