Respiratory System Flashcards
Upper respiratory tract structures
the nose, mouth, pharynx, and larynx
Lower respiratory tract structures
the trachea, bronchi, alveoli, and lungs
Anterior mediastinum structures
thyroid and thymus glands
Middle mediastinum structures
heart and great vessels, esophagus, and trachea
Posterior mediastinum structures
descending aorta and the spine
T or F: The bony structures such as ribs, sternum, and thoracic vertebrae provide support and protection and assist in both inspiration and expiration
True
The most frequently performed exam in the radiology department is the ____ which provides important information about _____________
-chest
-soft tissues, bones, the pleura, the mediastinum, and lung tissue
Which exposure factor should be adjusted based on the presence of a subtractive or additive condition within the patient?
*kVp
In the respiratory system, any condition that adds fluid or tissue to the normally aerated chest (e.g., pneumonia) requires an increase in technical factors to afford proper penetration and exposure. Similarly, any condition that increases the aeration of the chest (e.g., emphysema) reduces the amount of radiation required for proper exposure to be achieved and may require a decrease in technical factor
What is respiratory failure?
a term used to describe a lack of respiratory function or a lack of oxygen and carbon dioxide exchange
This may occur at two levels:
1. Within the lungs (intrapulmonary gas exchange)
2. As a result of impaired breathing (inability to move air into and out of the lungs)
Describe how respiratory failure can occur:
This may occur following acute trauma to the chest or as a result of an acute or chronic lung disease.
When ventilation is normal, carbon dioxide (CO2) is removed from the lungs to maintain metabolic homeostasis at the cellular level, thus ensuring that the partial pressure of CO2 (PCO2) in arterial blood is approximately 40 mmHg. When PCO2 levels are above 40 mmHg, this signals that the CO2 is not being removed properly, which denotes hypoventilation that can cause hypoxemia and hypercapnia
Hypoxemia vs Hypercapnia
-Hypoxemia signifies low oxygen levels within arterial blood
-Hypercapnia refers to failure of ventilation resulting in the inability to move air into and out of the lungs (High amounts of carbon dioxide in the blood)
Cystic Fibrosis etiology is due to a __________ defect and affects the function of the ________ gland
-genetic
-exocrine
Identify effects caused by cystic fibrosis:
Pulmonary damage is initiated by gradually increasing secretions as a result of hypertrophy of the bronchial glands, leading to obstruction of the bronchial system. The resultant plugging promotes staphylococcal infection, followed by more tissue damage, atelectasis (collapse of lung tissue) and emphysema.
Barrel-chest deformity, clubbing of fingers, and cyanosis occur as the disease progresses. In adolescents and adults, pulmonary complications associated with cystic fibrosis include pneumothorax, hemoptysis, and right-sided heart failure secondary to pulmonary hypertension.
RDS(Respiratory Distress Syndrome) is also known as ______________
hyaline membrane disease
What population is at risk for developing RDS?
premature infants or those born at less than a 37-week gestation
RDS Chest x-ray demonstrates:
severe atelectasis with an air-bronchogram sign, characterized by bronchi surrounded by nonaerated alveoli
Pneumonia is a ____________ disease
inflammatory
What is pneumonia?
the most frequent type of lung infection, resulting in an inflammation of the lung (pneumonitis) and compromised pulmonary function
T of F: Pneumonia is not the most frequent type of lung infection
False, it is
T or F: Pneumonia is one of the leading causes of death in U.S.
True
T or F: Pneumonia is one of the most lethal nosocomial infection
True
What information do CXRs provide when diagnosing/ evaluating the presence of pneumonia?
Determining the location of the inflammation, with the pneumonias appearing as soft, patchy, ill-defined alveolar infiltrates or pulmonary densities
Lobar (Pneumococcal) pneumonia
•What is it?
•How does it appear on x-ray?
•What is it? The most common bacterial pneumonia because this type of bacteria is often present in healthy throats. This infection is generally preceded by an upper respiratory infection
•How does it appear on x-ray? Collection of fluid in one or more lobes, with the lateral view serving to identify the degree of segmental involvement
Bronchopneumonia
•What is it?
Acute inflammation of the bronchi and associated alveoli
Interstitial (Viral) pneumonia:
•What is it?
•How does it appear on x-ray?
•What is it? Caused by various viruses, most commonly influenza virus A and B. It is more common than bacterial pneumonia but less severe. This disease is spread by an infected person shedding the virus, which is transmitted to a nonimmune individual
•How does it appear on x-ray? Radiographic findings are often minimal
Segmental pneumonia:
•What is it?
•How does it appear on x-ray?
•What is it? Inflammation affecting the alveoli within one segment of a lung
•How does it appear on x-ray? soft, patchy, ill-defined alveolar infiltrates or pulmonary densities
Aspiration (Chemical) pneumonia:
•What is it?
•How does it appear on x-ray?
•What is it? Caused by acid vomitus aspirated into the lower respiratory tract, resulting in a chemical pneumonitis
•How does it appear on x-ray? Edema produced by irritation of air passages, appearing as densities radiating from one or both hila into the dependent segments
Mycoplasma pneumonia:
•What is it?
•How does it appear on x-ray?
•What is it? Caused by mycoplasmas, the smallest group of living organisms. They have characteristics of both bacteria and viruses.
•How does it appear on x-ray? A fine, reticular pattern in a segmental distribution, followed by patchy areas of air space consolidation
COVID 19 is a _________ disease
Inflammatory
*severe RDS disease
What does the acronym COVID 19 stand for?
Corona Virus Disease 2019
Identify the family of viruses responsible for COVID 19:
SARS-CoV-2
Based on the information presented in the book, how is COVID 19 transmitted?
through droplets from the nose and mouth
Identify symptoms related to COVID 19 and when do they appear?
Symptoms can appear between 2 and 14 days after exposure to include cough, shortness of breath with difficulty breathing, fever, and sore throat. However, many individuals who are infected with COVID-19 are asymptomatic and can act as carriers.
Bronchiectasis is a __________ disease
Inflammatory
What is bronchiectasis?
a permanent, abnormal dilation of one or more large bronchi as a result of destruction of the elastic and muscular components of the bronchial wall
Identify and briefly describe the two means by which bronchiectasis may develop:
either congenital or an acquired weakness, typically following inflammation of the bronchial walls because of a viral or bacterial infection
Pulmonary Tuberculosis (TB) is a ____________ disease
Inflammatory
What is pulmonary tuberculosis?
an infection caused by inhalation of Mycobacterium tuberculosis that usually affects the lungs
Identify the body systems pulmonary tuberculosis can affect:
genitourinary system, the skeletal system, and the central nervous system
Early TB is usually Symptomatic or Asymptomatic?
Asymptomatic
T or F: Skin test is the initial identification procedure for TB
True
T or F: Later stages of TB, CXR shows lesions and nodular scars
True
T or F: TB is typically found in the apical region of the chest
True
T or F: Apical Lordotic projection is useful in TB evaluation
True
•What is miliary tuberculosis?
•Radiographic appearance of Miliary TB?
•What is miliary tuberculosis? Occurs when large numbers of bacteria are picked up and carried via the bloodstream throughout the body. Miliary refers to its characteristic resemblance to millet seeds, which are small, white grains.
•Radiographic appearance of Miliary TB? small, distinct nodules throughout the lung fields
How does TB spread?
through sputum and airborne droplets expelled while coughing
Define COPD
Chronic obstructive pulmonary disease (COPD) refers to a group of disorders that cause chronic airway obstruction
Identify the four forms of COPD
chronic bronchitis, emphysema, asthma, bronchiectasis
COPD is reversible or irreversible?
Irreversible
•What is emphysema?
•How does emphysema appear radiographically?
•What is emphysema? a condition in which the lung’s alveoli become distended(swollen), usually from loss of elasticity or interference with expiration
•How does emphysema appear radiographically? a depressed or flattened diaphragm, abnormally radiolucent lungs, and an increased retrosternal air space (barrel-shaped chest)
Pneumoconioses is a ____________ disease
Inflammatory
How does pneumoconioses develop?
result in pulmonary fibrosis from inhalation of foreign inorganic dust, most commonly from a work environment
Identify the etiology of the three primary types of pneomoconioses:
•Silicosis
•Anthracosis/ Black lung disease
•Asbestosis
•Silicosis: results from inhaling silica (quartz) dust and is common among miners, grinders, and sandblasters. It is the most widespread and most serious type of pneumoconiosis.
•Anthracosis/ Black lung disease: results from inhalation of coal dust over an extended period of about 20 years
•Asbestosis: results from the inhalation of asbestos dust, which causes chronic injury to the lungs
Severe fungal infections are termed ___________ unless they enter a compromised host (e.g individuals with HIV infection, TB, leukemia, etc)
opportunistic
T or F: Lung abscess is a localized area of dead (necrotic) lung tissue surrounded by inflammatory debris
True
Lung abscess is more common in the __________ because of the ____________of the right main bronchus
-Right lung
-Vertical orientation
Pleural effusion is a disease/sign/ symptom
Sign
Which radiographic exam(s) is/ are helpful to diagnose a pleural effusion?
best demonstrated on an erect lateral chest radiograph, lateral decubitus chest radiographs are also valuable
How do pleural effusions appear radiographically?
blunting of the costophrenic angles
Identify other modalities that may be useful in diagnosing/ evaluating a pleural effusion
•CT
•Diagnostic Sonography
Bronchial carcinoid tumors are also known as ___________
Adenomas
Bronchial carcinoid tumors are classified as benign/ malignant
Benign
The most common fatal primary malignancy in the U.S is
Bronchogenic carcinoma
Identify the two categories of lung cancers:
- non–small cell lung cancer (NSCLC)
- small cell lung cancer (SCLC)
Bronchogenic carcinoma tumors originate from _____________ and spread via ___________.
-epithelial tissue
-lymph nodes
_____________ are the most common type of bronchogenic cancer, found in the peripheral regions of the lung and are called as _________
-Adenocarcinomas
The bronchogenic cancer with the highest mortality rate is
Small Cell Lung Cancer
How does pulmonary metastasis appear radiographically?
single or multiple rounded opacities throughout the lungs
Pulmonary Embolism
•Definition
•Site of occurrence and where does it travel (if applicable)
•Modalities to diagnose
•Definition: occurs when a blood clot forms or becomes lodged in a pulmonary artery
•Site of occurrence and where does it travel (if applicable): arises from a thrombus that originates in a lower extremity, migrates to the lungs, and becomes lodged there, resulting in an obstruction of blood supply to the lungs
•Modalities to diagnose: Pulmonary angiography and nuclear ventilation/perfusion (VQ) lung scans are commonly used in the diagnosis of a PE; however, multidetector CT has been demonstrated to be the most time-saving and cost-effective
Venous Thrombosis
•Definition
•Site of occurrence and where does it travel (if applicable)
•Modalities to diagnose
•Definition: The formation of blood clots within a vein
•Site of occurrence and where does it travel (if applicable): in the veins of the lower extremities and result from a slowing of the blood’s return to the heart
•Modalities to diagnose: Sonography is performed to determine the location and the extent of this disease, primarily in the lower extremities, and venography may be of use in confirming the diagnosis
How might the lungs, heart, great vessels be damaged from a traumatic event?
•Penetrating, compressive, or decelerating trauma can cause pulmonary contusions
•Bone injuries such as rib, clavicular, sternal, or scapular fractures may penetrate the lungs
How often are CXRs done in cases of thoracic trauma? Why?
Radiographically, changes in the lungs from contusion appear 4 to 6 hours after the trauma. The radiographic appearance changes frequently during the first 24 to 48 hours, so multiple chest radiographs may be necessary to assess the damage to the lung tissue because pulmonary contusions are usually much larger than apparent on the initial chest radiograph.
Pneumothorax
•What is it?
•Identify some common causes of pneumothorax
•How does a pneumothorax appear radiographically?
•Which radiographic exam(s) assist with diagnosing/ evaluating a pneumothorax?
•What is it? occurs when free air is trapped in the pleural space and compresses lung tissue
•Identify some common causes of pneumothorax: penetrating chest trauma such as stab wounds, gunshot wounds, fractured ribs, or a thoracocentesis needle, and a spontaneous blowout of a bleb (a flaccid vesicle such as a blister) resulting from some other pulmonary disease
•How does a pneumothorax appear radiographically? as a strip of radiolucency devoid of vascular lung markings, with separation of the visceral and parietal pleura
•Which radiographic exam(s) assist with diagnosing/ evaluating a pneumothorax? an erect expiration posteroanterior chest radiograph obtained in conjunction with routine PA and lateral inspiration chest radiographs
Atelectasis
•Definition
•How does atelectasis appear on a radiograph?
•Definition: incomplete expansion of the lung as a result of partial or total collapse
•How does atelectasis appear on a radiograph? a decrease in the intercostal interspace, elevation of the hemidiaphragm of the affected side, and depression or elevation of the hilum, depending on which lobe is affected
