Witwer - Pulmonary Disease/Chest Films Flashcards

1
Q

lobes of the right lung

A

upper

middle

lower

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2
Q

fissures of the right lung

A

major

minor

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3
Q

lobes of the left lung

A

upper

lower

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4
Q

fissure of the left lung

A

major/oblique

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5
Q

the lung appears __ on CXR

bc it is filled w. __

A

dark

air

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6
Q

the heart appears __ on CXR

bc it is __ density

A

gray

water

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7
Q

what causes the silhouette sign

A

fluid, pus, or blood (fluid density) fills the lung → water density next to water density → obliterates boundary btw lung and heart

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8
Q

silhouette sign is commonly seen w. (2)

A

PNA

atelectasis

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9
Q

what structure in the lung forms a lace-like network that supports the lung

A

interstitium (same same stroma)

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10
Q

interstitium/stroma includes (3)

A

area btw alveolar epithelium

capillary endothelial basement membrane

perivascular and perilymphatic tissue

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11
Q

area of the lung involved in gas exchange

A

parenchyma

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12
Q

parenchyma includes (2)

A

alveoli

capillaries

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13
Q

fibrosis is a type of __ lung dz

A

interstitial

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14
Q

types of interstitial densities

A

coarse

strandy

linear

reticular

nodular

honeycomb

reticulonodular

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15
Q

pus, blood, fluid, or tumor in parenchymal airspaces

A

alveolar infiltrates

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16
Q

alveolar infiltrates are typically caused by what dz process

A

PNA

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17
Q

describe alveolar densities (5)

A

confluent

coalescent

hazy

fluffy

ill-defined

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18
Q

6 disease processes commonly associated w. alveolar infiltrates

A

PNA

COVID

CHF

atelectasis

PE

neoplasia

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19
Q

dense alveolar infiltrate in the lung w.o air bronchogram

A

drowned lung → bronchus filled w. fluid

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20
Q

air bronchograms are seen with

A

alveolar disease

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21
Q

fluid, pus, blood, fibrosis, or tumor in the interstitum/stroma, bronchi, pulmonary arteries, veins, or lymphatics

A

interstitial infiltrates

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22
Q

describe interstitial infiltrates

A

reticular

fine

coarse

strandy

linear

nodular

reticulonodular

honeycomb

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23
Q

7 dz processes that cause interstitial infiltrates

A

emphysema

bronchiectasis

asthma

kerley’s lines

sarcoidosis

CF

TB

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24
Q

wall of bronchi become thickened bc of fluid, inflammation, chronic infxn, bronchiolitis, CF

A

bronchial cuffing

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25
Q

bronchial cuffing is same-same

A

donut sign

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26
Q

bronchial cuffing dt CHF involves

A

fluid

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27
Q

bronchial cuffing dt PNA involves

A

infxn

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28
Q

what does bronchial cuffing due to inflammation make you think of

A

asthma

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29
Q

bronchial cuffing dt chronic inflammation commonly involves (2)

A

bronchiectasis

CF

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30
Q

network of crossing lines on CXR - linear interstitial pattern

A

kerley’s lines

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31
Q

what do you think when you see kerley’s lines

A

pulmonary edema → CHF

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32
Q

irreversible dilation of part of the bronchial tree

A

bronchiectasis

33
Q

bronchiectasis is mc 2/2 to __

and usually involves the __

A

chronic necrotizing bacterial infxn

lower lobes

34
Q

2 bacteria commonly associated w. bronchiectasis

A

staph

klebsiella

35
Q

5 conditions associated w. bronchiectasis

A

CF

kargagener’s syndrome (ciliary dyskinesia)

allergic bronchopulmonary aspergillosis

Swyer - James Syndrome

chronic productive cough/hemoptysis

36
Q

non cardiac alveolar infiltrates are commonly dt (5)

A

toxic agents

HAPE

drugs → heroin

shock lung

cerebral edema

37
Q

landmarks and anatomy

A
38
Q

landmarks and anatomy

A
39
Q

heart auscultation locations

A
40
Q

lung auscultation locations

A
41
Q

what is the 50% rule

A

measuring across, a normal heart is < 50% of the greatest diameter of the ribs → larger equals pathology

42
Q

pediatric silhouette can be up to __% of the cardiothoracic ratio

A

65

43
Q

on cxr, black represents

A

air

44
Q

on cxr, gray represents

A

fat → btw muscle layers

45
Q

on cxr, dark gray represents

A

water

46
Q

what structures appear dark grey on cxr

A

soft tissue:

muscle

heart

liver

kidneys

etc

47
Q

on cxr, what color is blood, pus, fluids

A

dark grey

48
Q

on cxr, white represents

A

bone

calcium

49
Q

what is this showing

A

upper lobe TB

50
Q

what is this showing

A

right middle lobe atelectasis

silhouetting on right side of heart

51
Q

what is this showing

A

silhouette sign

right middle lobe PNA

52
Q

what is this showing

A

silhouette sign

upper lobe atelectasis

53
Q

what is this showing

A

alveolar densities

54
Q

what is this showing

what are the arrows

A

alveolar densities

PNA

arrows: air bronchograms

55
Q

what is this showing

A

bronchial cuffing

enlarged heart

CHF

56
Q

what is this showing

A

alveolar densities

non cardiogenic pulmonary edema

57
Q

what is this showing

A

alveolar densities

pulmonary edema

CHF

58
Q

what is this showing

A

r lower lobe PNA

59
Q

what is this showing

A

alveolar densities

COVID

60
Q

what is this showing

A

left upper lobe collapse

air bronchograms

drowned lung

61
Q

what is this showing

A

silhouette sign left upper lobe

62
Q

what is this showing

A

bilateral pulmonary infiltrates/alveolar densities

ARDS

63
Q

what is this showing

A

interstitial infiltrates

coase, strandy, linear, reticular

64
Q

what is this showing

A

interstitial infiltrates

65
Q

what is this showing

A

interstitial infiltrates

precursor to alveolar in CHF

66
Q

what is this showing

A

tubular densities from fluid filled bronchi → CF

67
Q

what is this showing

A

flat diaphragm

increased AP diameter

hyperinflation → air trapping

68
Q

what is this showing

A

flat diaphragm

increased AP diameter

dark black lungs

hyperinflation → air trapping

69
Q

what is this showing

A

normal CXR

70
Q

what are the lines radiating from the hilum

A

blood vessels

71
Q

what is the thin walled ring in the center of the picture

A

bronchus

72
Q

what is this showing

A

normal CXR

73
Q

what is this showing

A

interstitial densities

74
Q

what is this showing

A

bronchial cuffing

75
Q

what is this showing

A

normal CXR

76
Q

what is this showing

A

air bronchogram → alveoli and interstitium infiltrates

77
Q

the left heard boarder is adjacent to which part of the lung

A

lingula of left upper lobe

78
Q

the right heart border is adjacent to which part of the lung

A

right middle lobe

79
Q

the diaphragm is adjacent to which parts of the lung

A

inferior lobes