PATH 179 LO3 part 2 Flashcards
What causes atelectasis?
- results from bronchial obstruction, neoplasm, FB
- Compression of the lung by pneumothorax, pleural fluid, tumor, lung abscess or large bulla
What are the signs and symptoms of atelectasis?
- Cough
- Chest pain
- Difficulty breathing
- Fever
What are the radiographic exams for atelectasis?
-x-ray
What is the radiographic appearance for atelectasis?
- local increase in density because of airless lung
- Vary from plate like streaks to complete collapse
- Displacement of interlobar fissures
What is the treatment for atelectasis?
- deep breathing
- Position changes
- Early ambulation
What is the cause of Adult respiratory distress syndrome?
- most commonly in patients with nonthoracic trauma
- Patients may also develop hypotension and shock (Lung shock)
- Severe pulmonary infection, aspiration, inhalation of toxins or irritants, drug overdose
What are the signs and symptoms of ARDS?
- Low blood pressure
- Difficulty breathing
- Organ failure
What are the radiographic exams for ARDS?
-x-ray
What is the radiographic appearance for ARDS?
- patchy ill-defined areas of alveolar consolidation produces coarse reticular pattern
- Size of heart remains normal
What is the treatment for ARDS?
- drug treatment with diuretics
- Oxygen therapy
- Positive pressure ventilation
What are secondary signs of intrabronchial FB?
partial or complete bronchial obstruction (usually lower lobes, Rt more often than Lt)
What are the signs and symptoms of intrabroncial FB?
- coughing
- Chocking
- Stridor
- Cyanosis
- Wheezing
What is the radiographic appearance for intrabronchial FB?
- partial obstruction
- Hyperaeration of the affected lobes and shift of heart and mediastinum toward the normal, contralateral side
- Best seen under fluoroscopy and expiration films
What is the treatment for intrabronchial FB?
removal of the object otherwise infection will occur
What is the other name mediastinal emphysema *
Pneumomediastinum
What is the cause of mediastinal emphysema?
after chest trauma, perforation of the esphagus or tracheobronchial tree, spread of air fascial planes in neck, peritoneal cavity or retoperitoneal space
What are the signs and symptoms of mediastinal emphysema?
Chest pain
What are the radiographic exams for mediastinal emphysema?
-x-ray
What is the radiographic appearance mediastinal emphysema?
- air causes lateral displacement of the mediastinal pleura
- Long, linear opacity runs parallel to the heart border
- Air is seen behind the sternum in streaks downward and anterior to the heart
- Infants-elevation of the thymus, air on one side “windblown sail or angel wings’
What is the treatment for mediastinal emphysema?
- No treatment needed as body will absorb the extra air
- Mat need surgery if trachea or esophagus is perforated
What causes subcutaneous emphysema?
- penetrating or blunt injurious that disrupt the lung and parietal pleura and forces air into the tissues of the chest wall
- when touching the skin you may hear crackles
what are the signs and symptoms of subcutaneous emphysema?
-pain the chest, arm, neck, wherever the air has migrated to
what is the radiographic exams for subcutaneous emphysema?
-x-ray
what is the radiographic appearance for subcutaneous emphysema?
appears as bizarre streaks with lucency around muscle bundles
What is the treatment for subcutaneous emphysema?
no treatment needed as body will absorb the extra air
-May need surgery if trachea or esophagus is perorated
What is coronary artery disease?
narrowing of coronary artery mostly attributable to plaque in the inner wall
What causes coronary artery disease? *
lifestyle factors that predispose to this condition: hypertension, obesity, smoking, lack of exercise, high cholesterol
What are the signs and symptoms of coronary artery disease?
- SOB
- Pain
- Tingling down left arm
- Chest pain
- Dizziness
- Anxiety
- Fatigue
- Nausea
- Vomiting
What are the radiographic exams for coronary artery disease?
- x-ray
- Angiography
What is the radiographic appearance for coronary artery disease?
-chest radiographs are non-conclusive for CAD, may see calcifications in coronary artery
What is the treatment for coronary artery disease?
treatment focuses on lowering your risk of heart attack and lifestyle changes
What is CHF?
inabiliy of heart to propel blood sufficiently throuh the system to supply tissues
What causes CHF?
cardiac abnormaility, hypertension, or peripheral resistance to blood flow
What are the signs and symptoms of CHF?
- fluid retention
- Dizziness
- Fatigue
- Weakness
What are the radiograph exams for CHF
CXR
What is the radiographic appearance for CHF?
-Many patients with CHF have cardiomegaly
What is the treatment of CHF?
- meds
- Surgery to treat underlying heart condition
What is the cause of pneumothorax?
-rupture of bulla (emphysema or spontaneous)
-Trauma (stabbing, gunshot, fractured rib)
-Iatrogenic cause such as needle biopsy or complication of hyaline membrane disease
spontaneous causes: idiopathic - tall thin males with no demonstrable cause
What is the the signs and symptoms of Pneumothorax?
- Sudden severe chest pain, dyspnea
- tension pneumothorax: weak rapid pulse, pallor, neck vein distension, anxiety
What are the radiographic exams for pneumthorax?
- AP/LAT CXR, inspiration and expiration, upright
- Decubitis veiws
- AEC not recommended because it may conceal a small pneumothorax
What is the radiographic appearance for pneumothorax?
hyperlucent area with no pulmonary markings
What is the treatment for pneumothorax?
- small pneumothoraces: may resolve by self
- Larger ones: chest tube drainage with suction
- Tension: medical emergency
What is pleural effusion?
accumulation of fluid in pleural space
What are the causes of pleural effusion?
CHF, pulmonary embolism, infection, pleuristy, neoplasm, connective tissue disorders
What are the signs and symptoms for pleural effusion?
- shortness of breath
- Chest pain
- Fever
- Cough
What are the radiographic exams for pleural effusion?
AP/LAT/decub chest
What is the radiographic apearance for pleural effusion?
- blunting of sharp costophrenic angle
- May appear as overall lung density if supine
- Massive effusions may compress adjacent lung
What is the treatment for pleural effusion?
Thoracentesis - remove fluid from pleural cavity
what causes Empyema - Hydrothorax - Hemothorax
empyema usually result of adjacent infection, or from surgery, trauma
What is the radiograpgic appearance of empyema - hydrothorax - hemothorax?
appears as a discrete mass that may vary in size
what causes pulmonary edema?
- elevated venous pressure, CHF, pulmonary venous obstruction, lmymphatic blockage
- uremia, narcotic overdose, toxic fumes, excess oxygen, high altitudes, fat embolism, ARDS, neyrologic abnormalities
What are the signs and symptoms of Puulmonary edema?
- Dyspnea (difficult breathing)
- Hypoxemia (low oxygen in blood)
- Orthopnea (shortness of breath)
What are the radiographic exams for pulmonary edema?
AP/LAT chest
What is the radiographic appearance for pulmonary edema?
- accumulation of fluid in interstitial spaces in earliest stages
- Fluid causes loss of normal sharp markings
- Peri-hilar haze ‘butterfly’ appearance *
- Pleural effusion is also associated with pulmonary edema, occurs mainly on the right side
What is the treatment for pulmonary edema?
lower stress, improve HPT, lower salt, diuretics, compresion stocking to improve tension of blood thru legs, varoius drugs
What is diaphragmatic paralysis?
elevation of one or both sides of the disphragm
What causes diaphragmatic paralysis?
paralysis resulting from damage to phrenic nerve
-accidential surfical transection, involvement of the nerve by primary bronchogenic carcinoa or metastatic malignancy in the mediastinum, or a variety of intrisic neurologic disease
What is the radiograph appearance for diaphragmatic paralysis?
- demonstrated best by sniff test
- during expiration the normal one rises and the paralyzed one descends
What is congenital hernia?
- developmental abnormality
- Hemidiaphragm does not adhere to the central tendon
- If it occurs in early development, the chest cavity is filled with intestines/stomach because the affected side fails to develop
What causes traumatic hernia?
by penetrating injury or compression of the abdomen which forces the stomach or intestines into the chest cavity
What is the radiographic appearance for traumatic hernia?
- plueral effusion
- gas shadows of the stomach and intestines are seen above the presumed level of the diaphragm
What is situs inversus?
total of partial movement of organs
ex) liver on the left and stomach on right
what are the anterior mediastinum masses?
- thymomas
- Teratomas
- Thyroid masses
- Lipomas
- Lymphoma
What are the middle mediastinal masses?
- lymph node disorders
- bronchogenic cyst
- vascular anomalies
- Mass anterior costophrenic angle
Posterior mediastinal masses?
- neurogenic tumors
- Neurogenic cysts
- aneurysms of the descending aorta
- Extrmedullary hematopoiesis
what are the signs and symptoms of mediastinal masses? *
- 1/3rd of patients - asymptomatic
- Chest pain, cough, dyspnea
What is the rad appearance for mediastinal masses?
- cystic mass: compress, multi-loculated
- Solid masses: compress + displace adjacent structures
what are the signs and symptoms of pulmonary embolism?
- usually non-specific
- Sudden chest pain
- dyspnea
- Tachycardia
- unexplained anxiety
- If from DVT - calf pain, tenderness and asymmetry
what are the radiographic exams for pulmonary embolism?
- x-ray
- CT
What is the rad appearance for pulmonary embolism?
- focal pulmonary oligemia and relative lucency of the involved portion of lung
- Enlargemnent of the ipsilateral main pulmonary artery - distention of the vessel with thrombus
- Area of lung consolidation
What is the treatment for pulmonary embolism?
- Anticoagulant therapy for an extended period of time
- Thrombolytics can assist in dissolving of clot
- Filter in the vena cava, if anticoagulant and thrombolytics cannot be used or are unsuccesful
What is septic embolism?
shower of bacteria that enters pulmonary circulation and remain trapped in lung
-Arise from heart - bacterial endocarditis
What is pulmonary ateriovenous fistula?
abnormal vascular communication between a pulmonary artery and pulmonary vein
-Shunting of blood from arteries to veins does not allow blood to be oxygenated
What is th rad appearance for pulmonary arteriovenous fistula?
round or oval, lobulated soft tissue mass in lower lobes
what is the treatment for pulmonary arteriovenous fistula?
embolization
