Radiology of the Thorax - 1 Flashcards
What are the four places in the thorax to see abnormalities
Mediastinum
Pleura
Lungs/Bronchi
Chest wall
What radiographic densities are normal and abnormal
Normal: Calcium (bone) Soft tissues Fat Air
Abnormal:
Metal
What is the one thing to look at for the lateral chest xray
The posterior costophrenic angle that can show you a small pleural effusion
Pleural cavity
Potential space between the pleura that normally contains a small amount of serous fluid
Pleural Issues
1) Pneumathorax
2) Pleural Effusions
3) Tumors - plaques
calcium
cancer
metastases
mesothelioma
Pneumathorax
asthma, trauma, a wrongly done central line results in air in the pleural cavity, seperating the parietal and visceral pleura (the surface-tension is broken).
Due to the lungs innate elasticity it collapses inwards, now no air can get in
Pneumacystist
Nasty pneumonia. Get cysts. Whites, stiff diseased lungs, we pump air in but if the cysts pop air is pumped into plural cavity (pneumathorax)
How to diagnose pneumothorax
- if you don see vessels in periphery (white lung, black outside of lung)
- see outline of lung
- If gasping for air = BILATERAL PNEUMATHORASES
Bilateral pneumathorases
No air getting in at all.
Pleural Effusion is? What does it look like?
Fluid in pleural cavity, accumulates at the bottom.
Looks like a balloon in a bucket (white meniscoid appearance, not always)
Causes of pleural effusions
Common:
CHF/Fluid overload; bilateral
Parapneumonia (irriating down bottom of lungs)
Less common:
Cancer/metastases
Trauma (inc iatrogenic)
How do pleural effusions evolve
Pneumonia (irriating down bottom of lungs> fluid) . Fever, cough, high WBC count
CHF: loss of the angles (bilateral effusion), ECG leads (chest pain), big heart! 80% right effusion bigger. Orthopnea, swollen ankles
Two MAIN causes.
Aortic Tranfusion
HUGE pleural effusion
- Part of aorta stationary, other still moving, it tears the inner two layers of the aorta, the adventia the only thing holding it together
- 90% die at the seen
Tumors of the pleura
Least common lung cancer, metastases, mesothelioma
Asbestos
Asbestosis is a process of lung tissue scarring caused by asbestos fibers. Asbestos is the only known risk factor for malignant mesothelioma, a cancer that affects the tissue lining the lung (pleura) or abdomen (peritoneum).
