Test 3: resp 37 Flashcards
what does diaphragm look like on Left lateral
Y
can see right lung better
Left crus cranial to R crus
Decreased cardiosternal contact (vs RLR)
Apex slightly displaces from sternum
what does diaphragm look like on R lateral chest
parallel lines
left lung is more aerated
cardiac apex more cardiosternal contact
right lateral
left lateral
lung lobes on Right lateral
accessory extends more dorsal
lung lobes
pulmonary veins are — on xrays
ventral and central
increased or decreased opacity?
increased
increased or decreased opacity
decreased opacity= increased radiolucency
what are some things that cause increased opacity
poorly inflated lungs: expiratory, abdominal distension, upper airway obstruction
obese
poor positioning
pleural effusion
what happens to alveoli to cause alveolar pulmonary pattern
alveolar filled with cells: fluid, blood
or
alveolar collapsed or never opened for air→ poor surfactant
can not see pulomonary vessels= they are white and now lung is white no contrast
what kind of pattern
alveolar pulmonary pattern
soft tissue opacity
can not see pulmonary vessels
+/- air bronchogram
+/- lobar sign
signs of alveolar pulmonary pattern
soft tissue opacity
can not see pulmonary vessels
+/- air bronchogram
+/- lobar sign
air bronchograms
can see all the branches
Alveolar pulmonary pattern
soft tissue opacity
can not see pulmonary vessels
+/- air bronchogram
+/- lobar sign
what is this a sign of
lobar sign - border between two lung lobes visible when one is opaque and the other is normal/aerated
Alveolar pulmonary pattern
soft tissue opacity
can not see pulmonary vessels
+/- air bronchogram
+/- lobar sign
differentials for alveolar pulmonary pattern
- Bronchopneumonia
- Edema → Cardiogenic vs. Non-cardiogenic
- Hemorrhage (contusions) → trauma
- Atelectasis (collapse, loss of volume)
- Neoplasia
Lung lobe torsion
Infarct/pulmonary thromboembolism
soft tissue opacity
can not see pulmonary vessels
+/- air bronchogram
+/- lobar sign
ventral often asymmetric alveolar pulmonary pattern dDx
Bronchopneumonia → infectious pneumonia, aspiration pneumonia
perihilar (to caudodorsal) alveolar pulmonary pattern dDx
cardiogenic edema (dog)
caudodorsal alveolar pulmonary pattern dDx
non-cardiogenic edema (neurogenic)
edema
diffuse alveolar pulmonary pattern dDx
severe disease: pneumonia, edema, hemorrhage, ARDS, near drowning, smoke inhalation
focal patchy +/- chest wall trauma (rib fracture, swelling) alveolar pulmonary pattern dDx
pulmonary contusion
hemorrhage
unilateral, ventral with mediastrinal shift to the same side alveolar pulmonary pattern dDx
atelectasis
Ddx
penumonia
Cranio- and caudoventral alveolar pattern – Just think ventral
alveolar pulmonary pattern
soft tissue opacity
can not see pulmonary vessels
+/- air bronchogram
+/- lobar sign
DDx
cardiogenic pulmonary edema
perihilar to caudodorsal alveolar pattern (R>L)
cardiomegaly- enlarged L atrium and ventricle
enlarged pulmonary veins
alveolar pulmonary pattern
soft tissue opacity
can not see pulmonary vessels
+/- air bronchogram
+/- lobar sign
ddx
non cardiogenic pulmonary edema
caudodoral
diffuse if severe
alveolar pulmonary pattern
soft tissue opacity
can not see pulmonary vessels
+/- air bronchogram
+/- lobar sign
DDx
pulmonary contusions
focal patchy +/- chest wall trauma (rib fractures, swelling)
alveolar pulmonary pattern
soft tissue opacity
can not see pulmonary vessels
+/- air bronchogram
+/- lobar sign
DDX
atelectasis/collapse
lung lobe collapsed- loss of volume
mediastinum (heart is shifted towards)
can be positional- if laying on same side for awhile
can be pathologic: bronchical obstruction: pneumonia, mucus, cancer, foreign body
extra-luminal obstruction: cancer, tracheobronchial lymph nodes
alveolar pulmonary pattern
soft tissue opacity
can not see pulmonary vessels
+/- air bronchogram
+/- lobar sign
bronchial pulmonary pattern
two causes of bronchial pulmonary pattern
bronchial wall thickening- allergic or infectious bronchitis
peri-bronchial infiltrates- pneumonia, edema, neoplastic cells
tram lines or donuts describe — pattern
bronchial pulmonary pattern- caused by bronchial or peribronchial thickening
bronchial pulmonary pattern
donuts
- overal pulmonary opacity is not markedly increased- alveoli are still air filled
- typically diffuse (generalized throughout the lung)
bronchial pulmonary pattern: donuts and tram lines
Bronchiectasis(dilation)
bronchial dilation- does not taper
usually acquired, secondary to chronic bronchial disease
main DDX for bronchial pulmonary pattern
- Chronic bronchitis (e.g. allergic) – dogs, cats
- Feline asthma
- Parasitic (e.g. aelurostrongylus; and in cats, heartworm)
- Eosinophilic bronchopneumopathy in dogs (can also cause other patterns)
- Infectious bronchitis (e.g. bacterial such as Bordetella) →Often see other lung patterns too, owing to presence of bronchopneumonia
Sometimes pulmonary edema
Rarely, neoplastic infiltrate
Bronchial wall mineralization – Incidental usually
what kind of pattern
bronchial pulmonary pattern
Hyperinflation
Diaphragm flattened on lateral
Diaphragm tented on VD
Lungs extend cd to ribs on lateral (goes past T13)
Ribs perpendicular to the spine on VD
cat DDX
feline asthma
bronchical pulmonary pattern
hyperinflation
right middle lung lobe- mucous plug cause atelectasis- alveolar pattern, lobe small, other lung lobes get bigger to take over
