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1. THORACIC > THORACIC Section 12: Airways > Flashcards

THORACIC Section 12: Airways Flashcards

1
Q

Describe the basic anatomy of the trachea

A

A bunch of anterior horseshoes of cartilage, with a posterior floppy membrane

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2
Q

The transverse diameter of the trachea should be no more than __ cm.

A

2.5 cm

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3
Q

Tracheal thickness

A

1-3 mm

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4
Q

Coronal diameter of less than two thirds the sagittal diamter

A

Saber-Sheath Trachea

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5
Q

I say “saber-sheath trachea, you say?

A

COPD

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6
Q

Three big questions to ask in tracheal diseases.

A
  1. Does it involve the posterior membrane?
  2. Is it focal or diffuse?
  3. Are there calcifications?
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7
Q

Tracheal/Bronchial diseases sparing the posterior membrane

A
  1. Relapsing Polychindritis
  2. Tracheobronchopathia Osteochondroplasia (TBO)
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8
Q

Tracheal/Bronchial diseases NOT sparing the posterior membrane

A
  1. Amyloid
  2. Post intubation
  3. Wegeners
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9
Q

TRACHEAL DISEASES

  • Spares the posterior membrane.
  • Diffuse anterior and lateral thickening of the trachea.
  • NO calcifications.
  • Recurrent Episodes of cartilage inflammation and recurrent pneumonia.
A

Relapsing Polychondritis

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10
Q

TRACHEAL DISEASES

  • Circumferential thickening, which can be focal or long segment.
  • NO calcifications
  • Subglottic involvement is common
A

Wegener’s

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11
Q
  • Spares the posterior membrane
  • Development of cartilaginous and osseous nodules within teh submucosa of the tracheal bronchial walls
A

Tracheobronchopathia Osterochondroplastica (TBO)

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12
Q

Diagnosis?

A

Tracheobronchopathia Osterochondroplastica (TBO)

Spares the posterior membrane + cartilaginous and osseous nodules in the submucosa of teh tracheal bronchial walls

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13
Q

TRACHEAL DISEASE

  • Irregular focal or short segment thickening,
  • Can invovle the posterior membrane
    • Calcifications
A

Amyloidosis

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14
Q

Most common location of Wegeners

A

Sub-glottic trachea

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15
Q

Recurrent episodes of cartilage inflammation.
Recurrent pneumonia is the most common cause of death

A

Relapsing Polychondritis

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16
Q

Pulmonary Neuroendocrine Tumors

> 3cm + Peripheral (distal to segmental bronchi) + Age ~60s + Smoking associated

A

Atypical Carcinoid
(Intermediate Malignant)

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17
Q

Pulmonary Neuorendocrine Tumors

< 3cm + Central (Tracheal bifurcation) + Calcifications in 30% + Age ~ 50s

A

Typical Carcinoid (Low-Grade Malignant)

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18
Q

Pulmonary Neuorendocrine Tumors

Peripheral Pulmonary mass - 3.5 cm

A

Large Cell Neuroendocrine Tumor (LNEC)

(Hight Grade Malignant)

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19
Q

Pulmonary Neuorendocrine Tumors

Large central/mediastinal mass involving the hilum

A

Small Cell Lung Cancer (SCLC)

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20
Q

Pulmonary Neuroendrocrine tumors in the Airway

A

Typical and Atypical Carcinoid

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21
Q

Bronchial carcinod prefered site of metastasis?

A

Uveal tract

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22
Q

GI carcinoid preferred site of metastasis?

A

Extra ocular muscles

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23
Q

2nd most common tracheal malignancy?

A

Adenoid cystic

24
Q

Tracheal/Bronchial tumors causing obstructive symptoms and hemoptysis?

A

Carcinoid

25
Q

Tracheal malignancy seen in the upper trachea, posterior lateral.

A

Adenoid

26
Q

What is the most common tracheal malignancy?

A

Squamous Cell

27
Q

Airway malignancy favoring the lower trachea/proximal bronchus

A

Squamous cell

28
Q

Most common BENIGN tumor of teh trachea

A

Suamous Cell Papilloma

29
Q

When it’s a single papilloma, think of?

A

Smoking

30
Q

When it’s multipe papillomas, think of?

A

HPV

31
Q

Most common cause of subglottic tracheal stenosis in adult?

A

Post intubation stenosis

32
Q

Classic look of Subglottic stenosis

A

FOCAL subglottic circumferential stenosis.

HOURGLASS configuration

33
Q

subglottic stenosis + No history of intubation =

A

A rare cast of adult croup (Acute laryngotracheobronchitis)

34
Q

Sodium pump doesn’t work and they end up with thick secretions with poor pulmonary clearance.

Damage is done by RECURRENT INFECTIONS

A

Cystic fibrosis

35
Q

Cystic Fibrosis pulmonary features?

A

Bronchiectasis + apical predominance + Hyperinflation + Pulmonary Arterial Hypertension (PAH)
+ Mucus plugging (finger in glove)

36
Q

Abnormal Mucus, Cilia can’t move it

A

Cystic Fibrosis

37
Q

Normal Mucus, Cilia don’t work

A

Primary Ciliary Dyskinesia

38
Q

Normal sperm, absent vas deferens

A

Cystic fibrosis

39
Q

Abnormal sperm, Normal vas deferens

A

Primary Ciliary dyskenesia

40
Q

Chronic mastoid effusion and conducting hearing loss (little ear nerve hair things are fucked up too)

A

Primary Ciliary Dyskenesia

41
Q

50% of primary ciliary dyskeneisa patients have this condistion

A

Kartagener’s Syndrome

Kartagener’s syndrome is a rare, autosomal recessive genetic ciliary disorder comprising the triad of situs inversus, chronic sinusitis, and bronchiectasis.

42
Q

Upper lobe bronchiectasis

A

Cystic fibrosis

43
Q

Congenital cystic bronchiectasis from a deficiency of cartilage in the 4th-6th order bronchi

A

WIlliams Campbell Syndrome

43
Q

“That’s one big fucking trachea”

> 3cm dilatation

A

Mounier-Kuhn (Tracheobronchomegaly)

44
Q

Inflammation of the small airways

A

Bronchiolitis

45
Q

Air trapping in bronchiolitis obliterans is seen in the setting of a ?

A

lung transplant

46
Q

Air trapping in small airway disease. Think of?

A

Asthma and bronchiolitis

47
Q

Dilatation and impaction of the centrilobular airways

A

Tree in bud

48
Q

Small Airway Disease

Tree in bud

A

Infectious brongiolitis

49
Q

Small Airway Disease

Smokers + Centrilobular
ground glass nodules
(upper lobe predominant)

A

RB-ILD

50
Q

Small Airway Disease

Inhaling dust / other misc
garbage. Centrilobular
Ground glass nodules

A

Sub-Acute
Hypersensitivity
Pneumonitis

51
Q

Small Airway Disease

RA and Sjogrens.
Centrilobular ground glass
nodules. Likes lower lobes

A

Follicular Bronchiolitis

52
Q

Small Airway Disease

Viral
Drugs
Transplant,
Inhalation
Air-Trapping.
DIPNECH

A

Constrictive
Bronchiolitis

53
Q

Aspiration Petterns

Airspace opacity, if massive can look
like pulmonary edema

A

Aspiration of Gastric Acid
“Mendelson s Syndrome ”

54
Q

Aspiration Petterns

“Fleeting Opacity”
that resolves in hours

A

Aspiration of water or
neutralized gastric
contents

55
Q

Aspiration Petterns

Gives you a real pneumonia, can get
para-pneumonic effusion, empyema,
or even broncho-pleural fistula.

A

Aspiration of Germs
(often mouth bugs)

56
Q

Aspiration Petterns

Lipoid Pneumonia. Low density

A

Aspiration of Oil
(often mineral oil)

1. THORACIC (28 decks)

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