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23 spring: med surg > Test 1: lecture 13 +14 Xray > Flashcards

Test 1: lecture 13 +14 Xray Flashcards

1
Q

what views are needed for heart Xray

A

dorsoventral
right and left lateral

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2
Q

why DV vs VD for heart xray

A

DV: heart closer to detector= less magnification
less distortion
atelectasis of lungs

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3
Q

what view is best for caudal lobar vessels and why

A

DV

magnified, less distorted, surrounded by aerated lung

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4
Q

what view for a pleual effusion

A

VD (on back)

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5
Q

how tall is normal heart in dog

A

<70% of thoracic height

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6
Q

normal angle between trachea and spine in dog

A
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7
Q

1/3 2/3 rule

A
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8
Q

how wide should normal dog heart be

A
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9
Q

deep or barrel chested dog will have a wider cardiac width on lateral

A

barrel

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10
Q

width of heart on DV for dog

A
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11
Q

cardiac width on lateral Xray for cat

A
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12
Q

what happens to older cat heart

A

lazy heart (lays down)

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13
Q

what happens to cat heart with age on DV

A

prominent aortic arch

old cats: lazy heart, prominent aortic arch, undulating descending aorta

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14
Q

how to measure vertebral heart score

A

compare height and width of heart to

number of vertebral bodies starting at T4

then add together

normal VHS in dogs: 8.7-10.7

some breeds have VHS >10.7

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15
Q

normal VHS in dogs

A

8.7-10.7

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16
Q

normal VHS for cats

A

6.8-8.1

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17
Q

short cut VHS

A

in cats only
heart width on VD/DV view
compared to vertebral length on lateral view

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18
Q

what is pericardial fat stripe sign

A

effusion can hide heart (same density)

fat will cause shadow to be able to see where heart is

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19
Q

where is LA on clock face lateral view

A
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20
Q

where is LV on clock face lateral view

A
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21
Q

where is RV on clock face lateral view

A
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22
Q

where is aorta, Main pulmonary artery, right auricular appendage on lateral clock face

A
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23
Q

where is aorta on VD clock face

A
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24
Q

where is the MPA on VD clock face

A
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25
Q

where is L atrium and L auricle on VD clock face

A
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26
Q

where is LV on VD clock face

A
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27
Q

where is RV on VD clock face

A

5-9

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28
Q

where is right atrium on VD clock face

A

9-11

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29
Q

what will xray show for left atrial enlargement on lateral view

A

loss of caudal waist
bulge at 12-2
increased height
dorsal elevation +/- compression of the caudal mainstem bronchi

back pack

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30
Q
A

enlarged Left atrium has displaced and compressed the mainstem bronchus

trachea has been compressed

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31
Q

what will left atrial enlargement on VD cause

A

left atrium is in middle of the heart in a dog

double density superimposed
bulge at 2-3
widened angle between the caudal mainstem bronchi (bow legged cowboy sign)

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32
Q
A

left atrial enlargement

double density superimposed
bulge at 2-3
widened angle between the caudal mainstem bronchi (bow legged cowboy)

left atrium in middle of heart

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33
Q

left atrial enlargement in cat in lateral view

A

hard to see

widening of the heart base

slight bulging or rounding of caudal contour

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34
Q

left atrial enlargement on VD of cat

A

left atrial bulge at 2-3 (can extend cranial)

valentine heart

severe left or left and right atrial enlargement

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35
Q

left ventricular enlargement in dogs lateral

A

tall cardiac silhouette
dorsal tracheal displacement
elevated caudal vena cava

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36
Q

left ventricular enlargement in dog on VD

A

elongated cardiac silhouette
rounded left heart

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37
Q

right atrial enlargement lateral

A

bulge 9-11

not common

38
Q

right atrial enlargement on VD

A

9-11 rounded contour

39
Q

right ventricular enlargement on lateral

A

rounded cranial heart at 5-9

right heart >2/3 of cardiac silhouette (wide heart)

increased cardiosternal contact (may be seen in some normal dogs (barrel chested))

caudodorsal tipping of apex

40
Q

right ventricular enlargement on VD

A

rounded right heart 5-9
reverse D

may displace the apex to the left (false impression of left sided cardiomegaly)

41
Q

microcardia on lateral

A

narrow, pointed heart

apex may lose contact with sternum

pulmonary arteries and veins may be small

42
Q

microcardia on VD

A

narrow, pointed heart

apex may lose contact with sternum

pulmonary arteries and veins may be small

43
Q
A

microcardia

44
Q
A

right ventricular enlargement

45
Q
A

right ventricular enlargement

46
Q
A

right atrial enlargement

47
Q
A

left ventricular enlargement

Rounded left heart
Elongated cardiac silhouette

48
Q
A

left ventricular enlargement

Tall cardiac silhouette
Dorsal tracheal displacement
“Elevated” Caudal Vena Cava

49
Q
cat
A

left atrial enlargement in cat

50
Q

differentials for microcardia

A

shock: hypovolemia
addisons (low cortisol)
constrictive pericarditis (rare)

51
Q

where are the pulmonary vein and artery

A

veins are ventral or central

52
Q

normal vasculature on lateral should be — the width of the proximal 1/3 of the — rib

A

less then
4th

artery and vein should be the same diameter

53
Q

where is aorta and CVC

A
54
Q

caudal vena cava should be — the diameter of the aorta and — in length

A

less then 1.5 x
less then T5

55
Q

veins and arteries

A

veins are ventral and central

56
Q

on VD the width of the — rib should be equal to the diameter of the pulmonary artery and vein

A

9th

57
Q

differential for enlarged aorta

A

Cats: Age-related (aortic arch)

Patent Ductus Arteriosus

Post-stenotic dilatation
§ Subaortic stenosis

Aortic aneurysm (very rare)

58
Q

enlarged caudal vena cava differential

A

Right heart failure

Obstruction of caudal vena cava or right atrium
§ Caval syndrome (Dirofilariasis)
§ Blood clot, Mass

Normal Variation
§ Respiration, Cardiac cycle o Evaluate on all views

59
Q

enlarged MPA differential

A

Post-stenotic dilatation
§ Pulmonic stenosis

Pulmonary hypertension

Dirofilariasis or Angiostrongylosis

Left to right shunt
§ PDA, ASD, VSD

Fake-Out
§ VD projection
§ Rotated projection
§ Cardiac cycle (systole)

60
Q

enlarged pulmonary arteries differential

A

Dirofilariasis
§ Pulmonary arteries often also tortuous and blunted

Pulmonary hypertension

Pulmonary thromboembolism (PTE)

61
Q

enlarged pulmonary veins differential

A

Left heart failure
§ May not be enlarged if the patient received diuretics

Fluid/volume overload (relative vs absolute)

Left atrial obstruction

62
Q

enlarged pulmonary arteries and veins differential

A

Left to right shunts

Pulmonary congestion
§ Fluid volume overload (relative vs absolute)
§ (Left heart failure - cats)

63
Q

small pulmonary arteries and vein differential

A

Pulmonary Hypoperfusion
* Hypovolemia
* Right to left shunts
* Pulmonic stenosis
* Pulmonary thromboembolism
* Decreased cardiac output
§ Pericardial effusion with tamponade
§ Restrictive pericarditis
§ Right heart failure

64
Q

4 main causes of left heart failure

A

volume or pressure overload (Mitral valve insufficiency)

myocardial failure

interference with filling

increased requirement for cardiac output

65
Q

3 major signs of Left heart failure on xray

A

enlarged left heart (big LA, double density on VD)

pulomonary venous congestion (enlarged veins (cats get enlarged arteries)

pulmonary edema (intersititial to alveolar pulmonary pattern) (caudodorsal)

66
Q

dogs with pulmonary edema from L CHF will cause

A

perihilar and caudodorsal interstitial to alveolar pulmonary pattern

can be more severe in right caudal lobe then left
dilated cardiomyopathy: can cause ventral peropheral alveolar pattern

67
Q

what kind of pulmonary edema will cats with Left CHF have

A

patchy distribution

can also get pleural effusion

68
Q

what is most common cause of Left CHF in dogs

A

mitral valve disease

leads to big LV, enlarged PV and edema in lungs

69
Q

dog with Left HF, what is wrong

A

enlarged LA and LV (double density, long and buldge)

enlarged pulmonary vein (ventral)

caudodorsal alveolar pattern worse on the right

70
Q

pulmonary edema from L HF in dog vs cat

A

dog: caudodorsal edema (R>L)

cat: diffuse or patchy

71
Q

what are the arrows

A

pleural effusion- retraction of lung lobe from the body wall

from left HF in cat

72
Q

right sided HF

A

enlarged Right heart (laying down, 1/3 2/3 rule)
enlarged caudal vena cava
hepatomegaly
ascites
pleural effusion

73
Q

what are some things that cause concentric ventricular hypertrophy

A

AS
PS
hypertrophic cardiomyopathy

heart would appear normal on XRay

74
Q

mitral valve disease leads to enlargement of —

A

left side

75
Q

tricuspid valve disease leads to enlargement of —

A

right side

76
Q

mitral valve disease

A

left artial enlargement (bulge)
pulmonary veins thicker

caused dorsal displacement of trachea, and tall cardiac silhouette

77
Q

degenerative mitral valve disease that progressed to HF will show

A

double density of Left atrium
bulge from big LA and ventricle
enlarged pulmonary veins
caudodorsal alveolar pattern 9R.L)

78
Q

doberman

A

dilated cardiomyopathy

left atrial enlargement (buldge and double oppasity on VD)

diffuse interstitital pattern, ventral alveolar regions

79
Q

hypertrophic cardiomyopathy in cats will cause

A

LA and LV enlargement (valentine shape on VD)
+/- heart failure

80
Q

cat cardiomyopathy

A

LA and LV enlargement (valentine shape)

left heart failure (patchy alveolar pattern)

81
Q

what will heart worm do to the heart

A

Pulmonary arteries are enlarged,
tortuous, and blunted
* Right caudal lobar artery affected first

Enlarged main pulmonary artery

Right-sided cardiomegaly
* Cor pulmonale (secondary to pulmonary hypertension)

Enlarged caudal vena cava
* “Caval syndrome”

Right heart failure

Bronchial pulmonary pattern, Multifocal alveolar pulmonary pattern
* Pneumonitis, Thromboembolism

82
Q

heart worm

A

enlarged, tortous, blunted pulmonary arteries

enlarged MPA

enlarged RV (reverse D)

diffuse bronchial pattern

83
Q

what direction shunt for PDA

A

left to right

patent ductus arteriosis

84
Q

PDA will cause what on Xray

A

triad bump: aortic arch, LA/Lauricle, MPA all enlarged

pulmonary arteries and veins also enlarged

85
Q

PS will cause

A

enlarged MPA (hat sign)
RV enlargement (reverse D)

86
Q

sub aortic stenosis

A

enlarged aortic arch

LV enlarged (tall sihouette, elevated caudal vena cava, dosal tracheal displacement)

+/- enlarged LA if severe (double density)

+/- Left HF

87
Q

if left to right shunt VSD what happens to pulmonary arteries and veins

A

enlarged

88
Q

if right to left shunting from VSD what happens to arteries and veins

A

small arteries

(skipping lungs)

89
Q

pericardial effusion on xray

A

large round (globoid) cardiac silhouette

sharp outline with no motion artifact from heart beating

90
Q

pericardial effusion can cause — which will cause — pulmonary vasculature

A

cardiac tamponade

small pulmonary vasculature
right heart failure

91
Q

what?

A

Peritoneopericardial Diaphragmatic Hernia (PPDH)

abdominal organs in pericardial sac

will ahve enlarged rounded silhouette

23 spring: med surg (60 decks)

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