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RAD 312 - Radiographic Pathology > Ch 1 & 3 > Flashcards

Flashcards in Ch 1 & 3 Deck (198)
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1

The pattern of the body's response to some form of injury that causes a deviation from or variation of normal conditions

Disease

2

5 causes of disease

Hereditary (genes) Trauma Infectious organisms Vascular processes Metabolic processes

3

Measurable or objective manifestations

Signs

4

Feelings that the patient describes - subject manifestations

Symptoms

5

Without subjective or objective manifestations

Asymptomatic

6

Identification of disease process

Diagnosis

7

Study of the cause of the disease process

Etiology

8

Underlying cause is unknown

Idiopathic

9

Probable patient outcome

Prognosis

10

Linked combination of signs and symptoms

Syndrome

11

Disease caused by physician or treatment

Iatrogenic

12

Contracted from the acute care facility

Nosocomial infections

13

Contracted in a public setting outside of the acute care favility

Community-acquired infections

14

The initial response of body tissues local injury

Inflammation

15

5 clinical signs of inflammation

Rubor Calor Tumor Dolor Loss of function

16

Rubor

Redness

17

Calor

Heat

18

Tumor

Swelling

19

Dolor

Pain

20

4 events that occur in inflammatory response

Alterations in blood flow and vascular permeability Migration of circulating white blood cells to the interstitium of the injured tissue Phagocytosis and enzymatic digestion of dead cells and tissue elements Repair of injury by regeneration of normal parenchymal cells or proliferation of granulation tissue and eventual scar formation

21

Allows fluids/cells to pass from one tissue to another tissue or location

Permeable membrane

22

Fibrous scar replaces destroyed tissue

Granulation tissue

23

Thick, yellow fluid called pus (dead white cells)

Pyogenic bacteria

24

Localized, usually encapsulated, collection of fluid

Abscess

25

Potential involvement of other organs and tissues in the body by organisms invading the blood vessels

Bacteremia

26

The accumulation of abnormal amounts of fluid in the intercellular tissue spaces or body cavities Ambulatory patients tend to accumulate fluid in tissues around the ankles and lower legs; in non-ambulatory/sedentary patients the edema fluid collects most prominently in the lower back, sacral area and lungs

Edema

27

Generalized edema occurs with pronounced swelling of subcutaneous tissues throughout the body

Anasarca

28

Localized lymphatic obstruction resulting in localized edema

Elephantiasis

29

Refers to an interference with the blood supply to an organ or part of an organ and deprives cells and tissues of oxygen and nutrients Blood unable to flow like it should and cells aren't getting the oxygen they should

Ischemia

30

Occlusions

Clots

31

3 things ischemia may be caused by

Atherosclerosis Thrombotic occlusion Embolic occlusion

32

Narrowing of an artery

Atherosclerosis

33

A localized area of ischemic necrosis within a tissue or organ; produced by occlusion of either arterial supply or venous drainage

Infarction

34

2 most common infarctions

Myocardial - heart Pulmonary - lungs

35

The rupture of a blood vessel that allows blood to escape externally or internally within surrounding tissues or a cavity

Hemorrhage

36

Hemorrhage/accumulation of blood trapped in body tissues A hemorrhage bleeding into tissues results in this

Hematoma

37

The changes in the number and size of cells, their differentiation, and their arrangement May develop in response to physiologic stimuli Numerous terms associated with this

Alterations of cell growth

38

An abnormal proliferation of cells that are no longer controlled by the factors that govern the growth of normal cells May be benign or malignant (cancer) From the Latin word for "new growth"

Neoplasia

39

Reduction in the size or number of cells in an organ or tissue with a corresponding decrease in function

Atrophy

40

Increase in the size of the cells of a tissue or organ in response to a demand for increased function

Hypertrophy

41

Increase in the number of cells in a tissue or organ

Hyperplasia

42

Loss of uniformity of individual cells and their architectural orientation

Dysplasia

43

Ungoverned abnormal proliferation of cells

Neoplasia

44

A study of neoplasms (tumors/cancer)

Oncology

45

Growth which closely resembles its cells of origin in structure and function

Benign

46

Neoplastic growth that invades and destroys adjacent structures

Malignant

47

Malignant neoplasms travel to distant sites, initial growth travels through the bloodstream and grows somewhere else

Metastasize

48

Malignant neoplasm of epithelial cell origin

Carcinoma

49

Undifferentiated cell growth without form (bizarre)

Anaplastic

50

Highly malignant tumor originating from connective tissue

Sarcoma

51

Major route of carcinoma to metastasize in lymphatic system

Lymphatic spread

52

Malignant tumors that have invaded the circulatory system and travel as a neoplastic emboli, bloodstream

Hematogenous spread

53

Assessment of aggressiveness or degree of malignancy, cancerous tumors have different grades

Grading

54

Extensiveness of tumor at the primary site Presence or absence of metastases to lymph nodes and distant organs

Staging

55

Study of determinants of disease events in given populations

Epidemiology

56

Rate that an illness or abnormality occurs

Morbidity

57

Reflects the number of deaths by disease per population

Mortality

58

Result from the abnormality in the DNA that pass from generation to the next through the genetic information contained in the nucleus of each cell Ex: breast cancer

Hereditary diseases

59

Genetic information contained in the nucleus of each cell passed to the next generation

Hereditary process

60

Forty-four chromosomes other than X and Y

Autosomes

61

Always produce an effect

Dominant genes

62

Manifest themselves when a person is homozygous for the trait

Recessive genes

63

Alterations in the DNA structures that may become permanent hereditary changes if they affect the gonadal cells May have a minimal effect and be virtually undetectable or may be so serious that they're incompatible with life, causing the death of the fetus and spontaneous abortion

Mutations

64

3 things mutations may result from

Radiation Chemicals Viruses

65

The most common hereditary abnormality that leads to a metabolic block that results either in a decreased amount of a substance needed for normal function or in an accumulation of a metabolic intermediate that may cause injury

Enzyme deficiency

66

Provides a powerful defense against invading organisms by allowing it to recognize antigens and produce antibodies to counteract them

Immune reaction

67

What are some examples of active immunity?

The vaccines given to prevent smallpox, polio, measles, tetanus and diphtheria

68

A person forms antibodies to counteract an antigen in the form of a vaccine or toxoid

Active immunity

69

3 types of immune ractions

Anaphylactic Cytotoxic reaction Delayed

70

Either the antigen is a component of a cell or it attaches to the wall of red blood cells, white blood cells, platelets, or vascular endothelial cells

Cytotoxic reactions

71

2 examples of cytotoxic reactions

The transfusion reaction occurring after the administration of ABO- incompatible blood Erythroblastosis fetalis (the hemolytic anemia of the Rh-positive newborn whose Rh-negative mother has produced anti-Rh antibodies

72

Foreign substance that evokes an immune response; ex: bacteria, viruses, fungi, and toxins

Antigen

73

Immunoglobulin responding to the antigen; make harmless

Antibody

74

Protected against antigens; antibodies bringing with antigens to make harmless

Immune

75

Contact with dead or deactivated microorganisms to form antibodies

Vaccine

76

Treated toxin with antigenic power to produce immunity by creating antibodies

Toxoid

77

Hypersensitive reaction resulting in a histamine release; causes sudden death to patients who are hypersensitive to the sting of bees, wasps, and other insects, and to medications such as penicillin, and contrast

Anaphylactic reaction

78

4 examples of anaphylactic reactions

Hypotension Shock Urticaria Bronchiolar spasm Laryngeal edema

79

Vascular collapse; acute peripheral circulatory failure

Shock

80

Urticaria

Hives

81

Low blood pressure

Hypotension

82

Hypersensitive

"Allergic"

83

Protection utilized when delivering healthcare services for any person

Standard precautions

84

Gowns, gloves, masks, shoe covers, and eye protection used to prevent transmission of potential infectious agents

Personal protective equipment (PPE)

85

Additional protective equipment to prevent the spread of highly infectious pathogens through contact, droplet, or airborne transmission

Transmission-based precautions

86

3 forms of protection from infectious disease exposure

Standard precautions from CDC Use appropriate PPE Utilize transmission-based precautions

87

Caused by human immunodeficiency viruses (HIV); characterized by a profound and sustained impairment of cellular immunity that results in recurrent of sequential opportunistic infections and a particularly aggressive form of Kaposi's sarcoma

Acquired Immunodeficiency Syndrome (AIDS)

88

2 high risk populations for AIDS

Young homosexual men Intravenous (IV) drug abusers

89

10 examples of additive (increased attenuation) diseases of the skeletal system

Acromegaly Acute kyphosis Hydrocephalus Marble bone Metastasis (osteosclerotic) Osteochondroma Osteoma Paget's disease Proliferative arthritis Sclerosis

90

12 examples of destructive (decreased attenuation) diseases of the skeletal system

Acute osteomyelitis Active tuberculosis Atrophy Carcinoma Degenerative arthritis Giant cell tumor Gout Hemangioma Metastasis (osteolytic) Multiple myeloma Neuroblastoma New bone (fibrosis)

91

11 examples of additive (increased attenuation) diseases of the respiratory system

Arrested TB (calcification) Atelectasis Bronchiectasis Edema Empyema (pus) Encapsulated abscess Hydropneumothorax Malignancy Miliary TB Pleural effusion Pneumonia

92

2 examples of destructive (decreased attenuation) diseases of the respiratory system

Emphysema Pneumothorax

93

4 examples of additive (increased attenuation) diseases of the circulatory system

Aortic aneurysm Ascites Cirrhosis of the liver Enlarged heart

94

What is an example of an additive (increased attenuation) disease of the soft tissue?

Edema

95

2 divisions of the respiratory system

Upper tract Lower respiratory system

96

Located outside the thorax and lower tract found within the thoracic cavity Provides structure for the passage of air into the lower respiratory system

Upper tract of the respiratory system

97

3 parts the upper tract of the respiratory system consists of

Nasopharynx Oropharynx Larynx

98

Composed of tubular structures responsible for conducting air from the upper respiratory structures

Lower respiratory system

99

3 parts the lower respiratory system consists of

Trachea Bronchi Bronchides

100

What is the primary function of the respiratory system?

The intake of oxygen into blood and the removal of body waste in the form of carbon dioxide from the blood

101

The smallest functional unit of the respiratory system where the actual gas exchange occurs

Alveoli

102

What is respiration controlled by?

The medulla at the base of the brain

103

2 different blood supplies of the lung

Pulmonary circulation Bronchial

104

Low-pressure, low-resistance system through which oxygen enters and carbon dioxide exits the circulatory system

Pulmonary circulation

105

A part of the high-pressure systemic circulation, supplies oxygenated blood to nourish/support the lung tissue

Bronchial

106

2 layers of pleura (double-walled membrane) that encase the lung

Visceral pleura Parietal pleura

107

Inner layer of pleura that adheres to the lung

Visceral pleura

108

Lines the inner chest wall (thoracic cavity)

Parietal pleura

109

Potential space between the layers of pleura which normally contains only a small amount of fluid to lubricate the surfaces to prevent friction as the lungs expand and contract; the airtight space between the lungs and chest wall has a pressure slightly less than that in the lungs, this difference in pressure acts like a vacuum to prevent the lungs from collapsing

Pleural space

110

5 devices chest radiographs are used to verify the proper placement of

Endotracheal tube Central venous catheter Swan-Ganz catheter Transvenous cardiac pacemaker PICC line

111

Accumulation of fluid in the pleural space; an inflammatory or neoplastic process that involves the pleura may produce fluid within the potential space Caused by numerous pathologies; most commonly congestive heart failure, pulmonary embolism, infections such as pneumonia or TB, lung cancer or other cancers that have metastasized to the lungs or the pleura, abdominal diseases, recent surgeries, ascites, subphrenic abscess, pleurisy, liver disease, or kidney disease Because one side is so full of fluid, it pushes all the structures to the other side Best seen on lateral decubitus (fluid level)

Pleural effusion

112

Flow directed catheter that consists of a central channel for measuring pulmonary capillary wedge (PCW) pressure and a second smaller channel connected to an inflatable balloon at the catheter tip, can also measure cardiac output and central venous pressure (CVP)

Swan-Ganz Catheter

113

For blood pressure; inserted into the subclavian vein or a more peripheral vein in the upper extremity are extremely useful for measurement of the CVP and for providing a conduit for the rapid infusion of fluid or chronic hyperalimentation

Central venous (CV) catheter

114

Long-term venous access device used for home therapy and for patients undergoing chemotherapy

Peripherally inserted central catheter (PICC)

115

Method of choice for maintaining cardiac rhythm in patients with heart block or bradyarrythmias

Transvenous cardiac pacemaker

116

What is the correct placement of an endotracheal tube?

Tip of tube 5-7 cm above the carina

117

2 complications of incorrect placement of an endotracheal tube

Low placement: atelectasis High placement: air entering the stomach

118

What is the correct placement of a central venous (CV) pressure catheter?

Tip of catheter should be in the superior vena cava

119

4 complications of incorrect placement of a CV pressure catheter

Internal jugular vein placement Right atrium: possible arrhythmias or perforation Pneumothorax with placement Infusion of fluid into mediastinum or pleural space

120

What is the correct placement of a Swan-Ganz catheter?

Right or left main pulmonary artery seen radiographically within the borders of the mediastinum

121

What is a complication of incorrect placement of a Swan-Ganz catheter?

Pulmonary infarction

122

What is the correct placement of a transvenous cardiac pacemaker?

Overexpose to demonstrate the tip of the electrode at the apex of the right ventricle

123

2 complications of incorrect placement of a transvenous cardiac pacemaker

Coronary sinus placement: needs a lateral chest image to distinguish Perforation at initial insertion

124

2 congenital/hereditary disease of the respiratory system

Cystic fibrosis Hyaline membrane disease

125

Characterized by the secretion of excessively viscous mucus by all the exocrine glands; also affects the pancreas and digestive system Hereditary, additive Common in children Thickening in lungs where it's not supposed to be Causes generalized irregular thickening of linear markings throughout the lungs Located in the bronchi

Cystic fibrosis

126

One of the most common causes of respiratory distress in the newborn, primarily premature caused by a lack of surfactant in immature lungs Located in the alveoli

Hyaline membrane disease Idiopathic respiratory distress syndrome (IRDS)

127

Consists of a mixture of lipids, proteins, and carbohydrates that creates a high surface tension, requiring less force to inflate and maintain the alveoli; without this the lung can collapse

Surfactant

128

2 inflammatory disorders of the upper respiratory system

Croup Epiglottitis

129

Inflammatory disorders of the upper respiratory system; primarily a viral infection of young children (because their respiratory system is smaller than adults's) that produces inflammatory obstructive swelling localized at the subglottic portion of the trachea Many cases come from parainfluenza viruses, while some may come from adenovirus, respiratory syncytial virus (RSV), or rhinovirus Characterized by a barking cough X-rays usually taken as AP and lateral soft-tissue neck; AP radiographs of the lower neck shows a smooth, tapered narrowing of the subglottic airway caused by swelling (steeple sign) Viral usually goes away on its own within one week; bacterial may require antibiotic treatment Located in the subglottic trachea or larynx

Croup

130

Most commonly caused by Haemophilus influenzae in children Causes a thickening of epiglottic tissue and the surrounding pharyngeal structures Incidence has decreased due to routine childhood immunization Located in the supraglottic area or supraglottis Appear on images as a rounded, thickening epiglottic shadow

Epiglottitis

131

7 inflammatory disorders of the lower respiratory system

Pneumonia Anthrax Lung abscess Tuberculosis (TB) Pulmonary mycosis Respiratory syncytial virus (RSV) Severe acute respiratory syndrome (SARS)

132

An inflammation of the lung that can be caused by a variety of organisms, most commonly bacteria and viruses; additive

Pneumonia

133

4 types of pneumonia

Alveolar/air-space pneumonia Bronchopneumonia Interstitial pneumonia Aspiration pneumonia

134

Exemplified by pneumococcal pneumonia, it is produced by an organism that causes an inflammatory exudate that replaces air in the alveoli so that the affected part of the lung is no longer air containing but rather appears solid (radiopaque); spreads from one alveolus to the next by the way of communicating channels, and it may involve pulmonary segments or an entire lobe (lobar pneumonia) Pneumonia in the alveoli

Alveolar/air-space pneumonia

135

Typified by staphylococcal infection and is primarily an inflammation that originates in the bronchi or the bronchiolar mucosa and spreads to adjacent alveoli Tends to produce small patches of consolidation that may be seen radiographically as opacifications that are scattered throughout the lungs

Bronchopneumonia

136

The inflammatory process predominately involves the walls and lining of the alveoli of the interstitial supporting structures of the lung, the alveoli septa Most commonly produced by viral and mycoplasmal infections The interstitial dispersal of the infection produces a linear or reticular pattern; when seen on end, the thickened interstitium may appear as multiple small nodular densities Left untreated, it may cause "honeycomb lung," which is demonstrated on CT as cystlike spaces and dense fibrotic walls

Interstitial pneumonia

137

Caused by the aspiration of esophageal or gastric contents into the lung Causes multiple alveolar densities, which may be distributed widely and diffusely throughout both lungs Located in the alveoli; appears on images as patchy opacifications

Aspiration pneumonia

138

Caused by Bacillus anthracis, can survive for decades in the soil without a host Easily transmitted and highly fatal Located throughout both lungs

Anthrax

139

3 ways to contract anthrax

Cutaneous- through an opening in the skin, most common Inhalation- lungs, usually fatal without prompt treatment; causes mediastinal widening and often pleural effusion without infiltrates on a chest image Gastrointestinal- caused by ingestion of contaminated meat

140

A necrotic area of pulmonary parenchyma containing purulent material Aspiration is most common cause; may also be a complication, bronchial obstruction, a foreign body, or the hematogenous spread of organisms to the lungs either in a patient with diffuse bacteremia or as a result of septic emboli Additive Most common in right lung because the right main bronchus is more vertical and larger in diameter Appears on images as an encapsulated opaque mass with air-fluid level

Lung abscess

141

Caused by Mycobacterium tuberculosis (rod-shaped bacterium with a protective waxy coat that permits it to live outside the body for a long time) Spreads mainly by droplets in the air Different types that show up differently on x-rays

Tuberculosis

142

A fungal infection of the lung Primary located in the lower lung or hilar lymph nodes; appears on images as pulmonary infiltration, granulomatous nodule, or hilar lymph node enlargement and/or calcification

Pulmonary mycosis

143

2 most common systemic fungal infections in North America

Histoplasmosis (looks like TB on x-rays) Coccidioidomycosis

144

Very contagious virus most common in children up to 2 years old Most common cause of bronchiolitis Attacks the lower respiratory tract, causes necrosis of the respiratory epithelium of the bronchi and bronchioles, and causes bronchiolitis Bronchial obstruction occurs due to necrotic material and edema that result from the infection Bronchiolitis produces bronchial spasm, and interstitial pneumonia occurs as a result of the obstruction Located in the bronchial epithelium Appears on images as hyperinflation with diffuse increased interstitial markings, interstitial pneumonia, or severe cases demonstrate focal areas of atelectasis

Respiratory syncytial virus (RSV)

145

First case appeared in China Causative agent: associated coronavirus of unknown etiology Transmitted by direct or droplet contamination, no known transmission since 2004 Located throughout both lungs Appears on images as early focal infiltrates progressing to generalized patchy interstitial infiltrates Can survive in environment today

Severe acute respiratory syndrome (SARS)

146

3 diffuse lung diseases

Chronic obstructive pulmonary disease (COPD) Sarcoidosis Pneumoconiosis

147

Includes several conditions in which chronic obstruction of the airways leads to an ineffective exchange of respiratory gases and makes breathing difficult (chronic bronchitis, emphysema, and asthma) Destructive Caused by: smoking, pollution, exposure to harmful substances, deficiency of Alpha 1 Atritrypsin enzyme No cure; most die from congestive heart failure, pneumonia, flu, or asthma attacks

Chronic obstructive pulmonary disease (COPD)

148

Crippling and debilitating condition in which obstructive and destructive changes in small airways (the acini or terminal bronchioles) lead to a dramatic increase in the volume of air in the lungs Black lungs and domes of diaphragm look flat Destructive disease, more air Located in the destroyed alveolar septa Appears on images as pulmonary hyperinflation, bulla formation, flattened diaphragm, or radiolucent retrosternal space

Emphysema

149

As the walls between alveoli are destroyed, these tiny air sacs become transformed into large air-filled spaces

Bullae

150

Very common, narrowing of the airways develops because of in increased responsiveness of the tracheobronchial tree to various stimuli (allergens) Occurs in the bronchi; appears on images as nothing unless during acute attack, bronchial narrowing/hyperlucent lungs, radiographic appearance, and excludes other processes

Asthma

151

A multisystem granulomatous disease of unknown cause that is most often detected in young adults; more common in women and African Americans Appears on chest radiography as bilateral hilar lymph node enlargement with or without diffuse parenchymal disease

Sarcoidosis

152

Chronic inflammation of the bronchi leads to severe coughing with the production of sputum; may be a complication of respiratory infection or the result of long-term exposure to air pollution of cigarette smoking (90%) The walls of the bronchi and bronchioles thicken and produce viscous mucus; over an extended period of time, the mucus glands become hyperplastic Appears on images with no image change in 50% of cases, increased bronchovascular markings, or hyperinflation and depressed diaphragm

Chronic bronchitis

153

Permanent abnormal dilation of one or more large bronchi as a result of destruction of the elastic and muscular components of the bronchial wall Located in basal segments of the lower lobes

Bronchiectasis

154

A severe pulmonary disease caused by inhalation of irritating particles

Pneumoconiosis

155

3 most common types of pneumoconiosis

Asbestosis Silicosis Anthracosis (coal worker's disease)

156

4 types of respiratory neoplasms

Solitary pulmonary nodule (SPN) Bronchial adenoma Bronchogenic carcinoma Pulmonary metastases

157

Most common type of lung cancer, typically arises in the major central lumen Bronchogenic carcinoma non-small cell type

Squamous carcinoma

158

Asymptomatic, incidental finding on chest x-ray Problematic in that it could represent: benign granuloma, small neoplasm, or solitary metastasis Located throughout lungs Appear on images as solitary nodule, dense or popcorn calcification (benign), or continued growth (malignancy)

Solitary pulmonary nodule (SPN)

159

Low-grade malignant lesions Appears in a younger age group than bronchogenic carcinoma Most common symptoms: hemoptysis and recurring pneumonia Located in the glandular structure of major segmental bronchi Appear on images as peripheral atelectasis (obstruction) or obstructive pneumonia

Bronchial adenoma

160

Primary carcinoma of the lung Arises from the mucosa of the bronchial tree Linked to smoking and the inhalation of cancer-causing agents (carcinogens), such as air pollution, exhaust gases, and industrial fumes Common types are non-small cell and small (oat) cell Located in the lung parenchyma Appear on images as an ill-defined solitary lesion, atelectasis with obstruction, hilar enlargement, or cavitation in the upper lung

Bronchogenic carcinoma

161

3 non-small cell type bronchogenic carcinomas (80% of all lung cancers)

Squamous carcinoma Adenocarcinoma Bronchiolar (alveolar cell) carcinoma (least common)

162

Develop from hematogenous or lymphatic spread Most commonly from musculoskeletal sarcomas, myeloma, and carcinomas of the breast, urogenital tract, thyroid, and colon Carcinomas of the breast, esophagus, or stomach may spread to lungs via direct extension due to anatomic proximity Located throughout the lungs Appear on images as multiple nodules with sharp margins, miliary/snowstorm nodules, solitary nodule, or coarsened interstitial markings

Pulmonary metastases

163

3 vascular diseases of the respiratory system

Pulmonary embolism Septic embolism Pulmonary arteriovenous (AV) fistula

164

Most common lung pathology of hospitalized patient, may be fatal Asymptomatic in about 80% of cases; difficult to diagnose even in those with symptoms More than 95% of embolisms arise from deep vein thrombosis in the lower extremities Blood clots Located most often in the lower lobes Serial images demonstrating progressive enlargement of the affected vessel

Pulmonary embolism

165

A bacterial "shower" that enters pulmonary circulation, then gets trapped in the lung Arise primarily from the heart (bacterial endocarditis) and peripheral veins (septic thrombophlebitis) More common in IV drug abusers Located in the lung periphery and appears on images as peripheral opacities

Septic embolism

166

An abnormal vascular communication between a pulmonary artery and a vein Multiple ones are not uncommon; often in other organs as well Very large or multiple can cause cyanosis due to too much venous blood shunting into arterial circulation Located most often in lower lobes and appears on images as defined soft tissue mass

Pulmonary arteriovenous (AV) fistula

167

A condition in which there is diminished air within the lung associated with reduced lung volume Caused by bronchial obstruction, which may be due to: neoplasm, foreign body, or mucous plug Important iatrogenic cause: improper placement of an endotracheal tube below the level of the tracheal bifurcation Located as an obstruction of segment/lobe or lung collapse Appears on images as local increased density; platelike streaks

Atelectasis

168

Lung structure breaks down, with massive leakage of cells and fluid into the interstitial and alveolar spaces Hypoxia and severe respiratory impairment results, life threatening Develops in those who have medical and surgical disorders but no major lung disease; most common in patients with nonthoracic trauma who develop hypotension and shock, "shock lung" Located as a lung structure breakdown Appears on images as patchy, ill-defined areas of consolidation

Adult respiratory distress syndrome (ARDS)

169

Air within the mediastinum Causes include: spontaneous (severe coughing, vomiting, or straining ruptures alveoli, releasing air), chest trauma, perforation of the esophagus or tracheobronchial tree, or spread of air along fascial planes in the neck, peritoneal cavity, or retroperitoneal space Air may also extend peripherally and rupture into the pleural space, causing an associated pneumothorax Located as air in bronchovascular sheath Appears on images as radiolucency running parallel to heart border

Mediastinal emphysema (pneumomediastinum)

170

Free air in the tissues of the chest wall caused by penetrating or blunt injuries that disrupt the lung and parietal pleura Characterized by crepitation (a crackling sound or sensation) on palpation Located in air in surrounding muscle bundles Appears on images as air streaks in muscle bundles

Subcutaneous emphysema

171

3 disorders of the pleura

Pneumothorax Pleural effusion Empyema

172

The presence of air in the pleural cavity, resulting in a parietal or complete collapse of the lung Difficulty breathing Causes: rupture of a subpleural bulla, spontaneous event in an otherwise healthy young adult, trauma, iatrogenic causes, or complications of neonatal hyaline membrane disease Treatment: prompt chest tube drainage with suction to remove the air and prevent recurrence Located in air in the pleural space Appears on images as peripheral radiolucency without pulmonary markings

Pneumothorax

173

A rare accumulation of infected liquid or frank pus in the pleural space Usually caused by the spread of an adjacent infection (e.g., bacterial pneumonia, subdiaphragmatic abscess, lung abscess, and esophageal perforation); may occur after thoracic surgery, trauma, or instrumentation of the pleural space Additive because any kind of fluid is harder to penetrate through Appears on images as a lesion - loculated fluid; possible air-fluid level

Empyema

174

3 compartments of the mediastinum

Anterior Middle Posterior

175

Extends from the sternum back to the trachea and the anterior border of the heart

Anterior mediastinum

176

Contains the heart, great vessels, central tracheobronchial tree, lymph nodes, and phrenic nerves

Middle mediastinum

177

The space behind the pericardium

Posterior mediastinum

178

5 anterior mediastinal masses

Thymomas Teratomas Thyroid masses Lipomas Lymphoma

179

4 middle mediastinal masses

Lymph node disorders Bronchogenic cysts Vascular anomalies Masses in the anterior costophrenic angle

180

3 lymph node disorders

Lymphoma Metastatic carcinoma Granulomatous processes

181

4 posterior mediastinal masses

Neurogenic tumors Neurogenic cysts Aneurysms of the descending aorta Extramedullary hematopoiesis

182

3 disorders of the diaphragm

Diaphragmatic paralysis Eventration of the diaphragm Other causes of elevation of the diaphragm

183

Caused by any process that interferes with the phrenic nerve Shows on images as the elevation of one or both leaves the diaphragm Results in diminished lung volume Caused by: fluid, obesity, pregnency Location: diaphragm movement Imaging appearance: sniff test to distinguish normal from abnormal

Diaphragmatic paralysis

184

Rare congenital abnormality in which one hemidiaphragm (very rarely both) is poorly developed and weak Permits the upward movement of abdominal contents into the thoracic cage Usually asymptomatic Occurs more commonly on the left Location: diaphragm poorly developed and elevated Imaging appearance: diaphragm elevation

Eventration of the diaphragm

185

4 other causes of elevation of the diaphragm

Ascites Obesity Pregnancy Any other process in which the intraabdominal volume is increased

186

Subcutaneous hematoma greater than 1-2 cm

Ecchymosis

187

Tumor-like mass of tissue caused by a chronic inflammatory process

Granuloma

188

Bands that form between tissues and organs, often as a result of injury during surgery

Fibrous adhesions

189

An excess of blood in the vessels supplying an organ or other part of the body

Hyperemia

190

Forming pus

Suppurative

191

In cases in which ischemia continues to progress, resulting in an infarction, necrosis may occur as a result of lack of blood flow Severe arterial disease of the lower extremities may result in necrosis of several toes or a large segment of the foot

Gangrene

192

Underdevelopment or incomplete development of a tissue or organ

Hypoplastic

193

Tumor of muscle

Myoma

194

A cancer in which the tumor cells resemble stratified squamous epithelium, as in lung and head and neck regions

Squamous cell carcinoma

195

An emotional disorder characterized by an obsessive desire to lose weight by refusing to eat

Anorexia

196

Difficulty swallowing

Dysphagia

197

Any new and abnormal growth, especially when the growth is uncontrolled and progressive

Neoplasm

198

A large membranous tube reinforced by rings of cartilage, extending from the larynx to the bronchial tubes and conveying air to and from the lungs; the windpipe

Trachea