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Pulmonary Patterns Flashcards

1
Q

Alveolar pattern

A

Diseases in the alveoli (air spaces)

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2
Q

What are alveolar patterns caused by?

A

Atelectasis/ collapse
Fluid accumulation
Cellular infiltrates
Pulmonary infarct
Extension of interstitial dz (edema, smoke, pneumonia)

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3
Q

Pathology of alveolar patterns

A

Alveoli filled with fluid, cells/ cellular debris (most opaque)
Alveoli collapsed

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4
Q

Lung collapse/ atelectasis causes

A

Airway obstruction (FB, mass)
Compression by adjacent lesion (lung mass)
Secondary to pleural effusion

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5
Q

Cranio-ventral/ gravity dependent part of lungs differentials

A

Bronchopneumonia and aspiration pneumonia (secondary to esophageal issue)

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6
Q

Caudo-dorsal part of caudal lobes distribution

A

Non-cardiogenic pulmonary edena (neurogenic)- peripheral part of the lung

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7
Q

Caudo-hilar (dorsal) distribution

A

Cardiogenic pulmonary edema secondary to left sided heart failure- central
(except in cats and dobermans)

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8
Q

Descriptions of distribution for alveolar patterns

A

Patchy, focal, multifocal, diffuse, consolidated*, asymmetrical

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9
Q

Bacterial pneumonia (bronchopneumonia)

A

Ventral portion: cr. and right middle lobes
Starts peripherally then spreads inward

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10
Q

Patterns associated with bronchopneumonia and aspiration pneumonia

A

Interstitial pulmonary pattern
Alveolar pattern (air bronchogram)

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11
Q

Diagnostics of bronchopneumonia (basic)

A

Rads
CBC: inflamm leukogram (left shift)
Neutropenia

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12
Q

Tx of bronchopneumonia

A

Supplemental O2
Antimicrobials
Bronchodilators
IV fluids
Saline nebulization and coupage

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13
Q

Aspiration pneumonia position

A

Ventral portion: right middle, cr., accessory and cd. lobes

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14
Q

What other signs come with aspiration pneumonia?

A

Esophageal dz:
Enlarged/ distended esoph.
Ventral deviation of trachea
Dorsal stripe sign

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15
Q

What is aspiration pneumonia secondary to?

A

Regrug, vomiting
Laryngeal dz (Paralysis/ neoplasia)
Iatrogenic aspiration from force feeds, anesthesia or meds
Weakness/ debilitating
Cleft palate
Tracheo-esophageal or broncho-esophageal fistula

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16
Q

Cardiogenic pulmonary edema is secondary to

A

Left sided heart dz from:
Mitral regurg in small breed dogs with Myxomatous mitral valve degeneration (MMVD)
DCM in large breeds
Hypertrophy cardiomyopathy (HCM) in cats

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17
Q

History of a patient with cardiogenic pulmonary edema

A

Coughing, resp. distress
Syncope
Exercise intolerance and heart murmur

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18
Q

Tx for cardiogenic pulmonary edema

A

Supplemental O2
Diuretics (furosemides)
Cardiovascular drugs
DV view preferred

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19
Q

T/F: IV fluids are contraindicated in animals with cardiogenic pulmonary edema

A

TRUE
could cause fluid overload

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20
Q

Non-cardiogenic pulmonary edema

A

Fluid accumulation secondary to direct or indirect lung injury and not due to cardiac coagulation
Results in hypoxemia
Fluid edema protein rich

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21
Q

3 mechanisms of Non-cardiogenic pulmonary edema

A

↑ endothelial permeability
↓ plasma oncotic pressure (pleural effusion)
Impaired lymphatic drainage

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22
Q

Differentials of Non-cardiogenic pulmonary edema

A

Neurogenic pulmonary edema (from electrocution, seizures, and cerebral injury)
Near drowning
Acute upper airway obstruction
Toxins/ inhaled irritants (smoke)
Drug reactions/ overdose

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23
Q

CS of Non-cardiogenic pulmonary edema

A

Coughing, resp. distress

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24
Q

Consolidation

A

Lung filled with fluid, pus or other material (norm. volume)
Soft tissue lung opacity
Stops @ lung limit

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25
What is consolidation secondary to?
Bronchopneumonia
26
Atelectasis
Volume loss (airless) Soft tissue lung opacity Seen as mediastinal shift on VD/DV
27
What is atelectasis secondary to?
External compression by severe pneumothorax, pleural effusion, large pleura or thoracic wall mass, prolonged recumbency, general anesthesia, airway obstruction
28
Lung lobe torsions
In cats, deep chested dogs and small breeds Associated with right middle lobe
29
What's seen on the radiograph with lung lobe torsions?
Concurrent pleural effusion Change in opacity, size, shape and position of lobe Abrupt stop to bronchus/ abnormally angled bronchus near hilus Trapped pockets of gas scattered throughout opaque lobe
30
Interstitial lung pattern
Disease within the interstitium (CT) of the lungs between airways
31
Unstructured interstitial lung pattern
Hazy interstitium or parenchyma from pulmonary opacity that obscures the margins of the pulmonary vasculature (still visible, margins blurred)
32
Structured interstitial lung pattern
Nodular interstitial lesions visualized greater than 4-5cm in diameter
33
Localized/ focal differentials for unstructured interstitial pattern
Atelectasis Contusion Hemorrhage Pulm. edema Airway obstruction Interstitial pneumonia, parasitic migration
34
Diffuse differentials for unstructured interstitial pattern
Pneumonitis Viral- distemper Parasitic Metabolic (uremia, pancreatitis, septicemia) Inhalation (allergy/ smoke) Toxic, edema, interstitial pneumonia, hemorrhage
35
Structured interstitial patterns
Pulmonary masses > 2 cm Nodules < 2cm Nodules visualized greater than 5 mm in diameter
36
Differentials for solitary/ pulmonary masses
CHANG Cyst Hematoma Abscess Neoplasia Granuloma
37
Primary pulmonary neoplasia
Solitary masses that can metastasize to other lung lobes (causing smaller nodules)
38
Metastatic neoplasia
Smaller nodules, well-defined Presents with history or suspicion of malignant neoplasms (spread to the lung)
39
Bronchioloar carcinoma (primary neoplasia)
75% of cases Orginiates from smaller airways and lcoated at periphery of th elung
40
Bronchogenic carcinomas (primary neoplasia)
Originated from large bronchi in the hilar region (adenocarcinoma, SCC, anaplastic carcinoma)
41
Nodular and miliary interstitial
Small nodules or very small (mille seeds) pulmonary opacities
42
Differentials for Nodular and miliary interstitial
Metastatic dz Fungal dz (thoracic lymphandenopathy- hilar or tracheobronchal LNs affected)
43
Fungal pneumonias
Histoplasmosis, blastomycosis, coccidiomycosis
44
Radiographic findings of fungal pneumonias
Miliary to nodular interstitial pattern Thoracic lymphadenopathy
45
CS of fungal pneumonias
Coughing, ↑ resp. effort Known history of travel to endemic area
46
Tx of fungal pneumonias
Itra-, fluco, ketoconazole Amphotericin B O2 therapy and supportive care
47
Visualization of bronchial walls from:
Thickening Calcification of bronchial cartilage Cellular infiltrates around bronchi and bronchioles (peri-bronchial cuffing)
48
Bronchial pattern
Dz involving the airway Thickened walls of bronchi and bronchioles
49
Radiographic findings of bronchial patterns
End-on/ cross sectional view of airways (donuts) Longitudinal view of airways (tramlines, train racks and monorails) Bronchiectasis (dilated bronchi)
50
Differentials for bronchial patterns
Infectious bronchitis (bacterial or viral) Non-infectious (Chr. or allergic bronchitis) Eosinophilic bronchopneumopathy Feline asthma Bronchial calcification
51
CS of bronchitis
Coughing, resp. distress, exercise intolerance
52
What's seen on thoracic radiographs with bronchitis?
↑ bronchial markings Interstitial pattern (peri-bronchial cuffing) Secondary pneumonia
53
Bronchiectasis
Disease where there's permanent enlargement of parts of the airways of the lung
54
Types of Bronchiectasis
Cystic/ Saccular: dilated bronchus forms clusters of cyst Varicose: irreg areas of constriction and dilation Cylindrical: enlarged and cylindrical
55
Feline Asthma
Bronchospasm and thicken airway by mucus and debris causes narrowing/ occlusion (airway obstruction)
56
Whats seen on the rads of a cat with feline asthma?
Lobar sign on right middle lobe Hyperinflated lungs from air-trapping causing flattening of the diaphragm
57
CS of feline asthma
Coughing, wheezing and resp. distress
58
Functional vascular system
Pulm. a. carry O2 deprived blood away from right ventricle to the lung Pulm. v. carry oxygenated blood to left atrium
59
Lobar artery, bronchus and vein to the left and right CRANIAL lung lobes
Assessed on lateral view Compared to diameter of proximal 1/3 of 4th rib
60
Lobar artery, bronchus and vein to the left and right CAUDAL lung lobes
Assessed on DV view Measured by assessing area of summation of vessels over 9th rib
61
Different lobar artery, bronchus and vein size
Good: make a square Enlarged vessel: wide rectangle Small vessel: Upright/ narrow rectangle
62
Hyper-vascular
Enlarged pulm arteries: heartworm dz or pulm hypertension Enlarged pulm veins: left sided heart failure Both: left to right shunts or iatrogenic overhydration
63
Hypo-vascular
Small pulm. arteries and veins Microcardia, small caudal vena cava and hyperlucent lung capacity
64
Differentials of hypovascular
Pulmonary hypotension (shock, blood loss, severe dehydration, hypoadrenocorticism and addisons dz)

!Diagnostic Imaging (21 decks)

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