Thoracic Radiography Flashcards
when looking at a DV or VD projection and you notice a reverse D sign, what part of the heart do you suspect is enlarged?
right ventricle
you see an enlargement of the heart on DV/VD at the 1-2 oclock position. what part are you suspecting is enlarged?
L/R pulmonary artery
left and cranial position on that type of xray
what is the “backpack sign”
left atrial enlargement: bulge at the caudal cardiac waist
can use the vertebral L atrial score: if >2.3 it will predict enlarged LA
left ventricular enlargement causes the heart to appear shorter/taller on lateral radiograph
taller: carina become elevated toward the spine, lessening the angle between spine and trachea
on radiograph you notice that the heart appears
“taller” on lateral projection. what part of the heart are you suspecting is enlarged?
left ventricle
elongation of the cardiac silhouette with a bulge at 3-6oclock position leads you to suspect what part of the heart is enlarged?
left ventricle
what structures can you see on a cranial lateral view?
- right auricle/atrium
- pulmonary trunk/artery
- aortic arch
where will you see aortic enlargement on a DV/VD view (clock)
11 to 1 oclock
often appears as widening of cranial mediastinum
dilation contiguous with the descending aorta
are the caval veins right or left sided structures? (VD/DV)
right
how can you quantify heart size?
- vertebral heart score: globally how big is the patient’s heart: draw line from carina to base of heart, then second line of the width of the heart
what do you compare the vertebral heart score to?
vertebral bodies: normalize the measurement lines to T4 vertebrae. transpose the lines drawn on the heart beginning at the 4th vertebral body and count the # of vertebral bodies that each of the lines covers
sum the vertebral #s of the long axis and short
what is the normal vertebral heart score?
9.7 +/- 0.5
use to clarify uncertainty from just looking at radiograph
VLAS
- vertebral left atrial size
- alternate measure of cardiac enlargement specific to the LA
- ventral carina to caudal LA border at level of the caudal vena cava
- score >2.3 predicts an enlarged LA
issues with VHS and VLAS?
- hemivertebrae (brachycephalics)
- structures: fat summating with cardiac silhouette
- breed differences
left sided heart failure can show as
- left atrial enlargement
- pulmonary venous congestion
- pulmonary edema
right heart failure can show as
- right atrial enlargement
- dilated vena cava
- cavitary effusion
are arteries lateral or medial?
lateral
veins on radiographs are _______ and central
ventral and central
why are lung patterns important to evaluate with a cardiac patient?
lung patterns tell us about which disease processes are most likely occurring
bronchial lung pattern
- increased opacity of airway walls
- fluid or cellular material in bronchial wall, lumen, or peribronchial space
- usually related to airway inflammation
bronchiectasis
pathologic dilation of the bronchi, usually related to chronic inflammation and damage to the bronchial wall
unstructured interstitial pattern
- increased fluid/cells in the pulmonary interstitial space
-diffuse, hazy appearance blocking ability to see normal vessels
top differentials for nodular lung pattern
- tumor
- granuloma
- abscess
- cyst
alveolar pattern
- alveoli filled with fluid/debris
- appearance comparable to trees in a snowstorm
- no gas exchange happening in the alveoli
