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PBR 2 and 3 > Page 30 and 31 > Flashcards

Page 30 and 31 Flashcards

1
Q

natomy, and Radiographic Findings of Chest Disease Minimum amount of fluid or air that can be demonstrated in a lateral decubitus view?

A

5 ml of fluid; 15 ml of air (Fraser - 10 mL of fluid)

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2
Q

Normal coronal-to-sagittal diameter ratio of the trachea?

A

0.6 : 1

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2
Q

Normal amount of fluid within the pleural space

A

<5 mL

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2
Q

Extrathoracic malignancies with a propensity to metastasize to the lung?

A

osteogenic sarcoma, breast, and RCC

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3
Q

Anatomy: Trace the branches of the trachea down to its terminal anatomic structure.

A

trachea > main bronchi > lobar bronchi > segmental bronchi > bronchioles (including the terminal brioncholes then respiratory bronchioles) > alveolar ducts > alveolar sacs

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3
Q

What is the coronal-to-sagittal diameter ratio of a saber sheath trachea?

A

<0.6 or <2/3

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3
Q

Normal width of the right paratracheal stripe?

A

4 mm

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4
Q

Normal measurement of the tracheoesophageal stripe?

A

<5 mm

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4
Q

Compare the right and left main bronchi in terms of their orientation to the long axis of
the trachea and their length.

A

right is more obtuse, right is shorter

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4
Q

Origins of the arterial supply to the anterior and apicoposterior segments and of the superior and inferior lingular arfteries?

A

upper division of the left main PA, and left interlobar artery, respectively

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4
Q

Origins of the RUL pulmonary artery and middle lobe pulmonary artery?

A

truncus anterior and right interlobar artery, respectively

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5
Q

Upper limit of normal for the transverse diameter of the proximal right interlobar artery on PA at the level immediately lateral to the proximal portion of the bronchus intermedius?

A

17 mm in men and 15 mm in women

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5
Q

What segments does the inferior accessory fissure separate?

A

separates the medial basal from the rest of the basal segments

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6
Q

What pulmonary arteries are measured in the assessment of PA dilatation on PA and lateral radiographs?

A

PA - right interlobar pulmonary artery; lateral - left descending pulmonary artery

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6
Q

How do you differentialte pleural from peritoneal fluid on CT?

A

pleural fluid will displace the crus laterally while the peritoneal fluid will displace it medially

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6
Q

Nodular opacity terms and their corresponding sizes

A

miliary - <2mm
micronodular - 2-7mm
nodule - 7-30mm
mass - >3cm

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6
Q

What is the most serious and potentially fatal manifestation of sclerosing mediastinitis?

A

obstruction of the CENTRAL pulmonary veins, mimicking severe mitral stenosis

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6
Q

Differentiate the location of costal cartilage calcifications in men and women.

A

Men - upper and lower margins, women - central

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6
Q

Malignancies that are most often associated with intrathoracic nodal metastasis?

A

-GU (renal and testicular)
-H&N (skin, larynx, and thyroid)
-breast
-melanoma

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6
Q

Classic cause of pulmonary venous hypertension

A

LV systolic failure

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7
Q

Classic cause of obstruction to left ventricular inflow

A

mitral stenosis (but poor LV compliance [diastolic dysfunction] is more common)

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7
Q

Meaurement of widened vascular pedicle on PA radiograph

A

> 53 mm

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7
Q

Autoimmune disorders associated with a systemic immune complex vasculitis?

A

Wegener granulomatosis, SLE, RA, polyarteritis nodosa

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7
Q

Radiographic features that suggest infarction in PE?

A

pleural effusion and Hampton hump

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7
Q

What is the single most important factor in characterizing SPN as benign or
indeterminate?

A

internal density

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7
Q

What are the most malignant neoplasms arising from bronchial neuroendocrine/Kulchitsky cells?

A

small cell ca aka Kulchitsky cell cancers / KCC-3

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8
Q

5 patterns of benign calcifications?

A

Complete, central, concentric/laminated, popcorn, peripheral

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8
Q

Malignant pattern of calcification?

A

Eccentric

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8
Q

Fat within an SPN is diagnostic of what lesion?

A

Pulmonary hamartoma

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8
Q

Metabolically active lesions

A

carcinoid tumor and bronchioloalveolar cell ca

8
Q

Which bronchogenic ca is the inhalation of radon asssociated?

A

small cell ca

8
Q

Marked mediastinal nodal enlargement producing a lobulated mediastinal contour is characteristic of?

A

small cell ca

9
Q

Air bronchongrams or bubbly lucencies within a nodule or mass or mixed solid/ground- glass attenuation is highly suggestive of?

A

adenoca, particularly bronchioloalveolar ca (BAC)

10
Q

What cell type is the majority of Pancoast tumors?

A

squamous cell ca or adenoca

10
Q

3 subtypes of infection via tracheobronchial tree (based on radiographic pattern)

A

1 lobar pneumonia, 2 lobular or bronchopneumonia, 3 interstitial pneumonia

10
Q

3 potential routes of infection

A

1 tracheobronchial tree (inhalation or aspiration), 2 pulmonary vasculature (systemic sepsis), 3 direct spread (from adjacent extrapulmonary source - mediastinum, chest wall, upper abdomen)

11
Q

Which segments are involved in aspiration in the supine position?

A

posterior segments of the upper lobes and superior segments of the lower lobes

12
Q

Where does the tracheal bronchus / bronchus suis arise from?

A

right lateral wall within 2 cm of the carina

12
Q

Which segments are involved in aspiration in the erect position?

A

basal segments of the lower lobes

12
Q

Causative agent of valley fever which is a self-limiting viral-type illness associated with erythema nodosum and arthralgia?

A

Coccidioides immitis

12
Q

What congenital abnormalities are associated with tracheal bronchus?

A

congenital tracheal stenosis and abberant left pulmonary artery

12
Q

Main drugs associated with enlargement of the hilar and mediastinal LNs (rare)

A

dilantin and methotrexate

12
Q

Radiographic staging of sarcoidosis

A

0 - normal
1 - bilateral hilar LN enlargement
2 - bilateral hilar LN enlargement and parenchymal disease
3 - parenchymal disease only
4 - pulmonary fibrosis

12
Q

What is the CT equivalent of peribronchial cuffing and tram tracking which are seen
radiographically?

A

thickening of bronchial walls / bronchovascular structures / peribronchovascular interstitium

12
Q

Earliest findings in LCH

A

nodules with upper and mid-lung zone distribution

12
Q

Classical clinical triad of tuberous sclerosis

A

seizures, mental retardation, and adenoma sebaceum

12
Q

What is the earliest parenchymal finding in sarcoidosis

A

diffuse micronodular pattern, identical to miliary TB

13
Q

What part of the lung does the tracheal bronchus most often supply?

A

apical segment of the right upper lobe

13
Q

Anomalies that are associated with congenital tracheal stenosis?

A

PA sling and tracheal bronchus

13
Q

Imaging hallmark of tracheobronchomalacia

A

excessive airway collapse on expiration

13
Q

What is the coronal-to-sagittal diameter ratio of a saber sheath trachea?

A

<0.6 or <2/3 (coronal diameter is diminished to <2/3 of the sagittal diameter)

13
Q

On frontal radiographs, what are the coronal diameters of the trachea and central bronchi in tracheobronchomegaly?

A

> 3cm and >2.5cm, respectively

13
Q

Most important plain radiographic finding of emphysema?

A

hyperinflation

13
Q

What type of emphysema is associated with deficiency of a-1-antitrypsin (a-1-protease
inhibitor)?

A

panlobular

13
Q

Central bronchiectasis is seen only in what conditions?

A

allergic bronchopulmonary aspergillosis, cystic fibrosis, bronchial atresia, or acquired central bronchial obstruction

14
Q

What type of bronchiolitis is associated with RA and Sjogren syndrome?

A

follicular bronchiolitis

14
Q

d Miscellaneous Chest Disorders Normal fluid in the pleural space

A

2-5 mL

14
Q

3 stages of parapneumonic effusions:

A

stage 1 - exudative stage; visceral pleural inflammation -> increased capillary permeability -> sterile exudative effusion
stage 2 - fibrinopurulent pleural fluid containing bacteria and neutrophils; fibrin deposition on the visceral and parietal pleural impairs resorption and produces loculations
stage 3 (2-3 weeks) - ingrowth of fibroblasts over the pleura, which produces pleural fibrosis and entraps the lung

14
Q

Causes of inferior rib notching?

A

COA, TOF, SVC obstruction, Blalock-Taussig shunt (unilateral right), NF, aortic thrombosis, Takayasu aortitis

14
Q

Why are the first two ribs uninvolved in COA rib notching?

A

1st and 2nd intercostal arteries arise from the superior intercostal branch of the costocervical trunk of the subclavian artery and therefore do not communicate with the descending aorta

14
Q

Earliest manifestation of asbestos-related pleural disease

A

pleural effusion

14
Q

What is the most reliable radiologic evidence that a lesion is benign?

A

Calcification

14
Q

Causes of superior rib notching?

A

paralysis, RA, SLE

14
Q

What form of atelectasis is round atelectasis?

A

compressive

14
Q

Most important radiologic signs that may be observed in association with an increase in
intrapulmonary air

A

signs related to the diaphragm

14
Q

What is/are the direct sign/s of atelectasis?

A

Fraser - displacement of interlobar fissures and crowding of vessels and bronchi (kay Brant, iyong bronchovascular crowding, indirect)

15
Q

In what type of atelectasis is the absence of air bronchograms (indirect sign of atelectasis) seen?

A

resorption (iyong ibang types, pwedeng (+) air bronchograms)

16
Q

Which is slight more vertical, left or right major fissure?

A

left

17
Q

What is the mininum amount of fluid necessary to blunt the lateral costophrenic sulcus on PA radiograph?

A

175 mL

18
Q

In an increased retrosternal space, the distance between the sternum and ascending aorta should be greater than?

A

2.5 cm

19
Q

Direct measurement of a flattened hemidiaphragm is best done on what view?

A

lateral x-ray

20
Q

Overinflation is present if the distance of the dome of the diaphragm to the line connecting the sternophrenic and posterior costrophrenic junctions is less than __.

A

2.6 cm

21
Q

Uncommon manifestation of SLE with fever, dyspnea, hypoxemia, & patchy diffuse opacities (xray) in the absence of infection

A

Acute lupus pneumonitis

PBR 2 and 3 (41 decks)

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