Test 3: resp 37

Question 1

what does diaphragm look like on Left lateral

Answer 1

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

Question 2

what does diaphragm look like on R lateral chest

Answer 2

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

Question 3

Answer 3

right lateral

Question 4

Answer 4

left lateral

Question 5

lung lobes on Right lateral

Answer 5

accessory extends more dorsal

Question 6

lung lobes

Answer 6

Question 7

pulmonary veins are — on xrays

Answer 7

ventral and central

Question 8

increased or decreased opacity?

Answer 8

increased

Question 9

increased or decreased opacity

Answer 9

decreased opacity= increased radiolucency

Question 10

what are some things that cause increased opacity

Answer 10

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

obese

poor positioning

pleural effusion

Question 11

what happens to alveoli to cause alveolar pulmonary pattern

Answer 11

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

Question 12

what kind of pattern

Answer 12

alveolar pulmonary pattern

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

Question 13

signs of alveolar pulmonary pattern

Answer 13

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

Question 14

Answer 14

air bronchograms

can see all the branches

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

Question 15

what is this a sign of

Answer 15

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

Question 16

differentials for alveolar pulmonary pattern

Answer 16

• 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

Question 17

ventral often asymmetric alveolar pulmonary pattern dDx

Answer 17

Bronchopneumonia → infectious pneumonia, aspiration pneumonia

Question 18

perihilar (to caudodorsal) alveolar pulmonary pattern dDx

Answer 18

cardiogenic edema (dog)

Question 19

caudodorsal alveolar pulmonary pattern dDx

Answer 19

non-cardiogenic edema (neurogenic)
edema

Question 20

diffuse alveolar pulmonary pattern dDx

Answer 20

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

Question 21

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

Answer 21

pulmonary contusion
hemorrhage

Question 22

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

Answer 22

atelectasis

Question 23

Ddx

Answer 23

penumonia

Cranio- and caudoventral alveolar pattern – Just think ventral

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

Question 24

DDx

Answer 24

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

Question 25

ddx

Answer 25

non cardiogenic pulmonary edema caudodoral diffuse if severe ## Footnote **alveolar pulmonary pattern** soft tissue opacity can not see pulmonary vessels +/- air bronchogram +/- lobar sign

Question 26

DDx

Answer 26

pulmonary contusions focal patchy +/- chest wall trauma (rib fractures, swelling) ## Footnote **alveolar pulmonary pattern** soft tissue opacity can not see pulmonary vessels +/- air bronchogram +/- lobar sign

Question 27

DDX

Answer 27

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

Question 28

Answer 28

bronchial pulmonary pattern

Question 29

two causes of bronchial pulmonary pattern

Answer 29

**bronchial wall thickening**- allergic or infectious bronchitis **peri-bronchial infiltrates**- pneumonia, edema, neoplastic cells

Question 30

tram lines or donuts describe --- pattern

Answer 30

**bronchial pulmonary pattern**- caused by bronchial or peribronchial thickening

Question 31

Answer 31

bronchial pulmonary pattern donuts * overal pulmonary opacity is not markedly increased- alveoli are still air filled * typically diffuse (generalized throughout the lung)

Question 32

Answer 32

**bronchial pulmonary pattern**: donuts and tram lines **Bronchiectasis**(dilation) bronchial dilation- does not taper usually acquired, secondary to chronic bronchial disease

Question 33

main DDX for bronchial pulmonary pattern

Answer 33

* 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

Question 34

what kind of pattern

Answer 34

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

Question 35

cat DDX

Answer 35

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