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Diagnostic Imaging > Thorax Part 1 > Flashcards

Thorax Part 1 Flashcards

1
Q

what is the silhouette sign?

A

two structures of the same radiographic opacity that are in direct contact with each other lose their margins and cannot be seen as separate entities

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2
Q

whenever you see fluid where there should not be any, it’s probably going to be: ___________________________

A

blood
pus
water

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3
Q

where does gas where it should not be come from?

A

communication with outside world
communication with a structure that normally has gas in it
gas forming organisms

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4
Q

why do we take thoracic radiographs?

A

rule in/out causes of respiratory signs
investigate suspected cardiac disease
screen for metastatic disease
screen patients prior to anesthesia
evaluate patients who have undergone trauma

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5
Q

what technique do we use for thoracic radiographs?

A

high kVp technique
minimize exposure time
take radiographs at peak inspiration
use a grid if patient is thicker than 10cm

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6
Q

is right lateral better for assessing changes in the left or right lung lobes?

A

left lung lobes

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7
Q

how can you tell a lateral thoracic view is right lateral?

A

heart is “egg shaped”
diaphragmatic crura parallel to each other
right crus more cranial
better for assessing left lung lobes

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8
Q

how can you tell a lateral thoracic view is left lateral?

A

heart rounded
diaphragmatic crura diverge
left crus more cranial
better for assessing changes in right lung lobes

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9
Q

what differentiates a dorsoventral view from a ventrodorsal view?

A

heart position more consistent
diaphragm has one dome (cupula)

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10
Q

what differentiates a ventrodorsal view from a dorsoventral view?

A

heart “flops” and may look elongated
diaphragm has three domes (cupula and two crura)

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11
Q

why do we take both lateral views with a thoracic study?

A

dependent lung collapses
collapsed lung hides soft tissue opacity nodules
opposite lateral: aerated lung, provides contrast

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12
Q

what are some special views with thoracic radiographs?

A

oblique views
horizontal beam views

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13
Q

why would we take oblique views?

A

highlight thoracic wall masses

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14
Q

why would we perform horizontal beam views of the thorax?

A

diaphragmatic hernia
small volumes of pneumothorax

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15
Q

do we take VD or DV views of large animals?

A

no, only lateral views taken
not even young foals

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16
Q

where do you put the lung of interest when taking radiographs of a large animal?

A

close to the plate

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17
Q

what happens with pleural effusion and a pneumothorax in large animals on radiographs?

A

pleural effusion will fall
pneumothorax will rise

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18
Q

what are some thoracic contrast procedures?

A

esophagography
angiography
celiography

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19
Q

what should you evaluate when evaluating the thorax?

A

extrathoracic structures
diaphragm
mediastinum
pleural space
lungs, including pulmonary vasculature
cardiac silhouette

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20
Q

what extrathoracic structures should you check on a set of thoracic radiographs?

A

caudal neck
thoracic limbs
cranial abdomen
thoracic wall

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21
Q

what are some thoracic wall abnormalities?

A

congenital abnormalities
trauma
masses

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22
Q

why is a flail chest a problem?

A

can cause trauma to the lungs

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23
Q

what are thoracic wall masses recognized by?

A

extrapleural sign: intact parietal pleeura contains the mass, mass will indent the lung

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24
Q

what causes a flail chest?

A

segmental fractures of adjacent ribs

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25
Q

what can be seen on thoracic radiographs that would indicate a diaphragmatic hernia?

A

inability to clearly identify the diaphragm
displacement or lack of organs in the abdominal cavity
visualization of organs in the thoracic cavity

26
Q

what can hamper your ability to identify a diaphragmatic hernia?

A

concurrent pleural effusion

27
Q

what is a peritoneal-pericardial diaphragmatic hernia?

A

abdominal contents in pericardial sac

28
Q

how can you identify a peritoneal-pericardial diaphragmatic hernia?

A

globoid cardiac silhouette
central/ventral diaphragm not clear

29
Q

what is a hiatal hernia?

A

stomach coming through esophageal hiatus

30
Q

what are the types of hiatal hernia?

A

sliding axial
GE intussusception
paraesophageal

31
Q

where does the mediastinum extend between?

A

thoracic inlet to diaphragm
spine to sternum

32
Q

what does the mediastinum consist of?

A

two layers of mediastinal pleura and the space between them

33
Q

what structures are normally seen in the mediastinum?

A

trachea
heart
aorta
caudal vena cava
fat

34
Q

what structures are occasionally seen in the mediastinum?

A

gas in esophageal lumen: aerophagia
thymus: normal if dog <1year

35
Q

what are some structures that are not normally seen in the mediastinum?

A

cranial vena cava, brachiocephalic trunk
lymph nodes
outer surface of trachea and esophagus

36
Q

what does the sternal lymph node drain?

A

pleural space
chest wall
abdomen

37
Q

if you see a big sternal lymph node, what should you do?

A

look for a problem in the abdomen

38
Q

what lymph nodes can be seen on thoracic radiographs (not normal)?

A

tracheobronchial aka hilar
sternal
tracheal

39
Q

what does hilar lymphadenopathy look like?

A

ill-defined soft tissue opacity surrounding the carina on the lateral view
where bronchi come together on the DV view

40
Q

what are some mediastinal abnormalities?

A

pneumomediastinum
mediastinal masses
mediastinal effusion
mediastinal shift

41
Q

how can you recognize a pneumomediastinum?

A

increased visualization of mediastinal structures

42
Q

where can gas dissect into from a pneumomediastinum?

A

subcutaneous tissues
retroperitoneal space

43
Q

the cranial mediastinum should be no wider than __________________________ on the DV or VD view

A

twice the width of the spine

44
Q

what breeds like to deposit fat in their mediastinum?

A

brachycephalic breeds

45
Q

what is mediastinal shift?

A

mediastinum is shifted to one side on thee DV or VD radiograph

46
Q

what is mediastinal shift recognized by?

A

displacement of the cardiac silhouette

47
Q

what can mediastinal shift be due to?

A

collapse of lung
increased volume of a lung/hemothorax
mass

48
Q

how can you recognize mediastinal fluid?

A

decreased visualization of mediastinal structures
diffuse widening of the mediastinum

49
Q

what can mediastinal fluid be mistaken for on the lateral view?

A

pleural effusion or pulmonary disease

50
Q

where does the esophagus live on the lateral view?

A

dorsal to the intrathoracic trachea
between aorta and caudal vena cava

51
Q

where is the esophagus on a DV view?

A

slightly to the left of midline

52
Q

what are some esophageal abnormalities?

A

esophageal motility disorder
vascular ring anomaly
esophageal mass
esophageal foreign body/choke

53
Q

what is esophageal motility disorder?

A

decreased ability of the esophagus to propel food/water into the stomach

54
Q

can you diagnose esophageal motility disorder if there is no food or water present?

A

no

55
Q

does esophageal dilation mean the patient has a motility disorder?

A

not necessarily
could be aerophagia

56
Q

when can ingesta be in the esophagus?

A

shortly after eaten (20 seconds)
in bolus form: 1 or 2 swallows’ worth

57
Q

how do we diagnose esophageal motility disorder?

A

esophagography
if food/fluid is present in esophagus and not in bolus form: diagnostic

58
Q

how can you perform an esophagography?

A

give barium liquid, paste and paste mixed with food
watch under fluoro or take rads after dog swallows

59
Q

what is vascular ring anomaly usually due to?

A

persistent right aortic arch

60
Q

what wraps around the esophagus in a vascular ring anomaly?

A

remnant of ductus arteriosus

61
Q

when does an animal with a vascular ring anomaly start to show signs?

A

after it is weaned: regurgitating when changed to solids

62
Q

what can chronic packing of food in the esophagus in vascular ring anomaly lead to?

A

pulsion diverticulum

Diagnostic Imaging (12 decks)

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