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23 spring: med surg > Test 3: resp 37 > Flashcards

Test 3: resp 37 Flashcards

1
Q

what does diaphragm look like on Left lateral

A

Y
can see right lung better
Left crus cranial to R crus
Decreased cardiosternal contact (vs RLR)
 Apex slightly displaces from sternum

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2
Q

what does diaphragm look like on R lateral chest

A

parallel lines
left lung is more aerated
cardiac apex more cardiosternal contact

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3
Q
A

right lateral

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4
Q
A

left lateral

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5
Q

lung lobes on Right lateral

A

accessory extends more dorsal

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6
Q

lung lobes

A
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7
Q

pulmonary veins are — on xrays

A

ventral and central

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8
Q

increased or decreased opacity?

A

increased

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9
Q

increased or decreased opacity

A

decreased opacity= increased radiolucency

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10
Q

what are some things that cause increased opacity

A

poorly inflated lungs: expiratory, abdominal distension, upper airway obstruction

obese

poor positioning

pleural effusion

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11
Q

what happens to alveoli to cause alveolar pulmonary pattern

A

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

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12
Q

what kind of pattern

A

alveolar pulmonary pattern

soft tissue opacity
can not see pulmonary vessels
+/- air bronchogram
+/- lobar sign

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13
Q

signs of alveolar pulmonary pattern

A

soft tissue opacity
can not see pulmonary vessels
+/- air bronchogram
+/- lobar sign

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14
Q
A

air bronchograms

can see all the branches

Alveolar pulmonary pattern
soft tissue opacity
can not see pulmonary vessels
+/- air bronchogram
+/- lobar sign

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15
Q

what is this a sign of

A

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

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16
Q

differentials for alveolar pulmonary pattern

A
  • 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

17
Q

ventral often asymmetric alveolar pulmonary pattern dDx

A

Bronchopneumonia → infectious pneumonia, aspiration pneumonia

18
Q

perihilar (to caudodorsal) alveolar pulmonary pattern dDx

A

cardiogenic edema (dog)

19
Q

caudodorsal alveolar pulmonary pattern dDx

A

non-cardiogenic edema (neurogenic)
edema

20
Q

diffuse alveolar pulmonary pattern dDx

A

severe disease: pneumonia, edema, hemorrhage, ARDS, near drowning, smoke inhalation

21
Q

focal patchy +/- chest wall trauma (rib fracture, swelling) alveolar pulmonary pattern dDx

A

pulmonary contusion
hemorrhage

22
Q

unilateral, ventral with mediastrinal shift to the same side alveolar pulmonary pattern dDx

A

atelectasis

23
Q

Ddx

A

penumonia

Cranio- and caudoventral alveolar pattern – Just think ventral

alveolar pulmonary pattern
soft tissue opacity
can not see pulmonary vessels
+/- air bronchogram
+/- lobar sign

24
Q

DDx

A

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

25
Q

ddx

A

non cardiogenic pulmonary edema

caudodoral
diffuse if severe

alveolar pulmonary pattern
soft tissue opacity
can not see pulmonary vessels
+/- air bronchogram
+/- lobar sign

26
Q

DDx

A

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

27
Q

DDX

A

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

28
Q
A

bronchial pulmonary pattern

29
Q

two causes of bronchial pulmonary pattern

A

bronchial wall thickening- allergic or infectious bronchitis

peri-bronchial infiltrates- pneumonia, edema, neoplastic cells

30
Q

tram lines or donuts describe — pattern

A

bronchial pulmonary pattern- caused by bronchial or peribronchial thickening

31
Q
A

bronchial pulmonary pattern
donuts

  • overal pulmonary opacity is not markedly increased- alveoli are still air filled
  • typically diffuse (generalized throughout the lung)
32
Q
A

bronchial pulmonary pattern: donuts and tram lines

Bronchiectasis(dilation)
bronchial dilation- does not taper
usually acquired, secondary to chronic bronchial disease

33
Q

main DDX for bronchial pulmonary pattern

A
  • 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

34
Q

what kind of pattern

A

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

35
Q

cat DDX

A

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

23 spring: med surg (60 decks)

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