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1. THORACIC > THORACIC Section 16: Pulmonary arteries and veins > Flashcards

THORACIC Section 16: Pulmonary arteries and veins Flashcards

1
Q

What are the 2 major forms of anomalous anatomy of the pulmonary and veins?

A

Parital (PAPVR) or

Total (TAPVR)

Anomalous pulmonary venous return.

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2
Q

PAPVR/TAPVR drain into?

A

systemic system

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3
Q

Where should the pulmonary veins drain?

A

Left atrium

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4
Q

Defined as one (or more) of the four pulmonary veins draining into the right atrium (or SVC)

A

Partial anomalous venous return

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5
Q

What consitions does PAPVR associated?

A

ASD

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6
Q

Most classic type of ASD PAPVR is associated

A

Sinus venosus type

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7
Q

Schmitiar syndrome is PAPVR + ?

A

PAPVR + Pulmonary hypoplasia

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8
Q

The most common pattern of PAPVR

A

Right superior pulmonary vein draining in to the SVC (Junction of SVC and RA)

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9
Q

Less common PAPVR

A

Left sided

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10
Q

What is the “classic” look of PAPVR

A

“Vertical Vein” draining a left pulmonary vein into the left brachiocephalic vein

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11
Q

The dilated right inferior pulmonary vein (PAPVR) draining into the IVC

A

Schimitar Sign

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12
Q

Sword VEin + Tiny Lung

A

Scimitar Syndrome

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13
Q

A cyanotic heart disease characterized by all of the pulmonary venous system draining to the right side of the heart.

A

Total anomalous pulmonary venous return (TAPVR)

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14
Q

This is the lost Dad vein, refusing to ask for directions because that is admitting failure.

It takes the scenic route, but it does always return to what structure?

A

Meandering Pulmonary vein

Left atrium

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15
Q

Vein NOT draining into the left atrium causing left-righ shunting

A

PAPVR/Sciimitar vein

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16
Q

Vein draining into the left atrium. NO left-right shunting

A

Meandering Pulmonary Vein

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17
Q

Diagnosis?

A

Meandering pulmonary vein

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18
Q

What causes dilatation of the right pulmonary vein?

A

Mitral regurgitation

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19
Q

Mitral regurgitation causes asymmetric pulmonary edema involving what lobe?

A

Rightupper lobe.

“Lower vein grows, upper lung shoes (turns white from pulmonary edema)”

“Grower not a shower” - Inferior pulmonary vein

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20
Q

Congenital absence of the right (or left) pulmonary artery with the more distal vasculature present.

A

Proximal Interruption of the Pulmonary Artery

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21
Q

The distal pulmonary arterial tree is supplied by?

A

collaterall vessls

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22
Q

Diagnosis.

Desrcibe.

A

Proximal interruption of the Pulmonary Artery

CXR/CT: Volume loss of one hemithorax.

CT + C+: Onley one PA. Raise suspision if with volume loss

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23
Q

The side of the Proximal Interruption ofhte Pulmonary Artery is determined by the side of what structure?

A

Aortic arch.

Absent right PA with left-sided aortic arch
Absent left PA with right-sided aortic arch

24
Q

Priximal Interruption of the Pulmonary Artery is associated with what congenital heart anomaly?

A

PDA

25
Q

Interrupted LEFT PA is associated with what heart anomaly?

A

TOF
Truncus arteriosus.

26
Q

Persons with Interruption of the Pulmonary Artery has reccurent infections due to?

A

LACK of arterial blood supply.

27
Q

Gold standard for diagnosis of Pulmonary Embolism?

A

Catheter Angiography.

28
Q

Diagnosis?

What sign?

A

Pulmonary Embolism

Westermark Sign - Regional Oligemia (Reduction of blood flow)

29
Q

Diagnosis?

Sign?

A

Pulmonary Emblolism

Fleishner Sign (Enlarged pulmonary artery)

30
Q

Diagnosis?

Sign?

A

Pulmonary Embolism

Hampton’s Hump (Peripheral Wedge-shaped opacity)

31
Q

Acute vs Chronic PE

Central clot

A

Acute PE

32
Q

Acute vs Chronic PE

Peripheral clot

A

Chronic PE

33
Q

Acute vs Chronic PE

VEnous Dilatation

A

Acute PE

34
Q

Acute vs Chronic PE

Shrunken veins with collateral vessels

A

Chronic PE

35
Q

Acute vs Chronic PE

Perivenous Soft tissue edema

A

Acute PE

36
Q

Acute vs Chronic PE

Calcifications within the thrombi and within the venous walls

A

Chronic PE

37
Q

Acute vs Chronic PE

Mosaic attenuation

A

Chronic PE

38
Q

Acute vs Chronic PE

Sudden death from arrythmia or acute right heart failure

A

Acute PE

39
Q

Acute vs Chronic PE

A well descrined cause of pulmonary hypertension

A

Chronic PE

40
Q

Exam of choice of Acute PE

A

CT Pulmonary Angiogram

41
Q

Exam of choic of Chronic PE

A

VQ Scan (Ventilation perfusion scan)

42
Q

Uncommon variant of primary pulmonary hypertension, that affects the post capillary pulmonary vasculature.

A

Pulmonary Veno-occlusive diease

43
Q

PAH+Normal Wedge

A

Pulmonary Veno-occlusive disease

The normal wedge pressure differentiates it from other post capillary causes

44
Q

PAH+Abnormal Wedge

A

Left atrial mexoma
Mitral Stenosis
Pulmonary Vein stenosis

45
Q

Most common cause of Pulmonary Artery Aneurysm/Pseudoaneurysm

A

Iatrogenic from swan Ganz Catheter (Think about “patients in the ICUS”)

46
Q

Other causes of Pulmonary artery aneurysm/Pseudoaneurysm

A

Behcets (Think about Turkish descent, Mouth and Genital Ulcers)
Chronic Pulmonary Embolism

47
Q

This is a zebra cause of pulmonary artery aneurysm that is similar (and maybe the same thing) as Behcets. It is characterized by recurrent thrombophlebitis and pulmonary artery aneurysm formation and rupture.

A

Hugh-Stovin Syndrome

48
Q

This has a cool name, which instantly makes it high yield for testing. This is a pulmonary artery pseudoaneurysm secondary to pulmonary TB. It usually involves the upper lobes in the setting o f reactivation TB.

A

Rassmussen Aneurysm

49
Q

Aneurysm from Right ventricular outflow tract (ROVT) repair

A

TOF Repair complication

50
Q

Pulmonary arterial pressure of Pulmonary Hypertension

A

> 25

51
Q

Most common cause of pulmonary hypertension

A

Secondary Pulmonary Hypertension

52
Q

Give Causes of Secondary Pulmonary Hypertension

A

Chronic PE
RHF/Strin
Lung Parenchymal Problems (Emphysema, Fibrosis)

53
Q

Pulmonary Hypertension + What condition? have an increased mortality.

A

COPD with high A/PA ratio - PA bigger than the aorta.

54
Q

Normal Pulmary artery Size

A

<29 mm

55
Q

Diagnosis?

Give the Sign

A

Pulmonary Hypertension

Banan and egg sign

56
Q

Diagnosis?

Give the Sign

A

Pulmonary Hypertension

Carina Crossover

1. THORACIC (28 decks)

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