Final Flashcards
(100 cards)
1
Q
When looking at a lateral chest film what diaphragm is which?
A
One you can see all the way is the right and one that is only half visible is the left
2
Q
Divisions of the mediastinum
A
Anterior: anterior to heart
Middle: posterior to heart
Posterior: 1cm behind VB
3
Q
Air space disease look
A
White cloudy ill-defined
SOL has displaced air
4
Q
Interstitial of lung
A
CT support
Capillaries, venues, and lymph vessels
5
Q
Interstitial disease appearance
A
Wall affected vs room affected (airspace)
Coarse white lines that can be defined
CT is white lines
6
Q
Air space vs interstitial pattern appearance
A
Air space: cloudy/hazy
Interstitial: coarseness defined lines
7
Q
Cervicothoracic sign
A
Finding that only structures posteriorly located are seen above the clavicles
8
Q
Air bronchogram sign
A
If lung is filled with water based pathology (pneumonia) bronchi appear radiolucent tubular (darker) densities
Confirms air-space disease
9
Q
Findings of atelectasis
A
Displaced fissures
Increased pulmonary radiodensity (white)
Elevated diaphragm
Approximation of the vessels, brochi and ribs
Displaced mediastinum and hilar TOWARD lesion
10
Q
Types of atelectasis
A
Obstructive MC!!! Ex: tumor Compressive (mass) Passive (pneumothorax) Contraction (scar formation TB) Adhesive (hyaline membrane disease-alveoli collapse)
11
Q
S sign of golden
A
Atelectasis of RUL
Usually due to a mass
12
Q
Two categories of bronchial asthma
A
Extrinsic: exposure to environmental triggers
Intrinsic: asthma, infection, exercise
13
Q
Bronchiectasis
A
Damage to large airways of lung causing them to widen and thicken
Associated with cystic fibrosis and recurrent infections
14
Q
Bronchiectasis xray
A
Ring shadows of dilated bronchi
Bilateral bc systemic
Honeycomb appearance
15
Q
Bronchopulmonary sequestration
A
Section of lung that doesn’t develop properly and is separated
Radiodense mass above or below diaphragm
16
Q
Emphysema
A
Chronic dilation of airspace distal to terminal bronchi
Alveolar wall destruction lead to large airspaces= Bullae
17
Q
XRAY of emphysema
A
Bilaterally flat depressed hemidiaphragm Lung overinflation Increased radiolucency (white) Increased retrosternal space Kyphosis Increased intercostal space Prominent hilar vasculature Bullae (MC in apex-open circular space)
18
Q
What may give a false appearance of cardiomegaly
A
Not taking a full breath in
19
Q
What is normal size of heart
A
Less than width of hemothorax
Less than half width of thorax
20
Q
What defines aneurysm
A
More than 50% dilation of aorta
Normal size is 2cm
21
Q
True vs false aneurysm
A
True: all 3 layers involved
False: only outer layers
22
Q
MC area of aneurysm
A
Descending thoracic aorta 50%
23
Q
Thumbnail sign
A
Thoracic aortic aneurysm
24
Q
MC heart defect
A
Ventricular septal defect
25
Left sided heart failsure
Lung edema/backflow
Dyspnea
Cyanosis
Chronic cough/pink phlegm
26
Right sided heart failure
JVD
Pitting edema
```
Frequent urination
Fatigue and weakness
Rapid heart rate
Confusion
Loss of appetite-ascites
```
27
Xray of CHF
Enlarged heart
LA/LV
Vessels appear engorged-cephalization
Enlarged superior vena cava
Kerley’s lines (interstitial disease)
Pleural effusion (blurring of costophrenic angles)
Pulmonary edema (batwing or butterfly appearance)
28
Pleural effusion
Fluid in pleural space
Gravity dependent so take lateral decubitus
Due to cardiopulmonary disease, inflammation, tumors and trauma
Blurred costophrenic angles
29
Pulmonary edema
Fluid accumulation in extra vascular space of the lungs
Interstitial or air-space looking
Due to left CHF, capillary permeability, renal failure, obstructive lymph channels
30
Interstitial pattern of pulmonary edema xray
Linear densities
Kerley’s lines
Nodular appearance of lungs
Subpleural edema
31
Kerley lines
Seen with excess pulmonary fluid
Pulmonary edema
32
Airspace/alveolar pattern of pulmonary edema
```
Homogenous radiodensity
Bilateral radiodense shadows extending laterally from hila:
Butterfly
Sunburst
Batswing
```
Air-bronchogram sign
33
Pulmonary thromboembolism xray
15% show Xray changes
Large arteries
Wedge shaped pleural based radiodensity= infarct
HAMPTONS HUMP
```
Resolves over time= melting sign
Residual adhesions (Fhleischner’s lines)
```
34
What is the single most important diagnostic modality for detecting PE
V/Q
Ventilation perfusion scanning
Shows air and blowflow in the lungs
35
Pneumonia xray
Lung consolidation
Pleural effusion
Air bronchogram sign
36
Methods do acquisition of pneumonia
Community acquired
Nosocomial (hospital)
Immunosuppressed
Aspiration (alcoholics)
37
Pneumonia radiographic types
Broncho(lobar)...large airways and bronchi central to peripheral
Lobar-distal bronchioles...peripheral to central pattern
Interstitial (rare)
Aspiration (RARE)
38
Pneumonia causative agents
Streptococcus pneumoniae
MC community acquired agent. Lobar distribution
Haemophilus influenzae...C disease patients, alcogholics
39
Bat wing pattern
Pulmonary edema
| Pneumonia
40
Taking PA chest xray
High kVp
14x17
72”
Inhale and hold
41
the parietal pleura is external to the visceral pleura
True
42
Largest to smallest pulmonary anatomy
Lung, lobe, bronchopulmonary segment, secondary lobule, primary lobule
43
Where is the heart located according to the roentgenometric/surgical and anatomical divisions
Middle mediastinum using anatomical divisions
| Anterior mediastinum using surgical divisions
44
Air bronchogram sign confirms
Air-space pattern of pulmonary disease
| Confirms surrounding alveoli are filled with water based pathology
45
What disease is described by chronic dilation, thickening and widening of bronchi
Bronchiectasis
46
What is the most likely presentation of atelectasis in chiropractic practice
Obstructive secondary to bronchial tumor
47
What finding can be used to distinguish lobar atelectasis from other presentations of air-space disease such as pneumonia or pulmonary edema
Significant volume loss and migration of the horizontal fissure
48
Which chamber of the heart creates the right cardiac silhouette in the PA projection and the left?
Right atrium
| Left ventricle
49
Which chambers of the heart form the anterior and posterior silhouettes of the heart in the lateral projection
Right ventricle = anterior
| Left atrium = posterior
50
What disease is stages for severity using the measure of forced expiratory volume in one second and the GOLD system criteria
Emphysema
51
What region of the thoracic aorta is MC to demonstrate and aneurysm
Descending aorta
52
What are the established causes of pulmonary edema
Capillary permeability
Renal failure
Congestive heart failure
53
Kerley lines are an example of what chest Xray pattern
Interstitial
54
Bilateral radiodense shadows extending laterally from the hila represent what and are associated with what
Bat wing or sunburst pattern of pulmonary edema
55
What is the next best step for a patient who you think has a PE
Refer patient for VQ scan of the lungs
56
Infections of the bronchi and lungs are termed
Lower respiratory tract infections
57
What radiographic pattern of pneumonia involved distal bronchioles and surrounding alveoli of the periphery of the lungs
Lobar pneumonia
58
What causative agent (s) is MC responsible for community acquired pneumonia that is likely to appear in your future practice
Streptococcus pneumonia
Tuberculosis
Globally mycpbacterial pneumonia is TB but in the US strep is MC
59
A Ranke complex describes what
Matched hilar and parenchymal primary infections of TB
60
What radiographic pattern of pneumonia is MC to present in your future practice
Lobar (broncho) pneumonia
61
Which tumor is known to secrete hormones causing the patient symptoms to mimic Cushing’s syndrome
Bronchial carcinoid
Uncommon
62
What is the most suggestive of malignant etiology for a SPN
15 year history of heavy smoking
63
What is the MC cause of a SPN presenting in your future practice
Pulmonary granuloma
64
What are predictors of a benign SPN
Nodule completely calcified
Stability over time
Younger age <35
65
M vs F MC lung cancer?
Women
66
What have thick walls adn what have thin walls
Thick:cavities
Thin: malignant or infective or cysts
67
What is associated with pancoast tumor
Mass in superior sulcus
Destruction of upper ribs
Drooping eyelid on ipsilateral side
Tracheal deviation away from involved side
68
Fluid accumulation in the distal pulmonary tissues secondary to capillary permeability that results from drug abuse and smoke inhalation is termed
ARDS
| Adult respiratory distress syndrome
69
What occupational pulmonary disease is associated with working around moldy hay
Farmers lung
70
What disease is nicknamed black lung
Coal workers pneumoconiosis
71
Which term describes the complication of slow growing, large, pulmonary fibrotic masses that seem to migrate toward the hilar over time
Progressive massive fibrosis
Classically develop as a complication to coal worker’s pneumoconiosis and silicosis
72
Pneumothorax is what
Air between the visceral and parietal pleura
73
Which term describes a group of pulmonary disease which develop secondary to excessive inorganic dust inhalation
Pneumoconiosis
74
Bladder calculi are MCin who
Elderly men
Associated with unable to fully void the bladder
75
What is true of renal stones
Small stones spontaneously pass through urinary symptoms without dramatic s/s
Flank pain is a common symptom
Renal stones typically contain enough calcium to be visible on plain film
Most stones are in the renal pelvis
76
Where are more renal stones located
Renal pelvis
77
What is used to image renal calculi
Intravenous pyelography
78
What percent of gallstones contain enough calcium to see them on plain film
0-25%
79
Where are gallstones usually seen
RUQ
80
What are some s/s of colorectal carcinoma
Change in frequency or other aspects of bowel
Presence of blood in the stool
Rectal bleeding
81
What is the MC type of hiatal hernia
Sliding
82
Mc primary lung tumor in patients under 16
Bronchial carcinoid
83
Bronchiogenic carcinoma
Leading cause of cancer related death in the US (20%)
Urban, industrial, cigarettes, inhalants
```
Small cell (oat)
Non-small cell
```
84
Nodule and determining whether malignant
Increases with age, 3+cm, no calcification, fast growing
Solid, central, laminated, stippled = BENIGN
Anything not those are treated as no Ca++ and malignant till proven otherwise
85
Peripheral lung cancer lesions concerned to be where
Lateral to hilum
| Better prognosis than central
86
Hamartoma
Focal tissue malformation at the organ level
MC benign lung tumor
25-75% stippled pattern
87
Mediastinal widening in a 20-40 year old patient
Lymphadenopathy= lymphoma
88
With metastatic bone disease nodules to lungs be calcified or not?
Not
89
Pleural mesothelioma
Benign local form
Malignant diffuse form (asbestos)
Rarely calcified
90
Tear to a location and appearance on xray
Anterior mediastinum with peripheral Ca++
91
Pneumoconiosis vs extrinsic allergic alveolitis
Pneumo: lung inflammation due to inhalation of inorganic agents-interstitial bilateral
Due to organic agents (dusts or animals etc)
As symmetrical appears similar to airspace though
92
Unilateral hilar enlargement
Bronchiogenic carcinoma
93
Sarcoidosis
Bilateral hilar enlargement
94
Where are gallstones seen in the AP and lateral projections
AP in RUQ
Anterior to spine in lateral
Only 10-15% have enough ca+ to visualize on xray
95
Pancreatic lithiasis
Calculus formation secondary to duct obstruction
MC due to alcohol
Small irregular scattered densities at L1/2 level
96
Hydatid disease
Infestation of echinococcus granulosus from sheep, cattle, deer etc. cysts are slow growing
97
Normal structures that calcify
Costal cartilage
Pelvic vein thrombosis (phleboliths)
Prostate
98
Calcification of these indicate pathology
Pancreases
Vascular
Mesenteric lymph nodes
99
Calcification of these ARE pathology
```
Renal calculi
Appendix oil this
Bladder calculi
Tear to a
Uterine fibroids
```
100
tar love or arachnoid cyst
Dilations of subarachnoid space surrounding a spinal NR
