Chest radiology II Flashcards Preview

Year 2 Respiratory > Chest radiology II > Flashcards

Flashcards in Chest radiology II Deck (27)
1

what is a silhouette sign?

two substances of the same radiographic density cannot be differentiated from each other on an x ray

2

what is the air bronchogram sign?

intrapulmonary bronchi are not visible on the normal CXR because they are filled with air and are surrounded y alveolar air

parenhcymal consolidation may result in visualization of these bronchi since air within the lumens will stand out in contrast to the surrounding opaque lung

3

air bronchograms are often seen in what conditions?

pneumonia and pulmonary edema

4

an air bronchogram is indicative of what process?

lesion is within lung parenchyma rather than in pleura or mediastinum (since airways are open)

5

what are the five mechanisms that cause lung volume loss?

1. resporption of air
2. relaxation
3. scarring
4. decreased surfactant
5. hypoventilation

6

what are the only two (natural) things that produce straight lines on CXRs?

fissures
fluid lines

7

what are the signs of direct lung collapse?

1. displacement of interlobar septa (fissures) - most reliable
2. loss of aeration of involved lobe
3. crowding of the bronchovascular markings

8

what are the indirect signs of lung collapse?

1. elevation of ipsilateral hemidiaphgram
2. hilar displacement
3. deviation of trachea to side of collapse
4. cardiac displacement
5. narrowing of rib cage on collapsed side
6. compensatory overaeration of normal lung

9

what makes up acini? what makes up secondary pulmonary lobules?

acini - multiple alveoli

secondary pulmonary lobule - multiple acini

10

what is the fundamental anatomic unit of the lung?

secondary pulmonary lobule

11

interstitial pattern can appear in what 3 forms?

generalized thickening
discrete thickening
combination

12

signs of acute interstitial markings

ill defined and are not distorted (normal branching pattern)

13

signs of chronic interstitial markings

interstitial markings are sharp and distorted (angular, irregular, or bowed)

14

what is the most reliable method for distinguishing acute from chronic interstitial changes?

finding an old film for comparison

15

most diffuse (and chronic) interstitial lung disease is caused by what factor?

fibrosis

16

focal alveolar consolidation = ?

pulmonary mass or nodule

17

what are the most common causes of acute diffuse alveolar disease?

bacterial pneumonia
pulmonary edema

18

where do the pleural spaces extend posteriorly and laterally?

posteriorly - 12th rib
laterally - 10th rib

19

which film view is most sensitive for detection of small pleural effusions? why?

lateral

can see fluid tracking up major fissure

20

how does air in the pleural space compare to normal lung air?

pleural space air is more radiolucent

also, no lung markings will be seen

21

where does the mediastinum go in a tension pneumothorax?

shifts mediastinum away from pneumothorax

22

what is the most frequent sign of mediastinal disease?

mediastinal widening

23

what is the most common cause of a middle mediastinal mass?

enlarged lymph nodes

24

how does LV enlargement appear on PA chest? lateral?

PA - left heart border moves laterally and the cardiac apex moves anterolaterally

lateral view - left heart border moves inferoposteriorly

25

what is the relationship of lobe vessels in CHF?

upper lobe vessels are larger than lower lobe vessels

26

what are the most common causes of redistribution or cephalization on CXR?

left heart failure and mitral valve stenosis

27

what is the downside of CT pulmonary angiogram?

ionizing radiation - significant increase in cancer risk especially in young women (breast cancer)