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!Diagnostic Imaging > Pulmonary Patterns > Flashcards

Pulmonary Patterns Flashcards

1
Q

Alveolar pattern

A

Diseases in the alveoli (air spaces)

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2
Q

What are alveolar patterns caused by?

A

Atelectasis/ collapse
Fluid accumulation
Cellular infiltrates
Pulmonary infarct
Extension of interstitial dz (edema, smoke, pneumonia)

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3
Q

Pathology of alveolar patterns

A

Alveoli filled with fluid, cells/ cellular debris (most opaque)
Alveoli collapsed

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4
Q

Lung collapse/ atelectasis causes

A

Airway obstruction (FB, mass)
Compression by adjacent lesion (lung mass)
Secondary to pleural effusion

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5
Q

Cranio-ventral/ gravity dependent part of lungs differentials

A

Bronchopneumonia and aspiration pneumonia (secondary to esophageal issue)

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6
Q

Caudo-dorsal part of caudal lobes distribution

A

Non-cardiogenic pulmonary edena (neurogenic)- peripheral part of the lung

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7
Q

Caudo-hilar (dorsal) distribution

A

Cardiogenic pulmonary edema secondary to left sided heart failure- central
(except in cats and dobermans)

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8
Q

Descriptions of distribution for alveolar patterns

A

Patchy, focal, multifocal, diffuse, consolidated*, asymmetrical

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9
Q

Bacterial pneumonia (bronchopneumonia)

A

Ventral portion: cr. and right middle lobes
Starts peripherally then spreads inward

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10
Q

Patterns associated with bronchopneumonia and aspiration pneumonia

A

Interstitial pulmonary pattern
Alveolar pattern (air bronchogram)

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11
Q

Diagnostics of bronchopneumonia (basic)

A

Rads
CBC: inflamm leukogram (left shift)
Neutropenia

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12
Q

Tx of bronchopneumonia

A

Supplemental O2
Antimicrobials
Bronchodilators
IV fluids
Saline nebulization and coupage

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13
Q

Aspiration pneumonia position

A

Ventral portion: right middle, cr., accessory and cd. lobes

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14
Q

What other signs come with aspiration pneumonia?

A

Esophageal dz:
Enlarged/ distended esoph.
Ventral deviation of trachea
Dorsal stripe sign

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15
Q

What is aspiration pneumonia secondary to?

A

Regrug, vomiting
Laryngeal dz (Paralysis/ neoplasia)
Iatrogenic aspiration from force feeds, anesthesia or meds
Weakness/ debilitating
Cleft palate
Tracheo-esophageal or broncho-esophageal fistula

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16
Q

Cardiogenic pulmonary edema is secondary to

A

Left sided heart dz from:
Mitral regurg in small breed dogs with Myxomatous mitral valve degeneration (MMVD)
DCM in large breeds
Hypertrophy cardiomyopathy (HCM) in cats

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17
Q

History of a patient with cardiogenic pulmonary edema

A

Coughing, resp. distress
Syncope
Exercise intolerance and heart murmur

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18
Q

Tx for cardiogenic pulmonary edema

A

Supplemental O2
Diuretics (furosemides)
Cardiovascular drugs
DV view preferred

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19
Q

T/F: IV fluids are contraindicated in animals with cardiogenic pulmonary edema

A

TRUE
could cause fluid overload

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20
Q

Non-cardiogenic pulmonary edema

A

Fluid accumulation secondary to direct or indirect lung injury and not due to cardiac coagulation
Results in hypoxemia
Fluid edema protein rich

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21
Q

3 mechanisms of Non-cardiogenic pulmonary edema

A

↑ endothelial permeability
↓ plasma oncotic pressure (pleural effusion)
Impaired lymphatic drainage

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22
Q

Differentials of Non-cardiogenic pulmonary edema

A

Neurogenic pulmonary edema (from electrocution, seizures, and cerebral injury)
Near drowning
Acute upper airway obstruction
Toxins/ inhaled irritants (smoke)
Drug reactions/ overdose

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23
Q

CS of Non-cardiogenic pulmonary edema

A

Coughing, resp. distress

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24
Q

Consolidation

A

Lung filled with fluid, pus or other material (norm. volume)
Soft tissue lung opacity
Stops @ lung limit

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25
Q

What is consolidation secondary to?

A

Bronchopneumonia

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26
Q

Atelectasis

A

Volume loss (airless)
Soft tissue lung opacity
Seen as mediastinal shift on VD/DV

27
Q

What is atelectasis secondary to?

A

External compression by severe pneumothorax, pleural effusion, large pleura or thoracic wall mass, prolonged recumbency, general anesthesia, airway obstruction

28
Q

Lung lobe torsions

A

In cats, deep chested dogs and small breeds
Associated with right middle lobe

29
Q

What’s seen on the radiograph with lung lobe torsions?

A

Concurrent pleural effusion
Change in opacity, size, shape and position of lobe
Abrupt stop to bronchus/ abnormally angled bronchus near hilus
Trapped pockets of gas scattered throughout opaque lobe

30
Q

Interstitial lung pattern

A

Disease within the interstitium (CT) of the lungs between airways

31
Q

Unstructured interstitial lung pattern

A

Hazy interstitium or parenchyma from pulmonary opacity that obscures the margins of the pulmonary vasculature (still visible, margins blurred)

32
Q

Structured interstitial lung pattern

A

Nodular interstitial lesions visualized greater than 4-5cm in diameter

33
Q

Localized/ focal differentials for unstructured interstitial pattern

A

Atelectasis
Contusion
Hemorrhage
Pulm. edema
Airway obstruction
Interstitial pneumonia, parasitic migration

34
Q

Diffuse differentials for unstructured interstitial pattern

A

Pneumonitis
Viral- distemper
Parasitic
Metabolic (uremia, pancreatitis, septicemia)
Inhalation (allergy/ smoke)
Toxic, edema, interstitial pneumonia, hemorrhage

35
Q

Structured interstitial patterns

A

Pulmonary masses > 2 cm
Nodules < 2cm
Nodules visualized greater than 5 mm in diameter

36
Q

Differentials for solitary/ pulmonary masses

A

CHANG
Cyst
Hematoma
Abscess
Neoplasia
Granuloma

37
Q

Primary pulmonary neoplasia

A

Solitary masses that can metastasize to other lung lobes (causing smaller nodules)

38
Q

Metastatic neoplasia

A

Smaller nodules, well-defined
Presents with history or suspicion of malignant neoplasms (spread to the lung)

39
Q

Bronchioloar carcinoma (primary neoplasia)

A

75% of cases
Orginiates from smaller airways and lcoated at periphery of th elung

40
Q

Bronchogenic carcinomas (primary neoplasia)

A

Originated from large bronchi in the hilar region (adenocarcinoma, SCC, anaplastic carcinoma)

41
Q

Nodular and miliary interstitial

A

Small nodules or very small (mille seeds) pulmonary opacities

42
Q

Differentials for Nodular and miliary interstitial

A

Metastatic dz
Fungal dz (thoracic lymphandenopathy- hilar or tracheobronchal LNs affected)

43
Q

Fungal pneumonias

A

Histoplasmosis, blastomycosis, coccidiomycosis

44
Q

Radiographic findings of fungal pneumonias

A

Miliary to nodular interstitial pattern
Thoracic lymphadenopathy

45
Q

CS of fungal pneumonias

A

Coughing, ↑ resp. effort
Known history of travel to endemic area

46
Q

Tx of fungal pneumonias

A

Itra-, fluco, ketoconazole
Amphotericin B
O2 therapy and supportive care

47
Q

Visualization of bronchial walls from:

A

Thickening
Calcification of bronchial cartilage
Cellular infiltrates around bronchi and bronchioles (peri-bronchial cuffing)

48
Q

Bronchial pattern

A

Dz involving the airway
Thickened walls of bronchi and bronchioles

49
Q

Radiographic findings of bronchial patterns

A

End-on/ cross sectional view of airways (donuts)
Longitudinal view of airways (tramlines, train racks and monorails)
Bronchiectasis (dilated bronchi)

50
Q

Differentials for bronchial patterns

A

Infectious bronchitis (bacterial or viral)
Non-infectious (Chr. or allergic bronchitis)
Eosinophilic bronchopneumopathy
Feline asthma
Bronchial calcification

51
Q

CS of bronchitis

A

Coughing, resp. distress, exercise intolerance

52
Q

What’s seen on thoracic radiographs with bronchitis?

A

↑ bronchial markings
Interstitial pattern (peri-bronchial cuffing)
Secondary pneumonia

53
Q

Bronchiectasis

A

Disease where there’s permanent enlargement of parts of the airways of the lung

54
Q

Types of Bronchiectasis

A

Cystic/ Saccular: dilated bronchus forms clusters of cyst
Varicose: irreg areas of constriction and dilation
Cylindrical: enlarged and cylindrical

55
Q

Feline Asthma

A

Bronchospasm and thicken airway by mucus and debris causes narrowing/ occlusion (airway obstruction)

56
Q

Whats seen on the rads of a cat with feline asthma?

A

Lobar sign on right middle lobe
Hyperinflated lungs from air-trapping causing flattening of the diaphragm

57
Q

CS of feline asthma

A

Coughing, wheezing and resp. distress

58
Q

Functional vascular system

A

Pulm. a. carry O2 deprived blood away from right ventricle to the lung
Pulm. v. carry oxygenated blood to left atrium

59
Q

Lobar artery, bronchus and vein to the left and right CRANIAL lung lobes

A

Assessed on lateral view
Compared to diameter of proximal 1/3 of 4th rib

60
Q

Lobar artery, bronchus and vein to the left and right CAUDAL lung lobes

A

Assessed on DV view
Measured by assessing area of summation of vessels over 9th rib

61
Q

Different lobar artery, bronchus and vein size

A

Good: make a square
Enlarged vessel: wide rectangle
Small vessel: Upright/ narrow rectangle

62
Q

Hyper-vascular

A

Enlarged pulm arteries: heartworm dz or pulm hypertension
Enlarged pulm veins: left sided heart failure
Both: left to right shunts or iatrogenic overhydration

63
Q

Hypo-vascular

A

Small pulm. arteries and veins
Microcardia, small caudal vena cava and hyperlucent lung capacity

64
Q

Differentials of hypovascular

A

Pulmonary hypotension (shock, blood loss, severe dehydration, hypoadrenocorticism and addisons dz)

!Diagnostic Imaging (9 decks)

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