Week 12 (exam 4) Flashcards
Define air opacities
ill-identified opacities that cover up normal shadows created by pulmonary vessels
air in alveolar spaces is replaced
In air opacities, the air in alveolar spaces is replaced by
inflammatory cells (ARDS)
pus (pneumonia)
blood (pulmonary hemorrhage)
water (pulmonary edema)
tumor cells
BLANK fundamental sign of consolidation
air bronchogram
Define interstitial markings
supporting structures of the lungs
- vessels, bronchi, connective tissue
Opacities in interstitial markings represent
disease process localized to the pulmonary interstitium
Define Kerley B lines
horizontal lines commonly found in lower lung periphery
Define nodule
discrete opacity seen on chest x-ray
- less than 3 cm
Define mass
discrete opacity is seen on chest x-ray
- greater than 3 cm
Lymphadenopathy can be represented by
an abnormal contouring of mediastinal shadows
Common locations of lymphadenopathy
right parabronchial area
hilar regions
Define cysts and cavities in the abnormal chest
areas of pulmonary parenchymal space normally containing lung tissue that become filled with air, fluid, or both
cavities usually created by tissue necrosis within lung nodule or mass
What is the most common pleural abnormality
pleural effusion
Examples of pulmonary calcifications
Asbestos-related to pulmonary disease
TB empyema
Define silhouette sign
elimination of the silhouette or loss of lung/soft tissue interface caused by a mass or fluid in the normally air-filled lung
anything that disrupts of the normal cardiac silhouette
What questions should you ask yourself when looking at pulmonary abnormalities
is it focal or diffuse
where is it (location)
is it interstital or alveolar
unilateral or bilateral
What should you also include when describing abnormal chest x-ray
describe any inflation
masses or nodules
consolidation or infiltrate
Infiltrates can be due to many factors…
hemorrhage
edema
pneumonia
Describe lobar pneumonia
airspace opacities largely confined to one lobe
most commonly due to bacterial infection
Describe lobular pneumonia
patchy consolidation in the lung
Commonly due to bacterial infections
Describe interstitial pneumonia
caused by atypical bacteria
primarily confined to the interstitium of the lung and the walls of the alveoli
GROUND GLASS appearance in CT scan
- COVID
Define an effusion
a build-up of fluid within the pleural space
transudate or exudate
Define transudate
fluid pushed through capillaries due to pressure changes
Define exudate
fluid leaked due to inflammation
What will travel to the most dependent portion of the pleura
And what does this depend on
mobile pleural effusions
depends on patient’s position
what is more sensitive for detecting smaller effusions
lateral decubitis
COPD: obstruction is suggested by presence of
increased lung volumes
COPD: may see early evidence of emphysema first
hyperinflation of lungs
COPD: increased lung volumes on chest x-ray show
flattening of the diaphragm and increased AP diameter of the chest
Define bronchiectasis
abnormal dilation of bronchial resulting in copious sputum production and recurrent infections
What causes bronchiectasis
cystic fibrosis
infection
- TB
- PJP pneumonia (pneumocystis pneumonia)
- severe bacterial pneumonia
What can we see on x-ray for bronchiectasis
coarse thickening of bronchovascular bundles
“tram track” lines
When does atelectasis occur
Occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid
- mild/moderate collapse of part of distal lungs
Difference between obstructive (blockage in airway) and non-obstructive (pressure outside the collapsed area) for atelectasis
obstructive
- mucous plug
- foreign body
- scarring/narrowing of airway
- tumor
non-obstructive
- trauma
- pleural effusion
- pneumonia
- pneumothorax
- lung tissue scarring
- tumor
What do you see on chest x-ray for atelectasis
white out pattern
Define pneumothorax and their types
abnormal presence of air in the pleural space
spontaneous
- bleb (on ct scan)
secondary
- disease process (COPD)
tension
- penetrating trauma, invasive procedure, (mechanical ventilation)
What is a hallmark of primary tuberculosis on chest x-ray
lymphadenopathy
What are classically most involved with atypical infection (TB)
right hilar nodes and right paratracheal nodes
What is the most common parenchymal finding in primary TB
focal consolidative opacity
post-primary or reactivation TB
Apical and posterior opacities and cavitary lesions
Reactivation TB =
Patchy airspace opacities
Pulmonary edema: hydrostatic edema is primarily due to
left heart failure and volume overload states
What are the three stages of hydrostatic edema
pulmonary venous hypertension
interstitial pulmonary edema
frank alveolar edema
- perihilar or “bat-wing” distribution
Pulmonary edema: if see cardiomegaly on chest x-ray…
suggests underlying congestive heart failure
Large pericardial effusions may cause
enlargement of the cardiac silhouette on chest x-ray
What suggests a large pericardial effusion on chest x-ray
bottle-shaped configuration
