Midterm/ Quiz 2 Flashcards
Real-Time Tomographic View of the Heart in Longitudinal and Transverse Planes that is good for assessing Masses, Valvular Abonormalities, Pericaridal Effusion and Septal Defects
B-Mode
*Blood will be a Black Color and the Walls of the Heart will be a Shade of Grey
Which View of an Echocardiogram is this, that is used to look at the Aorta and Left Atrium?
Right Parasternal Short Axis (B) View
What Measurement are we Taking in this Echocardiogram on the Right Side of the Patient?
M-Mode
*M-Mode is taken on the Right Side of the Patient and should Go through a Symmetrical Left Ventricle
*M-Mode is used for Cardiac Measurements and Fractional Shortening
Picture: Blood is Anechoic (Black) and represents the Ventricles, while the Grey Areas will be the Ventricular Walls
*Diagnose Heart Disease- Echocardiography
*Diagnose Heart Failure-Thoracic Radiograph (Cardiogenic Edema)
The Mediastinum has _____ Opacity
Soft Tissue
Free Gas in the Mediastinum, which May Progress to Pneumothorax
Pneumomediastinum
*The Mediastinum is Not a Closed Cavity, it has an Opening Cranially and Caudally at the Neck and Retroperitoneal Spacce
_*_Ex. If the Patient has a Neck Injury they can have Air Dissecting into the Mediastinum
*Pneumomediastinum can Cause a Pneumothorax, but a Pneumothorax can never cause a Pneumomediastinum
Persistant Right Fourth Aortic Arch commonly Leads to _____, that Constricts the Esophagus at the Heart-Base that May Result in Sacculations or Diverticulum of the Oral Part of the Esophagus as well as Generalized Megaesophagus
Vascular Ring Anomaly
*Constriction of the Esophagus at the Heart Base- Characteristic of Vascular Ring Anomaly
*Occurs in Young animals when they are switching from Liquid Food to Solid Food
Fat
What is Detected in This Radiograph?
Pleural Fissure Lines
On CT, Will the Ventral Dorsal or Dorsal Ventral View of Pleural Effusion Cause Cardiac Silouhetting Faster?
Dorsal Ventral
*In Dorsal Ventral View, you only need a small Amount of Pleural Fluid before Cardiac Silouhetting Occurs
*In the Ventral Dorsal View you need a Significant Amount of Pleural Fluid before Sillouhetting Occurs
What is Occuring in this Radiograph?
Moderate Pleural Effusion
*Retracted Lung Lobes and Pleural Fissure Lines
*Photo- In Ventral Dorsal View, the Heart is More Visible. In Dorsal Ventral View, you CANNOT see the Heart
What is this Radiograph of a Patient with Tension Pneumothorax showing?
Tenting of Diaphragm
True/False: This is a Radiograph of a Pneumothorax
False
*This is Volume Depletion- The Cardiac Silhouette is not Touching the Sternum because the Heart is Small, not because there is Gas within the Space. You can still see Pulmonary Blood Vessels and Bronchi in the Space between the Heart and the Thoracic Wall
Left Lateral
*Caudal Vena Cava crosses over the Cranial Crus and Enters the Caudal Crus. Caudal Vena Cava always enters the Right Crus
What is the Best Radiographic View for seeing the Pharynx and Larynx?
Lateral View
*In the VD View, most structures are Superimposed
Which Lung Pattern is seen in the Radiograph Below?
Bronchial Pattern
*Donut Shape
Right Pulmonary Artery
*The Left Pulmonary Artery and Vein is Always DORSAL to the Right Pulmonary Artery and Vein
*“X” in the Photo shows where the Bronchus is- Between the Vein and Artery
Atelectasis leads to an Increased Soft Tissue Opacity and Decreased Size of the Lung Lobe, while Consolidation leads to Increased Soft Tissue Opacity and ____ Size of the Lung Lobe
Normal
*Consolidation- The Heart stays in the Normal Position
This is a Radiograph of :
A. Lung Consolidation
B. Lung Atelectasis
B. Lung Atelectasis
*Heart is Not in the Normal Position
With Echocardiology, we use a ____ Frequency Transducer because we need to Penetrate Deeper Tissues
Lower
*3.0-5.0 MHz for Large Dogs
5.0-7.5 MHz for Small Dogs
*If you have a _Sector Transduce_r in your Clinic, it will most likely be used for Echocardiology and will have Lower Frequencies
What Thoracic Wall Lesion is this Radiograph Depicting?
Body Wall Hernia
*Intestinal Loops Herniating into the Subcutaneous Tissue
Area Between the Accesory and Left Caudal Lobes that is only seen in Dorsal Ventral/Ventral Dorsal Views
Caudoventral Mediastinal Reflection
*Arrow is Pointing at the Caudoventral Mediastinum
What is the Arrow Pointing to in this Radiograph?
Basihyoid Bone
*Can be Easily Confused with a Foreign Body
What is the Pathology in this Radiograph, leading to Displacement and Compression of the Trachea
Heart Base Tumor
2. Right Middle Lung Lobe
B. False
*You want to take a Left-Right Lateral, where the Right side of the Horse is near the Cassette
Mode of Echocardiography where only Structures associated with the Cursor will be Scanned that is used for measurement of Wall Thickenss, Chamber Size, and Valve Movement Pattern
M-Mode
*Only Records what is Occuring over the “Line”
*2-3 Measurments should be Taken
*The Right and Left Ventricles will Appear Anechoic (Black), while the Ventricular Walls will appear Grey
In the ____ Lateral View of the Diaphragm you See:
1. Left Crus is more Cranial
2. Caudal Vena Cava Crosses Over Cranial Crus and Enters Caudal One
3. Crura are Divergent
Left
*In Left Lateral, the Right Crus is Caudal
*The Left Crus is Cranially Positioned when the Animal is in Left Lateral
What is the Pathology in this Radiograph of a Horse?
No Pathology
*This is a Normal Thoracic Radiograph in a Horse
*Red Triangle- Very Important in a Horse- This would be the First place that Bronchopneumonia would Manifest and you would loose the Triangular Radiolucency- Area between the Caudal Vena Cava, Diaphram and Cardiac Silhouette
What is the Diagnosis based on this Radiograph on a Horse?
Bronchopneumonia
*Don’t see the Opaque Triangle like you Should
A. Detected
*Normally cannot see all those Blood Vessels
Pleural Disease Characterized by Fluid in the Pleural Space
Pleural Effusion
Review of Echocardiology
*We Begin Echocardiology on the Right Side with the Patient in Lateral Recumbancy
What Reading would you Expect from this Spectral Doppler Image?
(assuming the Patient has no Heart Problems)
Above the Baseline
*Blood is Flowing Towards the Transducer
In ____ Lateral View of the Diaphragm you See:
1. Right Crus is more Cranial
2. Caudal Vena Cava enters most Cranial Crus (1st Crus)
3. Crura are more Parallel
Right
*Caudal Vena Cava goes to the Right Crus- Enters the Cranial Aspect of the Diaphragm
*In Right Lateral the Vena Cava Sillouhettes with the Diaphragm
*Right Crus is Cranial when the Animal is in Right Lateral
Part of the Body that Consists of Two Layers of Mediastinal Pleura with a Space Between them that Communicates with the Neck Cranially and the Retroperitoneal Space Caudally
Mediastinum
*Fenestrated- Unilateral Disease is Uncommon
*If you get Unilateral Diease- It is Diagnostic for Pleural Effusion with Thicker Fluid (Ex. Pus)
Which is Incorrect about Perparation for Echocardiography:
A. Quiet Patient is Best
B. Sedation is Preferred
C. Begin in Right Lateral Recumbancy
D. Gel or Alcohol applied Liberally
B. Sedation is Preferred
*Sedation is AVOIDED due to Cardiovascular Changes
*We Start on the Right Side with Echocardiology
What pathology can be Seen in this Radiograph of the Trachea?
Tracheoesophageal Stripe Sign
*There must be Gas within the Esophagus
These are Characteristics of _____ Lung Pattern:
- Air Bronchograms
- Border Effacement (Silhouette)
- Lobar Distribution
- Labile
Alveolar
*Lobar Distribution- More likely to Involve just One Lobe
* Labile- Changes Quickly Over Time
*Air Bronchogram- Air in the Bronchi, but no longer in the Alveoli
Lung Pattern characterized by Inflammed Interstium leading to Soft Tissue Nodules and Haziness of the Radiograph
Structured Interstitial Pattern
*Top Differential- Metastasis
When Evaluating a Lesion in the Left Lung of a Horse, what View Radiograph would be Best?
Right-Left Lateral
*Lesion Detail in Adult Horses is Optimized by Placing the Lesion closer to the Cassette (opposite of Small Animal)
Which One of These Radiographs Depicts a Thoracic Wall Mass?
Left Photograph- Extrapleural Lesion (Thoracic Wall)
*Photograph A- Depicts an Intrapulmonary Lesion within the Lungs
*Extrapleural Sign- When you see the Mass Pushing the Thoracic Wall Pleura, that Indicates that the Mass is Coming from Inside the Thoracic Wall, and not within the Lungs
In the _____ View of the Diaphragm, the animal is Positioned in Dorsal Recumbancy and the Abdominal Contents fall into the Crura leading to Three Arches in the Diaphragm
Ventral Dorsal
*In Ventral Dorsal you May Detect 1,2, or 3 Dome Shaped Structures associated with the Diaphragm
Lung Pattern that is Normally only seen in Main stem Bronchi, but Smaller Bronchi become Visible with Mineralization and Cellular or Fluid Infiltration
Bronchial Pattern
*Only seen with Mineralization and Cellular/Fluid Infiltration
*Characterized by Ring Shadows (Donuts) and Tram Lines
What is the Pathology in this Radiograph of the Trachea?
Mass Lesion (Thyroid Mass)
*Trachea is Displaced to the Left Side of the Mediastinum- Trachea should be on the Right Side of the Mediastinum
Condition where Abdominal Viscera Protrudes through the Diaphragm, where the Most Common Cause is Trauma (Ex. Hit by Car)
Diaphragmantic Hernia
*May or May not result in Clinical Signs- Dyspnea, Abdominal Pain, Vomiting ect.
*Photo- Soft Tissue Opacity in the Thorax- Abdominal Contents that we are seeing in the Thoracic Cavity. The Lungs are displaced Dorsally by the Soft Tissue Opacity. Stomach is Displaced more Cranially than Normal
Technique Valuable for Assessing Esophageal Function and Structure that is Indicated in Patients with Regurgitation, Dysphagia, and Survey Radiographic Findings
Esophagram
*Must Select a Contrast agent that will Adhere to Mucosa and be Safe for the Patient
*Photo- Normal Canine Esophagram
What Lung Pattern is Occuring in this Radiograph?
Alveolar Pattern
*You cannot See the Cardiac Silhoutte- Only Lung Pattern that Leads to Border Effacement of the Heart
*Normal Blood flow should Travel from Left Atrium to the Left Ventricle- Towards the Transducer- Should be Above the Baseline
*Major Blood flow going in the Opposite Direction- Blood is Traveling Away from the Transducer from the Left Ventricle to the Left Atrium- Mitral Valve Insufficiency
What Abormality in this Radiograph is Causing the Marked Tracheal Displacement and Esophageal Enlargment around the Heart Base?
Vascular Ring Anomaly
*Kinked/Focal Depression of the Trachea
What Disease is Shown in this Radiograph of the Cranioventral Mediastinum?
Sternal Lymphadenopathy
Persistant Focal Narrowing with Dilation of the Oral Portion of the Esophagus that is Easily Demonstrated with Contrast Radiography
Esophageal Strictures
*Narrowing of the Lumen where only a Small amount of Contrast Passes Through
*Marked Dilation will Occur Orally to the Stricture. Stricture will be Aboral to the Dilation
Pleural ______ Lines- The Pleural Regions between Lung Lobes
Fissure
*Pleural Fissure Lines Vary with the Amount of Fluid Present and Alignment of Normal Pleura with X-Ray Beam
What Lung Pattern are we Seeing in this Radiograph?
Alveolar Pattern
*Soft Tissue Opacity- Only pattern that causes Soft Tissue Opacity
True
What View is this Echocardiogram?
Right Parasternal Long Axis View
*In Right Sternal the Right Side of the Heart will be at the Top of the Echocardiogram
*Great View for Looking at the Mitral Valves
What Structure is Outlined by the Purple Circle?
Carina of Trachea
*The Trachea should Run Straight
*Photo- This is what a Normal Trachea Looks Like
Lung Pattern Characterized by Air in the Bronchus and Fluid in the Alveoli, where the Bronchus stands out very Easily
Alveolar Pattern
In Standardized Echocardiography, we Start from the ____ Hand Side and do a 2D-Orientation and Morphology as well as Pulmonary Valve Flow Dynamic
Right
*The Only doppler Measurement done on the Right Side of the Animal is the Pumonary Valve Flow Dynamic
Usual Sites for _____ Include:
Thoracic Inlet
Heart Base
Esophageal Hiatus
Foreign Bodies
*Foreign Bodies are of Variable Opacities
What is the Pathology in this Radiograph of the Laryngeal Area?
Retropharyngeal Abscess
*Compression of the Trachea
Which Lung Pattern is present in this Radiograph?
Alveolar Pattern
*Air Bronchograms and Soft Tissue Opacity are Present
What is Detected in this Radiograph?
Pleural Fissure Lines
*Soft Tissue Opacity- Fluid within the Pleural Cavity- Pleural Effusion
Pick the Standard Protocal for Echocardiography:
A. Right Side- 2 Long Axis Views
B. Right Side- 4 Short Axis Views
C. Left Side- 2 Long Axis Views
All of the Above should be Done in Standard Echocardiography
Radiographic Signs of _____ Include:
Abdominal Viscera in Pleural Space
Displacement of Abdominal Structures
Displacement of Thoracic Structures
Pleural Fluid
Traumatic Diaphragmatic Hernia
Causes of ______ Include:
Air Escaping from Lung along Pleural Planes
Neck Trauma
Retroperitoneal Space Trauma
Rupture of Cervical Trachea or Esophagus
Pneumomediastinum
This is a Radiograph of :
A. Lung Consolidation
B. Lung Atelectasis
A. Lung Consolidation
*Heart is in the Normal Position
*Red Outline shows the “Lobar Sign” associated with Alveolar Pattern
What can be Diagnosed in this Radiograph?
Generalized Megaesophagus
*Trachea is Depressed Ventrally
The Cuadal Vena Cava enters the ____ Crus
Right
*Cuadal Vena Cava enters the Right Side of the Diaphragm
What is Most Likely Causing the Dorsal Displacement of the Trachea and Soft Tissue Opacity on this Radiograph?
Pleural Effusion with Mediastinal Mass
*The Pleural Effusion is Most Likely Hiding the Mediastinal Mass, but you can see Accentuated Soft Tissue opacity near the Mediastinal Space- Highly Suspicious that there is a Mediastinal Mass Hinding under the Pleural Fluid
What Pathology is occuring in this Radiograph leading to a Kink in the Trachea?
Persistant Right Aortic Arch
*This is very Diagnostic for PRAA
Are these Masses located in the Mediastinum or in the Lung?
Lung
*These Lesions are Not Located Near the Mediastinum
*There are No Extrapleural Signs- No Pushing on the Pleura, Therefore it is Intrapulmonary
_________ Leads to Gas Contrast in the Mediastinum allowing for Visualization of the Cranial Vena Cava, Brachiocephalic Trunk, Left Subclavian Artery, And Esophagus
Pneumomediastinum
* These Structures are Not Visible on Normal Radiograph of the Thorax, but in a Patient with Pneumomediastium, you will be able to Visualize these structures due to the Gas Contrast
*In Normal Animals, you should not be able to See These Structures
Best Radiographic View to see the Pulmonary Artery, Pulmonary Vein and Bronchus
Left Lateral
*Veins are Ventral and Central- In the Lateral View, the Vein will be Ventral
Mediastinal Mass that Gives a “Bow-legged Cowboy Sign” on Dorsal Ventral View because Enlargment of this Lymph Node Results in Displacement of the Principle Bronchi Laterally and a Curved Appearance
Tracheobronchial Lymph Nodes
Two Routinely Used Right Parasternal Short Axis Views on Echocardiography
B and E
What can be Diagnosed on this Radiograph?
Pneumothorax
*Everything between the Retracted Lung Lobe and the Thoracic Wall is a Gas Opacity. You can tell that the Space is not Lung, because you can’t see any Blood Vessels or Bronchi
Radiographic Signs of _____ occur when the Esophagus is Dilated Along its Entire Length but Prominent in Mediastinum, where the Esophagus may be Filled with Gas, Fluid or Ingesta
Generalized Megaesophagus
*Horizontal Beam Radiography may Demonstrate Fluid in the Esophagus
The Left Pulmonary Artery is always more ____ than the Right Pulmonary Artery, Regardless of Radiographic View
Dorsal
*The Bronchus is always accompanied by an Artery and Vein- Triad
What Abnormalitity is seen within the Red Circle?
Tracheoesophageal Stripe Sign
What Thoraic Wall Lesion is this Radiograph Depicting
Subcutaneous Emphysema
*Gas build up underneath the Skin
In Doppler Echocardiology, you want to Maintain the Angle at Less than ____ Degrees in order to Ensure an Error of less than 10%
22 Degrees
*If the Angle is Greater than 22 Degrees, the Error will be Greater than 10% (Substantial Error)
In the _____ View of the Diaphragm the Abdominal Contents Fall Sternally leading to Only One Bulge on Radiograph
Dorsal Ventral
Caudal Lung Lobe Pulmonary Blood Vessels are Better seen in _____ View
Dorsal Ventral
*Veins are Ventral and Central- In the DV View, the Vein will be Central
What can be Diagnosed in this Radiograph?
Pneumothorax
*Loss of Sternal Contact- Normally the Cardiac Silhoutte is Touching the Sternum. If the Heart appears to be “Floating” that is Diagnostic for Pneumothorax
*Photo- The White arrows are Pointing to the Lung Margins- In Pneumothorax, the Lungs are Compressed and become more Solid and Opaque
A _____ Transducer is used for Echocardiology because it Penetrates the Intercoastal Spaces and Can be Turned Around
Sector
*Pie Shaped
Detected
*Soft Tissue Opacity- No cardiac Sillhouette. Can see Air Bronchograms
Gold Standard Test for Thoracic Neoplastic Metastasis
CT
*Best test to Detect Metastasis- Gold Standard for Metastasis
Sign that Indicates Gas in the Esophagus
Tracheoesophageal Stripe Sign
*Ventral Wall of the Esophagus and Dorsal Wall of the Trachea will Shilouette causing the Tracheoesophageal Stripe Sign
Congenital Abnormality Characterized by:
Round Cardiac Silhouette
Heterogenous Opacity of Cardiac Silouette
Silhouetting of Heart and Diaphragm
Peritoneopericardial Diaphragmatic Hernia (PPDH)
*This is not an Enlarged Heart- The Opacity Surrounding the Heart is Fat. There Falciform Fat Herniated into the Peritoneal Pericardial Sac
*Confined to the Cardiac Silhouette- Otherwise it would be a Diaphragmatic Hernia
Most Commonly, only the Most Ventral portion of the Diaphragm is Detected as it is adjacent to the ______
Falciform Ligament
*Falciform Ligment Contains Fat
Which of the Following is Done on the Right Side in Echocardiology:
A. 2D Orientation and Morphology
B. M-Mode
C. Doppler Evaluation of Pulmonary Valves
D. All of the Above
D. All of the Above
*Only Valve we look at on the Right Side- Pulmonary Valve
____ is a Common Cause of Unilateral Distributions of Pleural Effusions
Pyothorax
In _____, Lung Lesions are Best Detected in the Lung Closest to the Cassette because Lesions in the “Far” Lung are Distorted due to Magnification
Large Animals
*Opposite Principle for Small Animals
What Pathology can be Seen in this Radiograph of the Larynx?
Fractured Hyoid Apparatus
*Dog Bite was the Cause
What is the Pathology in this Radiograph of the Trachea?
Mass Lesion
*Trachea is Displaced Ventrally- Trachea is Indented
What is Detected in this Radiograph?
Pleural Effusion
*Cannot See Cardiac Sillhouette
*Red Lines show Retracted Lung Lobes. Everything Ventral to the Lines is Pleural Effusion
True/False: This Radiograph demonstrates Tracheal Collapse
False
*Either Draping Esophagus or Redundant Trachealis Doralis Membrane causing Soft Tissue Opacity within the Trachea, However the Trachea is NOT Collapsed
Which Congenital Abnormality is this?
Peritoneopericardial Diaphragmatic Hernia
*Silouetting of the Heart and Diaphragm
*Fat Herniating into the Pericardial Sac
Sign that is Seen in the Ventral Dorsal View when the Enlarged Esophagus is Gas Filled, the Left and Right Walls of the Esophagus are sometimes Visible as Two Soft Tissue Stripes that Covers the Esophageal Hiatus of the Diaphragm
“V” Sign
*Two Convering Soft tissue Lines form a V at the Diaphragm
*Gas Filled Megaesophagus- V Sign is very characteristic for Megaesophagus
Most Severe (Emergency) Pneumothorax, characterized by Continuous Influx of air on Inspiration that does not return to the Lung on Expiration
Tension Pneumothorax
True/False: A Diagnosis of Cardiac Failure cannot be based on Echocardiology Alone
True
*Disadvantage of Echocardiology
Lung Pattern characterized by Inflammed Interstium leading to Diffuse Haziness of the Radiograph
Unstructured Interstitial Pattern
What are the Arrows Pointing to in these Radiographs?
Cranioventral Mediastinal Reflection
*Soft Tissue Opacity- This is the Cranioventral Mediastinal Reflection
2. On the Side where B is
*By Standardization, regardless if its a VD or DV View, Left will Always be the Side Labelled “B”
True/False: Pneumomediastinum can Cause a Pneumothorax, but a Pneumothorax can never cause a Pneumomediastinum
True
*KNOW THIS
*A Pneumothorax can Never Become a Pneumomediastinum
1. Detected
*You can see where the Dorsal wall of the Trachea and the Ventral Wall of the Esophagus meet- Thick White Line- Therefore there is Gas in the Esophagus
Pneumothorax where a Greater Degree of Lung Collapses leading to Tenting of the Diaphragm and “Barrel-Chested” Appearance
Tension Pneumothorax
*Emergency
*Red Line shows Retracted Lung Lobe- Severely Retracted
With Spectral Doppler, Anything Below the Baseline means the Blood is Flowing ____ from the Transducer
Away
Retraction of the Lungs with Increased Opacity between Lung and Body Wall
Pleural Effusion
*Soft Tissue Opacity between the Retracted Lung Lobes and Thoracic Wall
*Don’t see Cardiac Sillhouette- The Soft Tissue Opacity of the Heart is Hidden by Severe Pleural Effusion
What Condition is leading to the Very Characteristic Tracheal Indentation in this Radiograph?
Vascular Ring Anomaly
*Tracheal Indentation- Diagnostic for Vascular Ring Anomaly
*Esophagus that is Dilated and Filled with Ingesta
These Numbers Represent the Location of What Three Lymph Nodes?
1. Sternal Lymph Node
2. Cranial Mediastinal Lymph Node
3. Tracheobronchial Lymph Node
Is This Mass Located within the Mediastinum or the Lung?
Mediastinum
*The Mass is located on the Midline of the Thoracic Cavity (Near the Vertebral Column), which is where the Mediastinum Lies
*The Caudalventral Mediastinum is Visible in this Radiograph
CT
_____ Flow (Regurgitation) is Often Bright and a Mixture of Colors on Doppler Readings
Turbulent
*Blue = Away
Red = Towards
*In this Image the Blood is Mainly Traveling Away from the Transducer, from the Left Ventricle into the Left Atrium = Mitral Insufficiency
What Lung Pattern is seen in the Radiographs Below?
Bronchial Pattern
*Donuts and Tram Lines
In this M-Mode Reading, Point out Systole and Diastole
Which View of an Echocardiogram is This, that is used to Examine the Mitral Valve?
Right Parasternal Short Axis (E) View
