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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?

25
Tracheal malignancy seen in the upper trachea, posterior lateral.
Adenoid
26
What is the most common tracheal malignancy?
Squamous Cell
27
Airway malignancy favoring the lower trachea/proximal bronchus
Squamous cell
28
Most common BENIGN tumor of teh trachea
Suamous Cell Papilloma
29
When it's a single papilloma, think of?
Smoking
30
When it's multipe papillomas, think of?
HPV
31
Most common cause of subglottic tracheal stenosis in adult?
Post intubation stenosis
32
Classic look of Subglottic stenosis
FOCAL subglottic circumferential stenosis. HOURGLASS configuration
33
subglottic stenosis + No history of intubation =
A rare cast of adult croup (Acute laryngotracheobronchitis)
34
Sodium pump doesn't work and they end up with thick secretions with poor pulmonary clearance. Damage is done by RECURRENT INFECTIONS
Cystic fibrosis
35
Cystic Fibrosis pulmonary features?
Bronchiectasis + apical predominance + Hyperinflation + Pulmonary Arterial Hypertension (PAH) + Mucus plugging (finger in glove)
36
Abnormal Mucus, Cilia can't move it
Cystic Fibrosis
37
Normal Mucus, Cilia don't work
Primary Ciliary Dyskinesia
38
Normal sperm, absent vas deferens
Cystic fibrosis
39
Abnormal sperm, Normal vas deferens
Primary Ciliary dyskenesia
40
Chronic mastoid effusion and conducting hearing loss (little ear nerve hair things are fucked up too)
Primary Ciliary Dyskenesia
41
50% of primary ciliary dyskeneisa patients have this condistion
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
Upper lobe bronchiectasis
Cystic fibrosis
43
Congenital cystic bronchiectasis from a deficiency of cartilage in the 4th-6th order bronchi
WIlliams Campbell Syndrome
43
"That's one big fucking trachea" >3cm dilatation
Mounier-Kuhn (Tracheobronchomegaly)
44
Inflammation of the small airways
Bronchiolitis
45
Air trapping in bronchiolitis obliterans is seen in the setting of a ?
lung transplant
46
Air trapping in small airway disease. Think of?
Asthma and bronchiolitis
47
Dilatation and impaction of the centrilobular airways
Tree in bud
48
Small Airway Disease Tree in bud
Infectious brongiolitis
49
Small Airway Disease Smokers + Centrilobular ground glass nodules (upper lobe predominant)
RB-ILD
50
Small Airway Disease Inhaling dust / other misc garbage. Centrilobular Ground glass nodules
Sub-Acute Hypersensitivity Pneumonitis
51
Small Airway Disease RA and Sjogrens. Centrilobular ground glass nodules. Likes lower lobes
Follicular Bronchiolitis
52
Small Airway Disease Viral Drugs Transplant, Inhalation Air-Trapping. DIPNECH
Constrictive Bronchiolitis
53
Aspiration Petterns Airspace opacity, if massive can look like pulmonary edema
Aspiration of Gastric Acid “Mendelson s Syndrome ”
54
Aspiration Petterns “Fleeting Opacity” that resolves in hours
Aspiration of water or neutralized gastric contents
55
Aspiration Petterns Gives you a real pneumonia, can get para-pneumonic effusion, empyema, or even broncho-pleural fistula.
Aspiration of Germs (often mouth bugs)
56
Aspiration Petterns Lipoid Pneumonia. Low density
Aspiration of Oil (often mineral oil)

1. THORACIC (28 decks)

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