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Radiology > Trachea and Mediastinum > Flashcards

Trachea and Mediastinum Flashcards

1
Q

Normal position of trachea - should diverge from the spine by what angle? Exceptions with brachiocephlic and deep chested breeds?

A

15-30 degrees; barchiocephalic breeds less; deep chested breeds more

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2
Q

Carina should be placed posterior to rib #__

A

5

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3
Q

Trachea is normally runs right on the midline on the VD view, however in brachiocephalic breeds, it may right slightly to the ____ of the midline.

A

right

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4
Q

Dorsal displacement of trachea

A
  1. Cranioventral mediastinal mass - LN, thymus, tumor (lymphoma), abscess
  2. Heart enlargement or heart base tumor
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5
Q

Ventral displacement of trachea

A
  1. Megaesophagus - MC, vascular ring anomaly, foreign body

2. Dorsal mediastinal mass

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6
Q

Lateral tracheal displacement

A
  1. Cranial mediastinal mass, pulmonary mass
  2. Mediastinal shift/atelectasis
  3. Positional artifact - due to rotation of the dog
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7
Q

Caudal tracheal displacement

A

Cranial mediastinal mass

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8
Q

The most common vascular ring anomaly in puppies is:

A

Persistent 4th right aortic arch

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9
Q

Persistent 4th left aortic arch is abnormal or normal?

A

Normal

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10
Q

Normal tracheal size

A

Diameter of the lumen should be ~3xs the width of the 3rd rib; or 1/5 (20%) height of thoracic inlet; brachiocephalic dogs can have tracheal lumen be as low as 16% of the thoracic inlet

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11
Q

Ddx for small trachea

A
  1. Hypoplasia - congenital - MC, brachycephalic breeds
  2. Stenosis - trauma, congenital
  3. Intrathoracic tracheal collapse
  4. Compression by extralumenal mass
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12
Q

With an intrathoracic tracheal collapse, radiographs should be taken on ______, because the trachea will decrease in size, and illustrate the tracheal collapse.

A

Expiration

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13
Q

Ddx for large trachea

A

Upper respiratory obstruction

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14
Q

Is mineralization of the tracheal lumen normal?

A

Yes, it will mineralize with age

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15
Q

Tracheal rupture or puncture will most likely cause a pneumo____

A

pneumomediastinum

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16
Q

Three tumors in the tracheal lumen:

A

Chondroma, Osteosarcoma, and Squamous cell carcinoma

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17
Q

Redundant Dorsal Trachealis Membrane

A

You can still see the dorsal surface of the trachea (not a collapse), but the dorsal membrane falls, creating a flap that obstructs airflow

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18
Q

Mediastinum

A

Compartment of the thoracic cavity between the medial aspects of the two pleural sacs;
Cranial (precardiac), Middle (pericardiac), caudal (postcardiac)

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19
Q

Mediastinum opens -

A

Cranially and caudally

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20
Q

Unilateral penumothorax/pleural effusions are common. True or False.

A

False. They are RARE due to mediastinal communication

21
Q

Mediastinal structures normally seen:

A

Trachea, heart, aorta, caudal vena cava, carniomediastinal reflection, caudomediastinal reflection, thymus in young animals

22
Q

The cranioventral mediastinal reflection is best seen on which views

A

Lateral

23
Q

The caudoventral mediastinal reflection is ONLY seen on which views?

A

VD/DV

24
Q

Mediastinal structures NOT normally seen

A

Cranial vena cava, brachiocephalic trunk, left subclavian artery, azygous vein, LNs (sternal/retrosternal, hilar/tracheobronchial, cranial mediastinal); esophagus - unless it contains gas or fluid/mass

25
Q

Where can the thymus be seen in young animals (up to 4-6 months of age)?

A

Within the cranioventral mediastinal reflection

26
Q

Clinical signs of mediastinal abnormalities:

A

Dyspnea, dysphagia (trouble swallowing) and/or regurgitation, cardiovascular disturbances (signs of right heart enlargement: forelimb edema, ascites, hepatomegaly)

27
Q

Ddx to mediastinal shift

A
  1. Atelectasis - loss of lung volume
  2. Diaphragmatic hernia
  3. Adhesions
  4. Unilateral pneumothorax or pleural effusion (pyothorax)
  5. Technical artifact - poor VD positioning
28
Q

Radiographic signs of pneumomediastinum:

A

Increase in radiolucency, so structures not normally seen are visible; on lateral view you see tracheal stripe sign

29
Q

Tracheal stripe sign is indicative of:

A

pneumomediastinum; occasionally air in megaesophagus can highlight trachea and create a tracheal stripe sign

30
Q

Vessels seen of of the cranial vena cava is a definitive sign of:

A

Pneumomediastinum

31
Q

Causes of pneumomediastinum:

A
  1. Soft tissue wound - neck, axilla, venipuncture
  2. Tracheal rupture (trauma, venipuncture, over-inflated tracheal cuff, transtracheal wash)
  3. Bronchial rupture
  4. Alveolar rupture
  5. Esophageal perforation
  6. Gas producing organisms (rare)
32
Q

Three complications of pneumomediastinum:

A
  1. Pneumothorax
  2. Pneumoretroperitoneum
  3. Mediastinitis
33
Q

Treatment of pneumomediastinum:

A

Self-limiting if no complications - air resorbed in 7-10 days; remove gas if secondary pneumothorax present and animal is dyspneic

34
Q

Normal mediastinum should be no wider than __x the width of the thoracic vertebrae on the VD view.

A

2x

35
Q

MC cause of widening of mediastinum with NO mass:

A

Fat

36
Q

Causes of mediastinal widening:

A

Fat - evenly distributed, lymphadenopathy, mediastinitis, hemorrhage, abscess, edema

37
Q

Causes of cranioventral mediastinal masses:

A
  1. Fat (lipoma)
  2. Thymus (thymoma)
  3. Thyroid (thyroid adenocarcinoma)
  4. Mediastinal lymph nodes (lymphosarcoma)
  5. Retrosternal lymph nodes
  6. Abscess
38
Q

Differentials to cranioventral mediastinal mass:

A
  1. Pleural effusion

2. Pleural, pulmonary, and thoracic masses

39
Q

Radiographic signs of cranioventral mediastinal masses:

A
  1. Dorsal +/- lateral deviation of trachea
  2. Increased opacity of mediastinum cranial to heart
  3. Silhouette with heart
  4. Carina displaced caudally
  5. +/- esophageal air accumulation
40
Q

Causes of craniodorsal mediastinal masses

A

Esophagus MC - (megaesophagus, esophageal foreign body); trachea; cranial vena cava; aortic arch, nerves

41
Q

Radiographic signs of craniodorsal mediastinal mass:

A

ventral dispalcement of trachea; distended esophagus

42
Q

Causes of perihilar mediastinal masses:

A

Tracheobronchial lymph nodes, pulmonary vessels, left and right atria, esophagus

43
Q

Radiographic signs of perihilar mediastinal masses:

A

Increased opacity, displacement of tracheal bifurcation, constriction of trachea

44
Q

Radiographic appearance of HW disease

A

Torturous pulmonary arteries that stand out in the caudal lung lobes!

45
Q

Causes of dorsocaudal mediastinal masses

A

Caudal esophagus (granuloma, hiatal hernia, epiphrenic diverticulum, spirocerca lupi), diaphragmatic hernia, descending aorta, nerves

46
Q

Radiographic signs of dorsocaudal mediastinal mass:

A

Increased opacity dorsocaudal thorax on lateral; increased opacity midline on VD and DV

47
Q

Causes of caudoventral mediastinal mases:

A

Pericardial cyst, peritoneopericardial or other diaphragmatic hernia, abscess or granuloma

48
Q

Radiographic signs of caudoventral mediastinal mass:

A

Silhouette with the heart, increase opacity at midline on VD and DV

Radiology (4 decks)

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