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Radiographic Procedures And Pathology. Prep Course 1 > Module 3 Thoracic Cavity > Flashcards

Module 3 Thoracic Cavity Flashcards

1
Q

OPENINGS OF THE THORACIC CAVITY

A
  • Superior thoracic aperture

- Inferior thoracic aperture

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2
Q

SUB DIVISIONS OF THE THORACIC CAVITY

A
  • Right Pleural Cavity
  • Left Pleural Cavity
  • Pericardial Cavity
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3
Q

STRUCTURES OF THE RESPIRATORY SYSTEM

A
  • Pharynx
  • Trachea
  • Bronchi
  • Lungs
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4
Q

DEF: PARENCHYMA

A

A characteristic tissue of a particular organ.

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5
Q

LUNG PARENCHYMA

A

Light and spongy

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6
Q

PORTIONS OF THE LUNG

A
  • Apex
  • Base
  • Costophrenic angles
  • Hilum
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7
Q

MEDIASTINUM

A

Mass of tissue between the pleura of the lungs and includes all the contents of the thoracic cavity except the lungs. Divided into superior, anterior, middle and posterior mediastinum.

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8
Q

CXR POSITIONING

A
  • exposure taken on second inspiration
  • CR at T7
  • SID MUST be 180CM
  • Done preferably at erect
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9
Q

REASONS FOR DOING BOTH INSP AND EXP CXR

A
  • Pneumothorax
  • Atelactasis ( partial collapse or incomplete inflation of the lung )
  • Presence of a FB
  • Diaphragmatic Excursion ( movement of the thoracic diaphragm during breathing
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10
Q

ISTHMUS

A

A narrow band of tissue the connects the two lobes of the thyroid a cross the anterior trachea

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11
Q

THYROID GLAND

A

An endocrine gland that produces hormones that serve to increase metabolism .

  • Thyroxinehormone
  • Triodothyronine hormones
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12
Q

PARATHYROID GLANDS

A

Glands that produce parathyroid hormones which playa role in calcium homoestasis. They are two in number and situated on the superior aspect of each thyroid hormone

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13
Q

PHARYNX

A

A common passage for the respiratory and digestive systems located in front of the vertebrae and behind the nose and mouth. Pharynx is divided into three.

  • nasopharynx
  • oropharynx
  • laryngeal pharynx
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14
Q

LARYNX

A

Commonly referred to as a voice box, located below the the tongue base in front of the laryngeal pharynx, subdivided into three compartments

  • Superior pair folds
  • Inferior pair folds
  • Rima Glottis
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15
Q

AP SOFT TISSUE NECK PROJECTION

A
  • Dome supine or upright, preferably erect
  • Align MSP to the CR
  • Raise chin to prevent mandibular shadow
  • Cent-erring point is the laryngeal prominence
  • Collimation must include EAM and jugular notch
  • Exposure must be done under slow respiration
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16
Q

AP PROJECTION STRUCTURES DEMONSTRATED

A
  • Larynx and pharynx from C3- T3 and must be filled with air and visualised through the C spine
  • Pathology affecting the larynx,trachea, thyroid and thymus glands may be seen when present
  • Radiopaque or opacified foreign bodies may be visualised when present:
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17
Q

LATERAL SOFT TISSUE NECK PROJECTION

A

Done : -

  • Upright if possible
  • Depress the shoulders
  • Extend the patients chin slightly
  • SID/ FFD must be 180cm to minimise magnification
  • Exposure done during slow nasal inspiration ( to fill up the upper airway)
  • Collimate to include EAM to jugular notch
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18
Q

SOFT TISSUE NECK LATERAL PROJECTION, STRUCTURES DEMONSTRATED

A
  • Pharynx and larynx should be filled with air and we’ll visualised
  • Radiopaque or opacified FB may be visualised if present
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19
Q

AP PROJECTION OF TRACHEA

A
  • Done supine or upright ,preferably erect
  • Raise chine slightly and place MSP perpendicular tooth IR
  • Centre to the manubrium
  • Expose during slow deep inspiration to ensure filling of the trachea and upper airway
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20
Q

AP PROJECTION STRUCTURES DEMONSTRATED NECK

A
  • Outline of the air filled trachea superimposed over the cervical vertebrae
  • Visibility of the area from mid- cervical to mid thoracic region
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21
Q

LATERAL PROJECTION

TRACHEA

A
  • Patient in erect position with body in true lateral position
  • Patients hands clasped behind their back with shoulders rotated posteriorly
  • Collimate to above the upper border of the laryngeal prominence and the sorrow ding soft tissue
  • Expose during slow , deep inspiration to fill the trachea and upper airway with air
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22
Q

LATERAL TRACHEA PROJECTION

STRUCTURAL DEMONSTRATION

A
  • Air-filled trachea
  • Area from mid- cervical to mid-thoracic region must be seen
  • Trachea-and superior mediastinum free
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23
Q

PA CHEST PROJECTION

A
  • Position patient upright of seated
  • MSP perpendicular to the IR
  • MCP parallel to the IR
  • Patients dorsal surface of the hands placed on the hips
  • Patients shoulders rotated forward and relaxed downwards
  • Place the top of the IR 5cm above the shoulders
  • Collimate to the exposure field
  • Centre to the level of T7
  • Place lead runner for gonadal shielding
  • Practice breathing with the patient a few time and then instruct them to hold their breath and expose
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24
Q

LATERAL CHEST PROJECTION

A
  • Position patient upright, seated or standing with left side in contact with the IR
  • Make sure the patient has a balanced stance
  • MSP is parallel to the IR
  • MCP is perpendicular to the IR
  • Raise patients arms above the chest with chin elevated and looking straight a head
  • Top of IR. use be 5 cm above the top of the shoulders
  • Centre at the level of T7 ( inferior angle of scapular)
  • Provide shielding
  • Ask patient to inhale and exhale then inhale and hold

-

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25
Q

AP CHESTPROJECTION

A
  • Position patient supine or upright facing the x-ray position
  • MSP perpendicular to the IR
  • MCP parallel to the IR
  • Arms clear of the thorax region with the chin elevated and straight
  • Place IR 5 cm above the shoulders
  • Centre at the level of T7
  • Provide lead shielding
  • Practice breathing with patient then inhale and hold.

-

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26
Q

AP CHEST PROJECTION: Pulmonary Apices

A

Position patient standing or seated upright about 30cm in front of the IR.

  • MSP perpendicular to IR
  • Place arms clear of the thorax with the chine raised and
    Poking straight ahead
  • Place IR 5 cm above the shoulders
  • Centre at the mid sternum
  • Provide lead shielding
  • practice breathing with patient
  • NB= Modification - patients back flat of the IR, then angle CR 15-20 deg up
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27
Q

PA CHEST RAD CRITERIA

A
  • Include apices to costophrenic angles
  • Scapulae outside the lung fields
  • 3 ribs above the clavicle
  • Manubrium superimposed over the 4th thoracic vertebrae

Equal distance fromSC joint to vertebral column

  • 10 posterior ribs seen above the diaphragm on full inspiration
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28
Q

LEFT LATERAL. CHEST

RADIOGRAPHIC CRITERIA

A
  • Include Apices to costophrenic angles, sternum to posterior ribs
  • Project the right costophrenic angle inferiority
  • Posterior Rib separation of no more than 1 cm must be seen
  • Superimposed Thoracic vertebral bodies

No hi Earl superimposition on lung Apices must be seen

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29
Q

INFANT AP CHEST RADIOGRAPHIC CRITERIA

A
  • Apices to costophrenic angles seen
  • CR at T4
  • Baby’s chin must not superimpose the lung field
  • Equal distance from SC joints to the vertebral column
  • 8 or 9 posterior ribs seen above the diaphragm on full inspiration
  • All tubes and lines must be visible
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30
Q

INFANT OR CHILDS LATERAL CHEST

RADIOGRAPHIC CRITERIA

A
  • Must include Apices to costophrenic angles, sternum and posterior ribs
  • Posterior-ribs must be superimposed
  • Avoid humeral superimposition of lung Apices
  • Avoid exposure of chin or head
  • Centre @ T5
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31
Q

CENTRAL VENOUS CATHETER ( CVC)

A
  • A catheter inserted through subclavian or jugular vein
  • Ideal position is within the SVC 2,5 cm above the right atrium
  • Used to administer chemotherapy or parental nutrition

-

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32
Q

PERIPHERALLY INSERTED CENTRAL CATHETER ( PICC LINE )

A
  • Central line inserted through one of the peripheral veins
  • Ideal position is in the SVC
  • Used for long term IV therapy
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33
Q

ENDOTRACHEAL TUBE. (ETT)

A
  • Tube used to inflate the lungs
  • It is inserted into the trachea
  • And it’s ideal position 2,5-5cm above the carina
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34
Q

TRACHEOSTOMY

A
  • Surgical opening made in the trachea to create an artificial airway
  • Ideal position 1/2 distance from the tracheal stoma and carina
  • NB =Never to be tempered with
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35
Q

CHEST TUBE FOR PNEUMOTHORAX

A
  • Tube inserted into the chest for the purpose to remove air that has accumulated in the pleural cavity
  • Ideal position is within the pleural cavity anteriorly placed at the mid clavicular,level
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36
Q

CHEST TUBE ( drain) FOR PLEURAL EFFUSION

A
  • A chest tube inserted to remove fluid that has accumulated in the pleural cavity
  • The tubes ideal position is within the pleural cavity laterally placed at the 5th intercostal space
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37
Q

PACEMAKER

A
  • A medical device that generates impulses to regulate the heart rate
  • 8It is inserted through the antecubital, femoral, jugular, or subclavian vein
  • It’s ideal position is into the subcutaneous fat of the anterior chest wall with the catheter tip with in the right atrium and or ventricle
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38
Q

PORT-O-CATH

A
  • A medical device used to draw blood and give treatment

- It’s ideal position is in the subcutaneous fat of the anterior chest wall with the catheter tip advanced to the SVC

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39
Q

PULMONARY ARTERIAL CATHETER (SWAN- GANZ CATHETER)

A
  • A catheter inserted through subclavian, jugular or femoral veins
  • It’s ideal position is seen within the heart shadow with the catheter travelling to SVC, right atrium, right ventricle, pulmonary trunk and end at the right or left pulmonary artery
  • Used to measure the pressure in the pulmonary artery and atriums
  • Also measures the cardiac output
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40
Q

NEONATES CHEST UMBILICAL ARTERY CATHETER

A
  • Ideal position is in the thoracic aorta at the level of T6-T9 or below the renal artery
  • It’s purpose is to measure oxygen saturation
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41
Q

NEONATAL. CHEST UMBILICAL VEIN CATHETER

A
  • A catheter used to deliver fluids and medications

- Ideal position is the junction of the IVC and right atrium

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42
Q

HYALINE MEMBRANE DISEASE ( RESPIRATORY DISTRESS SYNDROME )

A
  • Neonatal respiratory distress syndrome more common in premature babies born six or more weeks.
  • Seen in premature infants with lack of surfactant ( a substance that lowers surface tension of fluid lining the alveoli, allowing the alveoli to remain expanded and promote gaseous exchange)
  • Without surfactant the alveoli are unable to stay inflated , and collapse when the baby exhales
  • Clinical signs- Dyspnea- shortness of breath- hypoxia
  • Imaging- AP mobile chest
  • RADIOGRAPHIC appearance- - Under aeration if the lung- Lungs have a granular appearance, ground glass appearance, hazy- Air bronchograms
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43
Q

CYSTIC FIBROSIS

A
  • A hereditary disorder that is affecting the exocrine glands
  • Exocrine glands secrete excessive mucous which affect multiple systems ( digestive and respiratory )
  • The exocrine secretions block the bronchi and trachea leading to areas of collapsed lung and recurrent lung infection
  • IMAGING - CXR
    - Chest CT
  • RADIOGRAPHIC APPEARANCE- Hyperinflation of the lung
    P. - Late stage: Brochiectasis
  • TREATMENT - Daily chest physio to loosen the mucous in the chest
    - Antibiotics for chest infections

-

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44
Q

AIR SPACE DISEASE

A
  • Non filling of the pulmonary tree with material that attenuates x rays more than the surrounding lung parenchyma
  • Produces opacities in the lung, producing a fluffy or hazy appearance
  • Can be throughout the lung or localised
  • Air bronchogramms are commonly seen due to the bronchi being surrounded by opacified alveoli
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45
Q

SUBCUTANEOUS EMPHYSEMA

A
  • This is free air within the tissues of the chest, neck and axilla
  • CLINICAL SIGNS- The skin will feel crunchy when touched
  • RADIOGRAPHIC APPEARANCE- Free air with in the muscle appears as a stripped appearance
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46
Q

EMPHYSEMA

A
  • Trapped air in the lungs because of the destroyed alveolar walls, this causes air to be trapped in the spaces on exhalation
  • Lung elastic recoil is damaged further increasing the air trapped in the lungs
  • CAUSE- Inhalation of cigarette smoke
  • CLINICAL SIGNS- Shortness of breath and wheezing
  • IMAGING- PA and Lateral CXR
  • RADIOGRAPHIC APPEARANCE- Lungs are hyper inflated, increased radio density
    - Blunted Diaphragms
    - Bullae, enlarged air spaces appear
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47
Q

ASTHMA

A
  • Bronchial, airway narrowing due to sensitivity to specific allergens causing air
    To be trapped in the lungs
  • CLINICAL SIGNS- Dyspnea, wheezing
    - Chest tightness
    - Tachycardia and fatigue
  • Imaging- PA and Lateral CXR
  • RADIOGRAPHIC APPEARANCE- Typically normal chest appearance
    - During an attack the lungs may appear hyper inflated due to trapped air
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48
Q

OBSTRUCTIVE ATELECTASIS

A
  • Collapse of the entire lung or segment of lung with loss of lung volume
  • Caused y air way obstruction ( tumour, foreign body or mucus) , or inadequate surfactant
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49
Q

CLINICAL SIGNS AND IMAGING FOR OBSTRUCTIVE ATELECTASIS

A

Signs- Dyspnea

      - Chest pains

Imaging- PA and Lateral CXR

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50
Q

RADIOGRAPHIC APPEARANCE OF OBSTRUCTIVE ATELECTASIS

A
    • Increased radiopacity of the lung due to loss of air in alveoli
  • Elevated diaphragm
  • Displaced lung fissures
  • Over inflation of unaffected lung or in affected lobes or segments of lung
  • Parietal and visceral pleura remain intact , causing shift of trachea, heart and hemidiaphragm towards the side of volume loss
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51
Q

COMPRESSIVE ATELECTASIS

A

External compression of the lung caused by pneumothorax or pleural effusion

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52
Q

CLINICAL SIGNS AND IMAGING FOR COMPRESSIVE ATELECTASIS

A

Clinical signs - Dyspnea
- Chest pain

Imaging. - PA and Lateral CXR

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53
Q

RADIOGRAPHIC APPEARANCE FOR COMPRESSIVE ATELECTASIS

A

Volume loss or collapse of lung due to external pressure of fluid or air

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54
Q

BRONCHIECTASIS

A

Chronic dilatation of the bronchi or bronchioles usually caused by bacteria, staphylococcus

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55
Q

CLINICAL SIGNS AND IMAGING FOR BRONCHIECTASIS

A

Signs - Productive cough
- Hemoptysis

Imaging- High Resolution CT chest

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56
Q

RADIOGRAPHIC APPEARANCE OF BRONCHIECTASIS

A
  • Enlarged bronchi

- Signet ring sign

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57
Q

CHRONIC BRONCHITIS

A

Inflammation of the air ways with excessive secretions of mucus caused by virus influenza A or B or by inhaling an irritant like cigarette smoke

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58
Q

CLINICAL SIGNS AND IMAGING FOR CHRONIC BRONCHITIS

A

Clinical signs- Productive cough
- Wheezing

Imaging- PA and Lateral CXR

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59
Q

RADIOGRAPHIC APPEARANCE OF CHRONIC BRONCHITIS

A

As the disease progresses the CXR may show signs of hyperinflation of the lung and increased vascular markings due to chronic obstruction of airways

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60
Q

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

A

This chronic obstruction of the airways due to chronic bronchitis or emphysema primarily caused by inhaling cigarette smoke

  • Bronchitis causes airway obstruction through excessive mucus production
  • Emphysema destroys the alveoli walls thus enlarging the airspace’s and trapping air
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61
Q

CLINICAL SIGNS AND IMAGING FOR COPD

A

Clinical signs- Productive cough

                   - Dyspnea 
                   - Wheezing 
                   - Barrel chest

Imaging. - PA and Lateral CXR

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62
Q

RADIOGRAPHIC APPEARANCE OF COPD

A
  • Blunted diaphragms,
  • Hyper-inflated lungs
  • Increased retrosternal space
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63
Q

PULMONARY EMBOLISM PE

A

This is blood clots within the pulmonary arteries often caused by an embolus from the deep veins of the legs ( DVT)

DVT maybe caused by prolonged sitting, prolonged bed rest-or immobility, surgery, recent fractures of the hip or lower leg etc.

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64
Q

CLINICAL SIGNS AND IMAGING FOR PULMONARY EMBOLISM

A

Clinical signs- Sudden onset, sharp chest pain

                   - Dyspnea 
                   - Diaphoresis ( excessive sweating)

NB :May be fatal if pulmonary infarction results

Imaging. - CT PE protocol, with contrast media utilised

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65
Q

RADIOGRAPHIC APPEARANCE OF PULMONARY EMBOLISM

A

Contrast filling defect on CT scan with in the pulmonary arteries affected

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66
Q

PULMONARY EDEMA

A

Fluid accumulation with in the lung tissue and alveoli-commonly caused by increased pulmonary venous pressure due to left sided heart failure

67
Q

CLINICAL SIGNS AND IMAGING FOR PULMONARY EDEMA

A

Clinical signs- Dyspnea
N. - Wheezing
- Feeling of suffocation

Imaging- PA and Lateral Chest

68
Q

RADIOGRAPHIC APPEARANCE OF PULMONARY EDEMA

A
  • Fluffy, patchy airspace densities, centrally located

- Bat- wing or Butterfly appearance

69
Q

PRIMARY LUNG CANCER

A

Most common fatal malignancy amongst en and second most common among women. Can be classified by their cell types SMALL CELLS are centrally located and NONSMALL CELLS are peripheral in location

70
Q

CLINICAL SIGNS AND IMAGING FOR PRIMARY LUNG CANCER

A

Clinical signs = Dyspnea
= Hemoptysis

Imaging = CXR
= CT chest

71
Q

RADIOGRAPHIC APPEARANCE OF PRIMARY LUNG CANCER

A
  • Usually a solitary mass
  • With irregular margins
  • Could be peripherally or centrally located based on the type of lung cancer demonstrated
72
Q

METASTATIC LUNG DISEASE

A

Spread of malignant cells to the lung via blood stream or lymphatic.
Most common primary sites of metastatic lung disease is COLORECTAL CARCINOMA in males and BREAST cancer in females

73
Q

CLINICAL SIGNS AND IMAGING FOR METASTATIC LUNG DISEASE

A

Clinical signs. = Dyspnea
= Hemoptysis

Imaging =. CXR
CT chest

74
Q

RADIOGRAPHIC APPEARANCE OF METASTATIC LUNG DISEASE

A

Multiple nodules throughout the lung

  • With various size nodules well marginated
75
Q

SEVERE ACUTE RESPIRATORY SYNDROME ( SARS )

A

A respiratory disease caused by SARS corona virus

76
Q

CLINICAL SIGNS AND IMAGING FOR SEVERE ACUTE RESPIRATORY SYNDROME ( SARS )

A

Clinical signs = Flu- like symptoms
= Cough
= Sore throat
= Fever

Imaging. = CXR
= CT chest

77
Q

RADIOGRAPHIC APPEARANCE OF SEVERE ACUTE RESPIRATORY SYNDROME ( SARS )

A

Bilateral patchy airspace opacity

78
Q

ACQUIRED IMMUNODEFICIENCY SYNDROME ( AIDS )

A

A condition caused by human immunodeficiency virus HIV which affects the lungs, GI system and CNS

79
Q

CLINICAL SIGNS AND IMAGING OF ACQUIRED IMMUNODEFICIENCY SYNDROME ( AIDS )

A

Clinical signs- Fever
N. - Cough
- Night seats

Imaging - CXR
- MRI

80
Q

RADIOGRAPHIC APPEARANCE OF ACQUIRED IMMUNODEFICIENCY SYNDROME ( AIDS )

A

Pneumonia, airspace consolidation, air bronchograms

81
Q

EPIGLOTTITIS

A

This is the swelling of the epiglottis causing an obstruction to the airway caused by a bacterial infection of the epiglottis ( supraglottic region) seen in children

82
Q

CLINICAL SIGNS AND IMAGING FOR EPIGLOTTITIS

A

Clinical signs = The child presents with mouth open, leaning forward and unable to n. swallow, drooling

Imaging = Upright soft tissue neck x ray

NB: Never lie a child down with suspected epiglottitis !!!!!

83
Q

RADIOGRAPHIC APPEARANCE OF EPIGLOTTITIS

A

Typical appearance of the epiglottis is a thin shadow, in EPIGLOTTITIS it appears as a thumb print, a thick soft tissue

84
Q

CROUP

A

A viral infection of the subglottic region of the trachea which causes the narrowing of the upper trachea

85
Q

CLINICAL SIGNS AND IMAGING FOR CROUP

A

Clinical Signs - Child has a barking cough, like a seal

Imaging - AP soft tissue airway

86
Q

RADIOGRAPHIC APPEARANCE OF CROUP

A

Tapered narrowing of the upper trachea

87
Q

PNEUMONIA

A
  • This is infection and inflammation of the alveoli
  • Fluid replaces air with in the alveoli
  • Commonly caused by streptococcus bacteria
88
Q

CLINICAL SIGNS AND IMAGING FOR PNEUMONIA

A

Clinical signs- Cough and fever

                   - Chest pain
                   - Dyspnea

Imaging- CXR

89
Q

RADIOGRAPHIC APPEARANCE PNEUMONIA

A
  • Radiopaque opacities in the lung tissue
  • Air bronchograms maybe present if the bronchi are not filled with exudate
  • No shift of mediastinal structures
90
Q

PNEUMOTHORAX

A

This the present of air in the pleural cavity caused by a penetrating injury or a spontaneous rupture of a small blob on the surface of the lung

91
Q

CLINICAL SIGNS AND IMAGING FOR PNEUMOTHORAX

A

Clinical signs- Chest pains
- Dyspnea

Imaging- CXR inspiration and expiration

92
Q

RADIOGRAPHIC APPEARANCE OF PNEUMOTHORAX

A
  • Decreased lung volume
  • No vascular markings within the free air
  • No mediastinal shift structures seen
  • Out line of visceral pleura seen
93
Q

TENSION PNEUMOTHORAX

A

Presence of air in the pleural space which continues to leak to a point that their is lung collapse with mediastinum shift away from the side of the pneumothorax

94
Q

CLINICAL SIGNS AND IMAGING of TENSION PNEUMOTHORAX

A

Clinical Signs- Chest pain
- Dyspnea

Imaging- CXR inspiration and expiration

95
Q

RADIOGRAPHIC APPEARANCE OF TENSION PNEUMOTHORAX

A
  • Decreased lung volume
  • No vascular markings within the free space
  • White line outlining visceral pleura
  • Shift-of mediastinal structures
96
Q

PLEURAL EFFUSION

A

Free fluid in the pleural cavity commonly caused by congestive heart failure, pneumonia and pulmonary embolism

A pleural tap or thoracentesis is done to remove the fluid

97
Q

CLINICAL SIGNS AND IMAGING FOR PLEURAL EFFUSION

A

Clinical signs- Shortness of breath
- Dyspnea

Imaging - CXR INSPIRATION AND EXPIRATION AND LATERAL DECUBITUS

98
Q

RADIOGRAPHIC APPEARANCE OF PLEURAL EFFUSION

A
  • Blunted costophrenic angles
  • Radiopaque appearance
  • Large pleural effusion may cause a shift of trachea, heart and hemidiaphragm from affected side
99
Q

EMPYEMA

A

Presence of infected fluid or pus within the pleural space, abbé caused by pneumonia or lung abscess etc.

100
Q

CLINICAL SIGNS AND IMAGING FOR EMPYEMA

A

Clinical signs = Dyspnea

Imaging = CXR

101
Q

RADIOGRAPHIC APPEARANCE OF EMPYEMA

A

Appearance is similar to a pleural effusion with increased density within the hemithorax

102
Q

ATRIAL SEPTAL DEFECT

A

The most common congenital cardiac lesion which is enlargement of the right heart ( Atrium and ventricle) due to increased left atrial pressure from a left to right atrium shunt that developed from the failure of the closure of the foramen ovale after birth

103
Q

CLINICAL SIGNS AND IMAGING OF ATRIAL SEPTAL DEFECT

A

Clinical signs- May be a symptomatic

                   - An unusual sound heard during a heart beat
                   - Dyspnea

Imaging- CRX

104
Q

RADIOGRAPHIC APPEARANCE OF ATRIAL SEPTAL DEFECT

A

Enlarged right atrium and/or right ventricle

105
Q

VENTRICULAR SEPTAL DEFECT

A

This is the opening in the interventricular septum, this causes shunting which occurs during systole and increases blood flow through pulmonary veins to the left side of the heart

106
Q

CLINICAL SIGNS AND IMAGING OF VENTRICULAR SEPTAL DEFECT

A

Clinical signs- - An unusual sound heard during heart beat

Imaging- CXR

107
Q

RADIOGRAPHIC APPEARANCE OF VENTRICULAR SEPTAL DEFECT

A
  • Enlarged left atrium and ventricle
  • ## No enlargement of right ventricle
108
Q

PATENT DUCTUS ARTERIOUS

A

This is a condition caused by failure of closure of the Ductus ARTERIOUS after birth thus causing shunting from left to right heart ( aorta to pulmonary artery )

109
Q

CLINICAL SIGNS AND IMAGING FOR PATENT DUCTUS ARTERIOUS

A

Clinical signs- Excess blood in the pulmonary artery, left atrium and left ventricle

Imaging- CXR

110
Q

RADIOGRAPHIC APPEARANCE OF PATENT DUCTUS ARTERIOUS

A
  • Enlarged left atrium and ventricle ( Cardiomegaly )

- Increased Pulmonary vascularity

111
Q

TETRALOGY OF FALLOT

A

This is increased pressure to the right ventricle caused by 4 abnormalities

  • Ventricular Septal Defect
  • Pulmonary Stenosis
  • Overriding of the aorta above the ventricular defect
  • Right Ventricular Hypertrophy
112
Q

CLINICAL SIGNS AND IMAGING FOR TETRALOGY OF FALLOT

A

Clinical signs- Cyanosis

                   - Child fails to thrive
                   - Fatigued easily

Imaging- CXR

113
Q

RADIOGRAPHIC APPEARANCE OF TETRALOGY OF FALLOT

A

Wooden shoe shaped heart

114
Q

COARCTATION OF THE AORTA

A

A narrowing of the aorta distal to the aortic arch.

- Collateral circulation may develop beyond the narrowing

115
Q

CLINICAL SIGNS AND IMAGING FOR COARCTATION OF THE AORTA

A

Clinical signs - Increased pressure in the upper extremities, head, and anterior intercostal arteries

Imaging- CXR
- Barium Swalllow

116
Q

RADIOGRAPHIC APPEARANCE OF COARCTATION OF THE AORTA

A

CXR- Rib notching due to increased pressure in the intercostal arteries
- Figure 3 sign bulging Aortic knob,

    - Narrowing at coarctation, 
   - dilation below stenosis

Barium Swallow- Reverse Figure of 3 sign

117
Q

DEXTROCARDIA

A

A congenital condition, where the apex of the heart is positioned to the right of the mediastinum instead of to the left.

  • It may be a symptomatic or be associated with other heart defects
118
Q

CLINICAL SIGNS AND IMAGING FOR DEXTROCARDIA

A

Clinical signs- No symptoms if the heart is normal other than the dextrocardia

Imaging- CXR
- CT

119
Q

RADIOGRAPHIC APPEARANCE OF DEXTROCARDIA

A

Apex of the heart pointed to the right

120
Q

CORONARY ARTERY DISEASE

A

This stenosis of the coronary arteries which cause insufficient oxygen supply to the myocardium resulting into ischemia ( decreased supply of oxygenated blood to the heart muscle ) .

121
Q

MYOCARDIAL INFARCTION

A

Caused by a prolonged stenosis of coronary arteries which then leads to necrosis of the myocardium

122
Q

CLINICAL SIGNS OF CORONARY ARTERY DISEASE

A
  • Pain and pressure in the chest , jaw and or left arm
  • Excessive sweating Diaphoresis
  • The above usually occurs during exercise, stress, and after a heavy meal
123
Q

TREATMENT OF CORONARY ARTERY DISEASE

A
  • Nitroglycerin tablets placed under the tongue of the patient, this causes venous dilation decreasing the oxygen demands of the myocardium
  • Stenting
  • Coronary by pass grafting
  • Percutaneous trans luminal angioplasty
124
Q

ATHEROSCLEROSIS

A

The hardening of the artery which is the result of narrowing of the artery lumen caused by fatty deposits called plaques.

125
Q

CLINICAL SIGNS AND IMAGING OF CORONARY ATHEROSCLEROSIS

A

Imaging - CXR
I. - Nuclear Medicine
- CT
- Coronary Angiogram

126
Q

RADIOGRAPHIC APPEARANCE OF CORONARY ATHEROSCLEROSIS

A

CXR- CXR are generally normal in appearance, performed to rule out congestive Heart Failure

    - Vessels may demonstrate calcification
127
Q

HYPERTENSION

A
  • High blood pressure which could lead to strokes and or congestive heart failure
128
Q

CAUSES OF HYPERTENSION

A
  • Increased blood volume, salt/ water imbalance
  • Artherosclerosis
  • Stenosis of the renal artery
129
Q

TREATMENT OF HYPERTENSION

A
  • Diuretic to reduce blood volume
  • Beta blockers to control blood pressure
  • Angioplasty to the renal artery
130
Q

CONGESTIVE HEART FAILURE

A

An acute or chronic state which developes when the heart cannot meet the oxygen demands of the body

May be caused by - Coronary artery disease

                             - Hypertension 
                             - Valvular disease
                             - Lung disease
131
Q

CLINICAL SIGNS AND IMAGING FOR CONGESTIVE HEART FAILURE

A

Clinical signs- Fatigue

                   - Fluid retention causing Edema in the ankles, legs abdomen and lung
                   - Dyspnea

Imaging- CXR

132
Q

RADIOGRAPHIC APPEARANCE OF CONGESTIVE HEART FAILURE

A

Cardiomegaly, heart shadow is greater than 50% of the cardio thoracic ratio

133
Q

RADIOGRAPHIC APPEARANCE OF RIGHT- SIDED HEART FAILURE

A
  • Enlarged atrium and ventricle
  • Enlarged SVC AND mediastinum
  • Peripheral Edema
134
Q

RADIOGRAPHIC APPEARANCE OF LEFT SIDED HEART FAILURE

A
  • Cardiomegaly
  • Pleural Effusion
  • Pulmonary Edema
135
Q

ANEURYSM

A

A dilation of an artery, vein or heart chamber due to a weakening within the wall

= most common is the abdominal aorta.

136
Q

SACCULAR ANEURYSM

A

A dilation of an artery or vein with a bulge on one side of the vessel

137
Q

FUSIFORM ANEURYSM

A

A dilation of an artery or vein which involves the entire circumstance of the vessel

138
Q

ANEURYSM CUASES

A
  • Some a congenital like the berry aneurysms in the Circle of Willis
  • Trauma
  • Inflammation
  • Degeneration
139
Q

CLINICAL SIGNS AND IMAGING OF ANEURYSM

A

CLINICAL SIGNS-

  • pain or pressure
  • rupture or haemorrhage

Imaging- CXR
- AXR series
CT Angiography

140
Q

RADIOGRAPHIC APPEARANCE OF ANEURYSM

A
  • A calcified vessel maybe demonstrated n plain radiographs

- On CTA will demonstrate the size of the aneurysm and whether the rupture or dissection has occurred

141
Q

DISSECTION OF AORTA

A

A tear In the intima of the artery allowing blood to enter the wall of the artery separating its layers

142
Q

CLINICAL SIGNS AND IMAGING OF DISSECTION OF AORTA

A

Clinical signs- Sudden severe pain
- No Diaphoresis

Imaging - CXR
- CT

143
Q

RADIOGRAPHIC APPEARANCE OF DISSECTION OF AORTA

A
  • Widened mediastinum on the CXR appearance,

- on contrast enhanced CT it will demonstrate an intimate flap which identifies the true and false lumen

144
Q

PERICARDIAL EFFUSION AND CARDIAC TEMPONADE

A

Excessive fluid in the pericardial cavity , maybe caused by trauma , pericarditis, dissecting aortic aneurysm, myocardial infarction.
= can be treated by performing a pericardiocentesis

145
Q

CLINICAL SIGNS AND IMAGING FOR PERICARDIAL EFFUSION AND CARDIAC TEMPONADE

A

Clinical signs-=

  • Chest pain and pressure
  • Dyspnea
  • Syncope, light headed ness

Imaging = CXR

146
Q

RADIOGRAPHIC APPEARANCE OF PERICARDIAL EFFUSION AND CARDIAC TEMPONADE

A

Enlarged cardiac silhouette

147
Q

THROMBUS

A

A blood clot with in a blood vessel which may be caused by =

  • Slow moving blood
  • Viscous blood
  • The inner lining of the wall, forming a clot
148
Q

EMBOLUS

A

When a thrombus or part of a thrombus moves away from its site of origin and can cause an occlusion

This can be treated with Anticoagulants ( Warfarin, Coumadin) blood thinners

149
Q

VARICOSE VEINS

A

Dilated, elongated and tortuous vessels commonly superficial cause by weak valves in the veins that allow blood to pool.

Risk factors are=

  • hereditary
  • prolonged standing
  • pregnancy
150
Q

CLINICAL SIGNS AND IMAGING FOR VARICOSE VEINS

A

Clinical signs=

  • Raised veins seen through the skin
  • Swelling and itching

Imaging =. Ultrasound

151
Q

ATRIAL FIBRILLATION ARRHYTHMIA

A

Uncoordinated contractions of the two atriums which causes an irregular heartbeat

152
Q

CLINICAL SIGNS AND IMAGING FOR ATRIAL FIBRILLATION ARRHYTHMIA

A

Clinical signs =

  • Maybe asymtomatic
  • Palpitations
  • Chest pain
  • Syncope

Imaging - CXR

153
Q

RADIOGRAPHIC APPEARANCE OF ATRIAL FIBRILLATION ARRHYTHMIA

A
  • Pneumonia
  • ## Congestive Heart Failure
154
Q

VENTRICULAR FIBRILLATION ARRHYTHMIA

A

Uncoordinated contractions of the. Ventricles which are caused by a myocardial infarction

155
Q

CLINICAL SIGNS AND IMAGING FOR VENTRICULAR FIBRILLATION ARRHYTHMIA

A

Clinical signs =

  • Sudden collapse and unconscious

Imaging = CXR

156
Q

LEUKAEMIA

A

Increased number of white blood cells. Two types =

= Myelocytic Leukemia- Malignancy of the bone marrow causing over production of granulocytes ( type of WBC) and under production of RBC and platelets

= Lymphatic Leukemia- Malignancy of the lymph nodes, over production of lymphocytes

157
Q

CLINICAL SIGNS AND IMAGING FOR LEUKAEMIA

A

Clinical signs =

  • Shortness of breath
  • Fatigue
  • Blood Clotting issues
    NB= Patient becomes highly susceptible to infection due to increased circulation of immature WBC,s

Imaging =

  • Skeletal survey
  • CXR
158
Q

RADIOGRAPHIC APPEARANCE OF LEUKAEMIA

A

Skeletal Survey=

  • Radiolucent bands at the metaphysical ends of long bones ( knees, ankles and wrists)
  • Moth- eaten appearance of bone as disease progresses

CXR=

  • Enlarged mediastinum
159
Q

LYMPHOMA

A

A group of cancers derived from lymphocytes, WBC,s in the lymphatic system .

Lymphoma occurs whenB and T cells-under go a transformation and begin to multiply and settle in various lymph odes or other lymphatic tissue

Two types=

  • Hodgkin Lymphoma

Non Hodgkin Lymphoma

160
Q

Non Hodgkin Lymphoma

A
  • Most common of the two
  • Originates in organs
  • Abnormal cells are derived from B or T cells
161
Q

Hodgkin Lymphoma

A
  • Originates in the lymph nodes

- Abnormal cells are derived from specific B- cells called REED- STERNBERG CELLS

162
Q

CLINICAL SIGNS AND IMAGING FOR LYMPHOMA

A

Clinical signs =

  • Painless enlargement of lymph nodes especially around the neck, axilla and groin
  • Weightloss
  • Night Sweats
  • Itchy skin

Imaging =

  • CXR
  • UGI
  • Spine imaging
  • CT
163
Q

RADIOGRAPHIC APPEARANCE OF LYMPHOMA

A

CXR=

  • Mediastinal lymph nodes enlargement, bilateral asymmetric
  • Gastrointestinal and skeletal involvement

Spine imaging =

  • Ivory Vertabra appearance

CT=

  • Malignant lymph nodes will appear enlarged, round or oval

Radiographic Procedures And Pathology. Prep Course 1 (18 decks)

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