Lung Flashcards

1
Q

Lung lesions should be identified on at least _____ orthogonal radiographs.

A

2

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2
Q

What are the predominat radiographic patterns for the lung?

A

B.A.Ni.V.Ui.

Bronchial

Alveolar

Nodular interstitial

Vascular

Unstructured interstitial

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3
Q

What are the types of distribution of lung patterns?

A

The LOCAL LOBAR had a GENERAL warning about DIFFUSE customers having SYMMETRICAL and ASYMMETRICAL intentions in your CRAINAL, CAUDAL, DORSAL AND VENTRAL areas. They have been seen on the HILAR, south CENTRAL, and in the PERIPHERAL subdivisions. It doesn’t matter if you are a UNILATERAL or a BILATERAL.

  1. Local- confined to a single lung lobe
  2. Lobar - lung lobe margin is visible
  3. General- involving all lung lobes
  4. Diffuse (involving 2 or more lobes)
  5. Symmetrical vs. Asymmetrical
  6. Cranial or caudal, dorsal or ventral
  7. Hilar, central, or peripheral
  8. Unilateral vs. Bilateral
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4
Q

Types of lung opacites:

A

Gas, fat/ fluid (check of a line), soft tissue, mineral, or metal

Homogenous (same) or heterogenous (different)

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5
Q

Nodules are described by:

A

Number- solitary, multiple, numerous

Nargination - well-difined or ill-defined

Shape- rounded or irregular

Opacity-soft tissue or mineral

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6
Q

Lung patterns are used to describe the pattern that is PREDOMINATELY affecting the lung AT THAT TIME!! The patterns are:

A

B.A.Ni.V.Ui.

Bronchial

alveolar

Nodular interstitial

vascularture

Unstructured interstitial

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7
Q

6 lung lobes

Bronchopulmonary segments

A

Right cranial
– Right middle
– Right caudal
– Accessory
– Left caudal
– Left cranial
• Cranial part
• Caudal part

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8
Q

What is the conducting zone and respiratory zone of the lung?

A

Bronchovascular bundle (conducting zone)

Pulmonary parenchyma (respiratory zone)

Pulmonary blood vessels

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9
Q

In the primary pulmonary alveolus what is the difference between an interstital patter and an alveolar pattern?

A

LungLobe

Bronchopulmonary segment

– Secondary pulmonary lobule

» Pulmonary acinus

Primary pulmonary lobuleAlveolus

Wall (interstitial pattern)

Space (alveolar pattern)

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10
Q

Where is the “imaging limit” in the lung lobe?

A

LungLobe

Bronchopulmonary segment

– Secondary pulmonary lobule

» Pulmonary acinus Imaging limit

Primary pulmonary lobuleAlveolus

Wall (interstitial pattern)

Space (alveolar pattern)

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11
Q

Which views do you use for cardiac vs. respiratory cases?

A

RLAT and DV Cardiac cases

LLAT and VD Respiratory cases

In small-animals, see lung lesions best in the “up” lung

Other lesions best when placed close to the detector

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12
Q

What are the Principles of Radiographic Interpretation?

A

Assuming proper

Examination

Positioning

Exposure

No superimposition of collar, wet hair, etc.

Breed conformation

Age related changes and body conformation

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13
Q

Pulmonary patterns are a combination of signs which are?

A

Degree of lung expansion–Reduced, normal, or increased

The opacity of the lung–Increased or decreased

Appearance of increased opacity–Alveolar, interstitial, bronchial, vascular

Macroscopic distribution of altered opacity–Cranioventral, diffuse, lobar, focal, etc

Additional signs

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14
Q

Incomplete lung expansion is often considered as only a technical complication, but can also be caused by?

A

Commonly due to normal exhalation

Can be a component of the disease process

Reduced or absent gas exchange

Clue to the underlying pathology

Obscure pathology

Spurious pathology–Cardiomegaly–Increased lung opacity

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15
Q

Some signs of incomplete lung expansion are?

A

Decreased lung size

Increased opacity Lobar sign Crowding of ribs

Air bronchogram sign Positive silhouette sign

Poorly defined margins of vessels Mediastinal shift (toward collapse)

Crowding and reorientation of pulmonary blood vessels

Compensatory hyperinflation

Bronchial rearrangement

Cardiac rotation

Displacement of diaphragm

Rounded pulmonary margins

Displacement of pleural fissures

Changed location of abnormal structures

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16
Q

What is the difference between anectasis vs. atelectasis vs. collapse?

A

Anectasis-Lungs never expanded

Atelectasis-Lungs previously expanded then collapsed

Collapse-Same as atelectasis, but often used when more severe

Less severity may be indicated by “partial collapse”

17
Q

Atelectasis or Collapse is related to the physiology of lung expansion. What are those components?

A

Related to physiology of lung expansion

Elasticity

Compliance

Airway patency

Surface tension

18
Q

What is Relaxation Atelectasis and what causes it?

A

Exhalation

Pleural fluid

100% oxygen

Pneumothorax

Shallow breathing

Gravity dependent

Space-occupying lesion

19
Q

What is Obstructive Atelectasis and what can cause it?

A

Lung not expanded due to absorption of alveolar gas without replacement due to airway obstruction

Infectious bronchitis or pneumonia

Mucous plugging (eg, asthma)

Ciliary dyskinesia

Foreign body

Neoplasm

20
Q

What is Cicatrizing Atelectasis and what causes it?

A

Lungs do not increase in volume under normal respiration due to reduced compliance

Chronic immune-mediated lung disease

Chronic idiopathic fibrosis

Radiation pneumonitis

Chronic pneumonia

21
Q

What is Adhesive Atelectasis and what causes it?

A

Lungs do not expand due to lumen surfaces of alveoli sticking from surfactant abnormality

Neonatal respiratory distress syndrome

Acute respiratory distress syndrome

Pulmonary thrombosis

(Surfactants (surface active agents) are compounds that lower the surface tension between two liquids or between a liquid and solid. Surfactants may act as detergents, wetting agents, emulsifiers, foaming agents, and dispersants.)

22
Q

What is Hypoxic Vasoconstriction and what causes it?

A

Pulmonary InflammationIncreased vasodilation

Perfusion to non-ventilated lung

V/Q mismatch

Zone 1: V>Q Hypotension Hyperexpanded alveoli

Zone 2: V=Q Normotensive Normally expanded

Zone 3: V<q></q>

V < Q

Decreased oxygen saturation

“Functional R-L shunt”

23
Q

What is the goal of Ventilation and Perfusion and what is it effected by?

A

Goal is to match ventilation of air (V) with the perfusion of blood flow (Q) to the lung

Ventilation perfusion quotient (V/Q) is the amount of air that is breathed in and perfused into the blood

V/Q affected by-Gravity, Normal physiology, Disease

  • Apex: V/Q = 3 (wasted ventilation); intraplerual pressure most negative
  • Base: V/Q = 0.6 (wasted perfusion); intrapleural pressure least negative
  • Both ventilation & perfusion are greater at the base of the lung than the apex
24
Q

Appearance of Increased Lung Opacity are?

A

Classic description

Interstitial pattern

-Unstructured-Structured-Nodular-Reticular

Alveolar pattern- Alveolar

-Alveolointerstitial-Airspace

Bronchial pattern

Vascular pattern

Mixed pattern

Variable terminology Bronchial

  • Bronchointerstitial

—Peribronchial

Vascular

  • Bronchovascular
25
Q

Lung Fields should look like?

A

Basically, lungs are evaluated for the presence of fluid and air**. Radiographically, air is black. A **normal lung field has a black background with soft tissue structures (vessels) passing through it. Lungs must be evaluated for an increase or decrease in the radiopacity of the parenchyma. These changes can be generalised or localised, diffuse or focal. The two sides of the thorax must be compared in a DV view; they should be of equal opacity. There are four lobes on the right - cranial, middle, caudal, and accessory. There are two left lung lobes - cranial and caudal. The left cranial lobe is further divided into cranial and caudal components.
If an animal is dyspnoeic, do not compromise respiration further by taking a VD view; instead take a DV.

26
Q

What are the 3 areas of the lungs?

Explain the “directions” of the lungs (cranial, caudal, dorsal, ventral)

A
  1. Hilar- near the carina and includes the heart, origins of the major blood vessels and primary bronchi
  2. Central or (middle) which includes visiblepulmonary vessels and larger lobar bronchi
  3. Peripheral area at the lungs edges whre there is mostly air and vascular and bronchial markings fade.

Cranial= toward head

Caudal= toward diaphragm

Dorsal = above trachea

Ventral = below trachea

27
Q

How many lung lobes in the dog and cat?

A

Six

Right: 4 lobes (cranial, middle, caudal, accessory)

Left: 2 lobes (cranial with cranial and caudal segments and caudal)