Radiology of the Thorax - 1 Flashcards Preview

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Flashcards in Radiology of the Thorax - 1 Deck (19)
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1
Q

What are the four places in the thorax to see abnormalities

A

Mediastinum
Pleura
Lungs/Bronchi
Chest wall

2
Q

What radiographic densities are normal and abnormal

A
Normal:
Calcium (bone)
Soft tissues
Fat 
Air

Abnormal:
Metal

3
Q

What is the one thing to look at for the lateral chest xray

A

The posterior costophrenic angle that can show you a small pleural effusion

4
Q

Pleural cavity

A

Potential space between the pleura that normally contains a small amount of serous fluid

5
Q

Pleural Issues

A

1) Pneumathorax
2) Pleural Effusions
3) Tumors - plaques
calcium
cancer
metastases
mesothelioma

6
Q

Pneumathorax

A

asthma, trauma, a wrongly done central line results in air in the pleural cavity, seperating the parietal and visceral pleura (the surface-tension is broken).
Due to the lungs innate elasticity it collapses inwards, now no air can get in

7
Q

Pneumacystist

A

Nasty pneumonia. Get cysts. Whites, stiff diseased lungs, we pump air in but if the cysts pop air is pumped into plural cavity (pneumathorax)

8
Q

How to diagnose pneumothorax

A
  • if you don see vessels in periphery (white lung, black outside of lung)
  • see outline of lung
  • If gasping for air = BILATERAL PNEUMATHORASES
9
Q

Bilateral pneumathorases

A

No air getting in at all.

10
Q

Pleural Effusion is? What does it look like?

A

Fluid in pleural cavity, accumulates at the bottom.

Looks like a balloon in a bucket (white meniscoid appearance, not always)

11
Q

Causes of pleural effusions

A

Common:
CHF/Fluid overload; bilateral
Parapneumonia (irriating down bottom of lungs)

Less common:
Cancer/metastases
Trauma (inc iatrogenic)

12
Q

How do pleural effusions evolve

A

Pneumonia (irriating down bottom of lungs> fluid) . Fever, cough, high WBC count

CHF: loss of the angles (bilateral effusion), ECG leads (chest pain), big heart! 80% right effusion bigger. Orthopnea, swollen ankles

Two MAIN causes.

13
Q

Aortic Tranfusion

A

HUGE pleural effusion

  • Part of aorta stationary, other still moving, it tears the inner two layers of the aorta, the adventia the only thing holding it together
  • 90% die at the seen
14
Q

Tumors of the pleura

A

Least common lung cancer, metastases, mesothelioma

15
Q

Asbestos

A

Asbestosis is a process of lung tissue scarring caused by asbestos fibers. Asbestos is the only known risk factor for malignant mesothelioma, a cancer that affects the tissue lining the lung (pleura) or abdomen (peritoneum).

16
Q

Cancer/ mesothelioma

A

Calcification on CT
Irregular thickening of pleura, mediastinal size of pleural (heart get shrunken)
Oblique fissure thickens.

17
Q

Pulmonary (lung) or extrapulmonary (pleura/mediastinum/chest-wall)

A

Pulmonary:

  • Acute angles between lesion and chest wall
  • May have fussy margins
  • May have air bronchograms

Extra-pulmonary:

  • Lung makes obtuse angle
  • sharp margins
18
Q

Chest Wall

A

Tumors: Ribs, soft tissues

Rib Fractures

19
Q

Tracheobronchial tree & airways

A
  • Symptoms
  • PFTs
  • CXR
  • CT Scanning
  • Bronchoscopy