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Respiratory System Flashcards

1
Q

What are the 2 Congenital/Hereditary Diseases of the lungs?

A

Cystic Fibrosis (CF)
Idiopathic Respiratory Distress Syndrome

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2
Q

What is cystic fibrosis a result of?

A

Chromosome 7 mutation

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3
Q

What pathology is this describing?

Secretion of excessively viscous mucus by exocrine glands

Increased sodium reabsorption and decreased chloride secretion (fluid doesn’t flow out, it goes into the cells along the lining)

A

Cystic fibrosis

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4
Q

T/F

There is no known cure for cystic fibrosis

A

True

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5
Q

What structures of the body does cystic fibrosis affect?

A

Affects lungs, pancreas (mucus can block things), and digestive system

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6
Q

T/F

90% CF mortality is the result of respiratory involvement

A

True

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7
Q

What are the radiographic signs of Cystic fibrosis?

A
  1. Hyperinflation (Harder to exhale),
  2. fibrotic lungs (scratchy),
  3. small cysts
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8
Q

T/F

With cystic fibrosis, the tissue appears radiolucent.

A

False; Tissue appears radiopaque

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9
Q

Why do individuals with cystic fibrosis have a decreased amount of salt in thier body?

A

Excessive perspiration leads to loss of salts (cells doesn’t take chlorine back into the cells)

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10
Q

What are the physical signs/symptoms of cystic fibrosis?

A
  1. copious phlegm (widening of the diameter of the airways),
  2. incessant coughing,
  3. hemoptysis (burst blood vessels)
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11
Q

What pathology is seen here?

A

Cystic fibrosis

Lung looks scratchy

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12
Q

What pathology is shown here? How do we know?

A

Cystic fibrosis
-Haziness inside the airway is the mucus, bronchiectasis (dilation of the airways)

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13
Q

What is Idiopathic Respiratory Distress Syndrome (IRDS) caused by and what age group does it affect?

A
  1. Immature lungs
  2. Insufficient surfactant
    -Affects infants

Usually resolved after 30 weeks with treatment

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14
Q

What is another name for IRDS?

A

Hyaline Membrane Disease

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15
Q

What radiographic signs are visible with IRDS?

A
  1. Atelectasis (alveoli collapsed, whiter)
  2. Granular appearance of parenchyma (“ground glass”)
  3. Air bronchogram sign (lung white, darker airways on top)
  4. Hypoaeration (lungs not inflating as well)
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16
Q

What pathology is seen here? How do we know?

A

-IDRS
-Seeing the darker airways

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17
Q

What are the two Inflammatory Disorders of the upper Respiratory system?

A

Croup
Epiglottitis

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18
Q

What are the auditory signs of Croup?

A
  1. Barking cough, harder to breath
  2. Inspiratory stridor (high pitch wheeze)
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19
Q

How does croup appear radiographically?

A

Hour glass shape on an AP neck

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20
Q

What is croup and what age does it usually affect?

A

Subglottic inflammation and narrowing of the trachea usually affecting the young

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21
Q

What pathology is seen here?

A

Croup

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22
Q

What is Epiglottitis prevented by?

A

Prevent by giving HIV vaccine

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23
Q

What is the radiographic sign of eppiglottitis?

A

Thickened epiglottis (Thumb sign)

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24
Q

What is epiglottitis and what are the physical signs/symptoms?

A

Acute, rapid onset of infection of the epiglottis which causes Dysphagia; (trouble swallowing)

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25
Q

T/F

Epiglottitis requires the patient to be intubated

A

True

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26
Q

What is the radiographic sign of Epiglottitis?

A

Thickened epiglottis (Thumb sign) on a lateral soft tissue neck

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27
Q

What pathology is seen here?

A

Eppiglottitis (see the red arrow pointing to thumb print sign)

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28
Q

What are the 4 Inflammatory Disorders of the Lower Respiratory?

A
  1. Pneumonia
  2. Lung Abscess
  3. Tuberculosis
  4. Severe Acute Respiratory Syndrome (SARS)
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29
Q

What is this describing?

Infection causing inflammation of the lungs

A

Pneumonia

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30
Q

What are the 4 things that Pneumonia can be caused by?

A
  1. Bacteria
  2. Viruses
  3. Inhaled chemicals
  4. Aspirated chemicals
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31
Q

What are the most common causes of pneumonia?

A

Bacteria and viruses most common causes

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32
Q

What are the four types of Pneumonia?

A
  1. Alveolar Pneumonia
  2. Bronchopneumonia
  3. Interstitial Pneumonia
  4. Aspiration Pneumonia
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33
Q

What is Alveolar Pneumonia

A

Consolidation in one or more lobes (alveolar collapse) affecting the alveoli

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34
Q

What is another name for Alveolar Pneumonia?

A

“Lobar pneumonia”

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35
Q

T/F

Alveolar Pneumonia has no involvement of the airways

A

True

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36
Q

How does Alveolar Pneumonia appear on a radiograph?

A

-Whiter looking tissue, and darker looking alveoli
-Air Bronchogram

-Total volume of chest is not really affected; lungs look the same size, just filled with crud

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37
Q

What is the most common type of alveolar pneumonia?

A

Streptococcus

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38
Q

What type of infection is alveolar pneumonia?

A

Bacterial infection

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39
Q

What pathology is seen here?

A

Alveolar Pneumonia

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40
Q

What is the air bronchogram sign?

A

Darker airways on whiter lung tissue

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41
Q

What pathology is seen here?

A

Alveolar Pneumonia

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42
Q

What is Bronchopneumonia

A

Inflammation of the bronchi and bronchioles that spreads to alveoli

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43
Q

T/F

Bronchopneumonia
often involves both lungs (bilateral)

A

True

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44
Q

What is the most common type of Bronchopneumonia?

A

Staphylococcus (Bacterial)

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45
Q

What are the radiographic signs of Bronchopneumonia?

A

-Small patches of consolidation
-No Air Bronchogram sign, just inflammation around the airways

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46
Q

What pathology is shown here?

A

Bronchopneumonia

-Is more bilateral unlike the alveolarpneumonia

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47
Q

What are the most common causes of Interstitial Pneumonia?

A

Viral and mycoplasmal infections

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48
Q

What does Interstitial Pneumonia lead to?

A

Leads to fibrosis

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49
Q

How does Interstitial Pneumonia appear radiographically?

A

-“Honeycomb Lung” as seen on CT
-Interstitial tissue thicker between all of the alveoli (inflammation between the air spaces)
-Tissue between alveoli more visible

No heavy mucus, bronchiectasis as seen in CF

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50
Q

What is the shaggy heart sign?

A

Harder to see the outline of the heart associated with Interstitial Pneumonia

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51
Q

What pathology is seen here?

A

Interstitial Pneumonia

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52
Q

What pathology is seen here?

A

Interstitial Pneumonia

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53
Q

What is Aspiration Pneumonia and in what population is it common to see this pathology?

A

-Aspiration of esophageal or gastric contents
-Common with anesthesia, stroke patients, trauma

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54
Q

What location of the body does aspiration pneumonia typically affect?

A

-Typically affects the lower lobes
(Right lung more affected)

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55
Q

How does Aspiration Pneumonia appear radiographically?

A

Inflammation, consolidation

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56
Q

What pathology is seen here?

A

Aspiration Pneumonia

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57
Q

What pathology is seen here?

A

Aspiration Pneumonia

Barium swallow in the airway; hard to remove

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58
Q

What are Lung Abscesses
and how do they appear radiographically?

A

-Necrotic area of lung parenchyma containing pus
-Typically round and have an air-fluid level

Body goes to fight it off, but tissues release toxins, the body cannot clear it so it builds a wall around the necrotic tissue (isolation). In the lungs, you can get air within these abscesses (if they connect with airways).

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59
Q

What are the 5 causes of Lung Abscesses?

A

-Aspiration
-Bronchial obstruction
-Complication of bacterial pneumonia
-Septic emboli
-Diffuse bacteremia

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60
Q

What is a Septic emboli?

A

Blood infection carried in a clot through the lungs

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61
Q

What is Diffuse bacteremia?

A

Bacteria in the blood spread throughout the body and the lungs

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62
Q

T/F

Lung abcesses may just appear with fluid initially

A

True

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63
Q

What pathology is seen here?

A

Lung Abscess

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64
Q

What pathology is seen here?

A

Lung Abscess

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65
Q

What is TB caused by?

A

Caused by mycobacterium tuberculosis

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66
Q

What procautions are taken for TB?

A

Airborne Precautions: N95 mask

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67
Q

Where can TB spread to?

A

GI, urinary and skeletal system

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68
Q

What are the four radiographic signs of TB?

A
  1. Patchy consolidation, nodules
  2. Hilar and mediastinal node enlargement
  3. Pleural effusion
  4. Calcified as healing occurs
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69
Q

What inflammatory disorder is killed by sunlight?

A

TB

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70
Q

What is the best method for imaging TB?

A

Dual energy x ray

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71
Q

What pathology is seen here?

A

TB

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72
Q

What pathology is seen here?

A

TB

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73
Q

What pathology is seen here?

A

TB

Can grow to cyst like abscesses

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74
Q
A

TB

Can have air fluid levels present

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75
Q

What type of TB is present here? When does this occur?

A

-Miliary TB
-This happens when TB spreads through the blood stream (end up as fine nodules)

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76
Q

How do initial radiographs of SARS appear?

A

Initial chest images appear normal

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77
Q

How does SARS coronavirus appear radiographically as it progresses?

A

Progress to focal opacities (localized opacities), then to diffuse opacities

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78
Q

What pathology is seen here?

A

Severe Acute Respiratory Syndrome (SARS)

-Focal opacitices (earlier stage)

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79
Q

What are the 4 types of COPD?

A
  1. Chronic Bronchitis
  2. Emphysema
  3. Bronchiectasis
  4. Asthma (not always considered COPD)
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80
Q

What pathology is this describing?

-Often includes multiple disease processes coexisting
-Chronic obstruction of airflow to lungs
-Ineffective exchange of respiratory gases

A

COPD

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81
Q

What are the physical symptoms of COPD?

A

Persistent cough & difficulty breathing

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82
Q

What are the predisposing factors to COPD

A
  1. Smoking
  2. Air pollution
  3. Occupational exposure to harmful substances
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83
Q

What is Chronic Bronchitis?

A

-Inflammation of the bronchi and bronchioles
-Walls thicken and produce thick mucus

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84
Q

What is a physical sign that Chronic Bronchitis is present?

A

Productive cough (coughing up mucus) for 3 months in 2 successive years

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85
Q

What are the four radiographic appearances of Chronic Bronchitis?

A
  1. Subtle changes
  2. Generalized increase in vascular markings, especially in lower lobes
  3. Tram lines (thicker walls of the bronchi-train tracks)
  4. Wall thickening on CT; inner part-lumen, more narrow
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86
Q

What pathology is present?

A

Chronic Bronchitis

-Walls around airway are thicker (predominant)

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87
Q

What is the white arrow pointing to?

A

Tram lines as seen with Chronic Bronchitis

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88
Q

Why do the lungs become over inflated with Emphysema?

A

Continuous bronchial narrowing and a loss in elasticity (become stiff) makes it hard to exhale as alveoli remain filled with air

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89
Q

What can occur in an individual coughing with Emphysema?

A

Coughing may cause the alveoli to rupture

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90
Q

What pathology is this describing?

Inflammation causes the lungs to become stiff

A

Emphysema

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91
Q

What is a Bullae?

A

A pocket of ruptured alveoli
(One big alveolus)

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92
Q

What are the 4 radiographic signs of over inflated lungs as seen with Emphysema?

A
  1. Flattening of hemi-diaphragms (instead of a nice pointy base)
  2. Increased AP diameter of chest (barrel chest)
  3. Bullae
  4. Increased retrosternal space (seen on lateral projection)
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93
Q

What pathology is seen here?

A

Emphysema

-Costophrenic angles are not seen well even though it looks like they are taking a deep breath
-Barrel chest

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94
Q

What pathology is seen here?

95
Q

What pathology is seen here?

96
Q

What pathology is seen here?

A

Emphysema

-Flat lungs
-Barrel chest

97
Q

What could Emphysema lead to?

98
Q

What pathology is seen here?

99
Q

What is Bronchiectasis?

A

Permanent abnormal dilation of the bronchi and bronchioles that destroys the elastic and muscular layers

100
Q

Why is it harder to clear secretions with Bronchiectasis?

A

Enlarged airways make it harder to clear secretions

-Because they are so big, you will not have as much pressure when coughing, making it harder to remove mucus

101
Q

What are two physical symptoms of Bronchiectasis?

A

-Hemoptysis: Coughing up blood
-Copious amounts of sputum

102
Q

T/F

Bronchiectasis can lead to more infections

A

True

-Prone to keeping bacteria because of decreased pressure when coughing, leading to more infections in the lungs

103
Q

What is the cause of Bronchiectasis?

A

Seen because of chronic/ long term bronchitis

104
Q

What is the best modality for diagnosing Bronchiectasis?

105
Q

What are the 3 radiographic signs of Bronchiectasis?

A
  1. May show coarseness and loss of definition of interstitial markings (because of inflammation)
  2. Advanced stage: oval or circular cystic spaces can develop
  3. Can cause honeycombs due to interstitial fibrosis

Walls are normal thickness

If we see honeycomb, for the purpose of the test, it isn’t this pathology

106
Q

What are the 2 radiographic signs of Bronchiectasis seen in CT?

A
  1. Signet ring sign
  2. String-of-pearls sign: Very uncommon
107
Q

What pathology is seen here?

A

Bronchiectasis

-Seeing cysts (advanced)
-Fibrosis throughout the lungs

108
Q

What pathology is seen here?

A

Bronchiectasis

-Airway very dilated
-Walls are normal thickness

109
Q

What pathology is seen here?

A

Bronchiectasis

-Signet ring appearance (ring is the bronchus, stone sitting on the ring is the blood vessel beside)

110
Q

What pathology is seen here?

A

Bronchiectasis

-Large airways
-Collection of mucus in airways

111
Q

What pathology is seen here?

A

Bronchiectasis; String of pearls

112
Q

What is extrinsic asthma?

A

Diffuse narrowing of airways due to allergen hypersensitivity

113
Q

What is intrinsic asthma?

A

Caused by heat, cold, strong emotions, exercise

114
Q

What pathology is this describing?

  1. Swelling of membranes
  2. Excess mucus
  3. Bronchial wall spasm
115
Q

What are the 3 radiographic signs of an acute asthma attack?

A
  1. Bronchial narrowing
  2. Flattened hemidiaphragms
  3. Increased retrosternal space
116
Q

What is a radiographic sign of chronic asthma?

A

Dirty lung appearance

117
Q

T/F

Normal chest x-rays in 75% of asthma cases

118
Q

What pathology is seen here?

A

Chronic asthma

119
Q

Whatis the most common type of neoplasm of the lung?

A

Bronchogenic Carcinoma

120
Q

Where does Bronchogenic Carcinoma arise from, and how does it spread?

A

Arises from mucosa of bronchial tree, metastatic bone spread

121
Q

What are the two types of Bronchogenic Carcinomas?

A
  1. Small Cell Carcinoma (less common of the two)
  2. Non-Small Cell Carcinomas
122
Q

What are the 3 types of Neoplasms of the lungs?

A
  1. Bronchogenic Carcinoma
  2. Solitary Pulmonary Nodule
  3. Metastatic Lung Cancer
123
Q

What are the 3 types of Non-Small Cell Carcinomas?

A
  1. Adenocarcinoma
  2. Squamous Cell Carcinoma
  3. Large Cell Carcinoma
124
Q

What is the cause of Bronchogenic Carcinoma?

A

Inhalation of carcinogens

125
Q

How can you differenciate the different types of Bronchogenic Carcinoma?

A

Requires lung biopsy to differentiate type of cancer

126
Q

What percentage of cases does Small Cell Carcinoma make up for the types of Bronchogenic Carcinoma?

127
Q

What perecentage of cases does Non-Small Cell Carcinoma make up for the types of Bronchogenic Carcinoma?

128
Q

What is the most agressive type of Bronchogenic Carcinoma with the worst prognosis?

A

Small Cell Carcinoma

More likely to spread to other regions

129
Q

Where does Small Cell Carcinoma appear?

A

Typically occur in the hilar region (closer to midline)

130
Q

What is another name for Small Cell Carcinoma?

A

Oat cell carcinoma; small cells that look like oats

131
Q

What are the risks assosiated with Small Cell Carcinoma?

A

SVC obstruction and other airway obstruction

132
Q

What pathology is seen here?

A

Small Cell Carcinoma
-Advanced cases

-White large masses; taking up all of the anterior portion of the thorax
-Make it harder to breath, move, excsersie

133
Q

What pathology is seen here?

A

Small Cell Carcinoma

134
Q

Where is Squamous Cell Carcinoma located?

A

In the lining, closer to the midline and the mainstem bronchi

135
Q

Where is Adenocarcinoma located?

A

Located more in the peripheries, epithelial origin from glandular tissues

136
Q

Where can Large Cell Carcinoma be located?

A

Can be located anywhere

137
Q

What is the best modality for imaging Bronchogenic Carcinoma?

138
Q

What are the 3 radiographic signs of Non-Small Cell Carcinoma?

A
  1. Hilar and mediastinal node enlargement
  2. Cavitation
  3. Secondary signs from obstruction: might see lungs collapsing, lungs looking over inflated
139
Q

What pathology is seen here?

A

Non-Small Cell Carcinoma- Adenocarcinoma

140
Q

T/F

Solitary Pulmonary Nodule is ussually an
Incidental finding

141
Q

T/F

Solitary Pulmonary Nodule is malignant.

A

False; may be benign or malignant.

142
Q

What are the 2 radiographic signs of a benign Solitary Pulmonary Nodule?

A
  1. Smooth, sharp margins
  2. Presence of calcification
143
Q

What modalities can be used for diagnosing a Solitary Pulmonary Nodule?

A

PET
CT, Biopsy
Bronchoscopy

144
Q

What pathology is seen on the right?

A

Fungal infection; solitary pulmonary nodule

145
Q

How does Metastatic Carcinoma spread to the lungs?

A
  1. Lymphatic spread
  2. Hematogenous spread
  3. Direct invasion
146
Q

T/F

1/3 or 33% of all types of cancers spread to lungs

147
Q

What are the 3 radiographic signs of Metastatic Carcinoma

A
  1. Cannonball lesions-multiple large lesions
  2. Fine miliary nodules
  3. single lesion (less common)
148
Q

What are Cannonball lesions

A

Multiple large lesions seen with Metastatic Carcinoma

149
Q

What pathology is seen here?

A

Metastatic Carcinoma; Canon ball lesions

150
Q

What pathology is seen here?

A

Metastatic Carcinoma-miliary nodules

151
Q

What pathology is seen here?

A

Metastatic Carcinoma; Canon ball lesions

152
Q

What is a pulmonary embolism?

A

Blockage of the pulmonary arterial system

Free to float from the venous system all the way back to the heart

These form in the legs, issue is that once they get through the heart and to the pulmonary system, now the arteries get smaller until the blood clot blocks everything

153
Q

T/F

A Pulmonary embolism is potentially fatal

154
Q

What percentage of pulmonary embolism patients are asymptomatic?

A

80% of patients are asymptomatic

155
Q

What is the most common cause of pulmonary embolisms?

A

Deep Vein Thromboses (DVT’s)

156
Q

What percentage of pulmonary embolisms result from DVTs?

A

95% arise from DVTs

157
Q

What are all the possible causes of pulmonary embolisms?

A

Venous stasis, pregnancy, post surgery, oral contraceptives, stroke, DVT

158
Q

What modality is best to image pulmonary embolisms?

A

CT is the modality of choice;CT pulmonary angiogram or M V/Q scan (Ventilation-Perfusion scan)

159
Q

What are the 3 symptoms of pulmonary embolisms?

A
  1. Dyspnea-Trouble breathing
  2. Chest pain
  3. Hemoptysis-Coughing blood
160
Q

Why is CT the modality of choice to image pulmonary embolisms?

A

Shows filling defects in arteries

161
Q

How would a pulmonary embolism appear in a nuc med scan?

A

Would show up as a cold spot

162
Q

What pathology is seen here?

A

Pulmonary Embolism (PE)

-Filling defect seen
-As the vessels get smaller it will occlude the whole thing

163
Q

What pathology is seen here? What are the arrows pointing to?

A

Pulmonary Embolism (PE)
Red arrows: Areas with less signal

164
Q

What is Atelectasis?

A

Collapse of one or more areas of the lung

Trapped air is absorbed by the blood, lung collapses

165
Q

What are the 5 main causes of Atelectasis?

A
  1. Neoplasm
  2. Foreign body
  3. Mucous plug
  4. Pneumothorax/pleural effusion
  5. ET tube positioned into the right main stem bronchus-Iatrogenic cause

(these things stop air flowing to the area)

166
Q

What are the four radiographic appearances of Atelectasis?

A
  1. Localized increase in density (area that is collapsed is whiter)
  2. Shift of structures toward the affected area (everything thing else moves into the space that is made-(free real estate)
  3. Compensatory over-inflation of the unaffected lung
  4. Upward shift of the hemi-diaphragm on the ipsilateral side (L atelectasis, L hemidiaphragm, L structures move)
167
Q

What pathology is shown here?

A

Atelectasis

Heart shadow moved to the other side of the body

168
Q

What pathology is seen here?

A

Atelectasis

169
Q

What pathology is the blue arrow pointing to?

A

Atelectasis

170
Q

What is pulmonary edema?

A

Abnormal accumulation of fluid in the extravascular pulmonary tissues (interstitial fluid and alveoli)

171
Q

What are the causes of pulmonary edema? List 3:

A
  1. Left-sided heart failure
  2. Fluid overload
  3. High altitudes

Other causes:
-ARDS, Overdose, Near drowning, Aspiration

172
Q

What is the most common cause of pulmonary edema?

A

Left-sided heart failure

173
Q

What are the three radiographic signs of pulmonary edema?

A
  1. Air space opacification
  2. Perihilar haze
  3. Kerley B lines
174
Q

What are Kerley B lines?

A

Horizontal lines at the lateral edges of the lung bases

175
Q

What pathology is seen here?

A

Pulmonary Edema

-Opacification
-Enlarged heart

176
Q

T/F

Kerley B lines can appear in other places besides the bases of the lungs.

177
Q

What is the red arrow pointing to?

A

Kerley B lines

178
Q

What pathology is seen here?

A

Pulmonary Edema

Increased density within the interstitial areas
Kerley B lines

179
Q

What pathology is seen here?

A

Pulmonary edema

Increased density within the interstitial areas
Kerley B lines

180
Q

T/F

Acute Respiratory Distress Syndrome (ARDS) is Life-threatening.

181
Q

In what population is ADRS most common?

A

Develops in critically ill or post-op patients with no major underlying lung disease

182
Q

What are the four causes of Acute Respiratory Distress Syndrome (ARDS)?

A
  1. Severe pulmonary infection
  2. Aspiration
  3. Drug overdose
  4. Inhalation of toxic substances (suddenly)
183
Q

What are the radiographic appearances of Acute Respiratory Distress Syndrome (ARDS)?

A

Bilateral, patchy, ill-defined areas of consolidation

Similar to PE (without the large heart)

184
Q

What pathology is this describing?

-Breakdown of lung parenchyma
-Substantial leakage of fluid/cells into interstitial/alveolar spaces
-Low levels of O2 in blood
-Severe respiratory impairment

A

Acute Respiratory Distress Syndrome (ARDS)

185
Q

What pathology is seen here?

A

Acute Respiratory Distress Syndrome (ARDS)

186
Q

How are radiolucent foreign bodies diagnosed?

A

Radiolucent foreign bodies are diagnosed by secondary signs

187
Q

If a foreign body has caused a complete obstruction, what radiographic sign will be seen?

A

Complete-Atelectasis

188
Q

If a foreign body has caused a partial obstruction, what radiographic sign will be seen?

A

Overinflation like with COPD

189
Q

What is Sinusitis? What are the three causes?

A

-Inflammation of the sinuses caused by infection
1. Viral
2. Bacterial
3. Allergies

190
Q

What is the best modailty to image Sinusitis?

191
Q

When imaging for sinisitis, what is the best positioning technique? Why?

A

Erect imaging with horizontal beam to show air-fluid levels

Never use an angle on the tube!

192
Q

What pathology is seen here? What projection is this?

A

-Sinusitis
-Waters sinus method

193
Q

What are the radiographic appearances of sinusitis in CT?

A
  1. See fluid posteriorly in CT
  2. Increased thickening of the walls
  3. Airway inflamed
194
Q

What are the four Disorders of the Pleura?

A
  1. Pneumothorax
  2. Pleural Effusion
  3. Hemothorax
  4. Empyema
195
Q

What are the four causes of a Pneumothorax?

A
  1. Trauma
  2. Spontaneous
  3. Bullae or bleb rupture
  4. Iatrogenic
196
Q

What is the most common cause of a PTX?

A

Bullae or bleb rupture

197
Q

What population is most likely to have a spontaneuous PTX?

A

More likely to happen with asthenic males

198
Q

What 2 possible Iatrogenic causes of a PTX

A

Lung biopsy, pacemaker insertion

199
Q

What are the 3 radiographic appearances of a PTX?

A
  1. Visible visceral pleural edge is seen as a very thin, sharp white line
  2. No lung markings are seen peripheral to this line
  3. Peripheral space is radiolucent compared to adjacent lung
200
Q

What projections are done to image a PTX?

A
  1. Inspiration and expiration PA chest images
  2. Lateral decubitus chest image with the affected side up
201
Q

What projection is better for imaging a PTX; inspiration or expiration?

A

Expiration

202
Q

What pathology is seen here?

A

PTX; L sided

Putting pressure on the lungs and pushing it the opposite direction

203
Q

What pathology is seen here?

A

PTX

Inspiration and expiration view
-More subtle on inspiration
-No lung markings, lung condenses

204
Q

What pathology is seen here?

A

PTX

can see the edges of the lung on expiration

205
Q

What is tthe treatment for a PTX?

A

A chest tube insertion

206
Q

What pathology is seen here?

207
Q

What pathology is this describing?

-Air continues to enter pleural space, but cannot exit
-Complete collapse of the lung and flattening of the diaphragm

A

Tension Pneumothorax

Patient breaths out, lung moves inwards, pressure increases which causes air escaping into pleural space, each time they breath it becomes more shallow

208
Q

T/F

A tension PTX is fatal if not relieved immedietly

209
Q

How is a tension PTX treated?

A

Chest tube connected to suction

210
Q

What pathology is seen here?

A

A Tension PTX

211
Q

What is the main radiographic sign of a tension PTX?

A

Shift of the heart and mediastinum towards the opposite side

212
Q

What pathology is seen here?

A

Tension PTX

213
Q

What is Subcutaneous Emphysema?

A

Free air in the tissues of the chest wall (below the skin) that can spread to other places in the body

214
Q

What are the 2 causes of subcutaneous emphysema?

A
  1. Penetrating or blunt injuries that disrupt the lung and parietal pleura
  2. Chest tube insertions incorrectly
215
Q

What is one physical sign of subcutaneous emphysema?

A

Crepitation on palpation (When you are touching them, skin is crinkely)

216
Q

What pathology is seen here?

A

Subcutaneous Emphysema

217
Q

What pathology is seen here?

A

Subcutaneous Emphysema

218
Q

What pathology is seen here?

A

Subcutaneous Emphysema

219
Q

What is a Pleural Effusion?

A

Fluid within the pleural space/cavity

Not interstitial tissue as seen with Pulmonary edema

220
Q

What are the causes of a Pleural Effusion? List 3:

A

Congestive heart failure
Pulmonary embolism
Infection (especially TB)

Other causes include;
Neoplastic disease, Ascites, Pancreatitis

221
Q

What image projections are done to visualize a Pleural Effusion?

A
  1. Erect (looking for fluid)
  2. Decubitus images with affected side down
222
Q

What radiographic sign indicates a Pleural Effusion?

A

Blunting of the costophrenic angles

223
Q

What treatment is done for a Pleural Effusion?

A

Thoracentesis

224
Q

What pathology is seen here?

A

Pleural Effusion

225
Q

What pathology is seen here?

A

Pleural Effusion

226
Q

What pathology is seen here?

A

Subtle case of Pleural Effusion

Gravity pulls fluid to the posterior

227
Q

What is a Hemothorax?

A

Blood in the pleural cavity/space

228
Q

What are the 2 causes of a hemothorax?

A
  1. Trauma
  2. Chest tube inserted against the bottom of the rib where the vessels are
229
Q

What pathology could this be?

A

Hemothorax; follows where gravity is

The difference between Pleural effusion and Hemothorax is by using HU to determine density (blood has higher density)

230
Q

What is Empyema?

A

Pus, or infected liquid, accumulation in the pleural space

231
Q

What are the causes of Empyema?

A
  1. Spread of an adjacent infection (Bacterial pneumonia, Lung abscess, Esophageal perforation)
  2. Penetrating trauma (stabbed with dirty object)
  3. Unsterile surgical instruments
232
Q

What are the 2 radigoraphic signs of Empyema?

A
  1. Creates abscess with an air fluid level
  2. In the pleural space, not in the lung

(seeing crud)

233
Q

What pathology is seen here?

234
Q

What pathology is seen here?

Pathology (15 decks)

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