What does this ECG show and why?
S-T depression, can be sign of chronic ischaemia
A: arcuate vessels
B: interlobular arteries
C: interlobar vessels
What are A, B and C?
A: posterior intercostal artery
B: lateral cutaneous branch
C: anterior intercostal artery
Label A-F around the diaphragm.
B: R sympathetic trunk
C: L sympathetic trunk
E: Thoracic duct
NB: diaphragm attachement around costal margin (inferior border of lower rib)
What changes can you see in this asthma-affected airway?
Wall thickening (inflammation)
Smooth muscle hypertrophy
What is wrong in this Xray?
Mitral valve stenosis, enlarged L atrium and pulmonary oedema.
What are the 2 main features of this CXR?
Blunting of costophrenic angle. If fluid in pleural cavity, goes to this area due to gravity = indicitave of pleural effusion, can be caused by many things e.g. heart failure
Label A-C (with percentages)
A: plasma 55% (water 90%, solutes 10%)
B: erythrocytes (45%)
C: Leukocytes and thrombocytes (platelets)
What is this showing in the lungs and why?
Early Mycobacterium tuberculosus - early caseous granuloma , central area of caseous necrosis (CN), surrounded by macrophages (M) which fuse to giant Langerhans cells (L). Arrows = rim of lymphocytes.
What type of ciliated epithelium is this?
What is the arrow pointing to?
What are the arrow heads pointing to?
65yo male, increasing breathlessness on exertion, long history of diabetes mellitus and hypertension leading to poor renal function. Low Hb.
How would you best classify this patient's anaemia?
What terms describe the red cell appearances?
What is the most likely reason for this patient't anaemia?
Acanthocytes (burr cells), schistocytes (fragments), anisocytosis (diff shapes), poikilocytosis (diff sizes)
Erythropoietin deficiency. (Anaemia due to chronic renal failure and consequent EPO deficiency, anaemia usually normocytic with red cells showing abnormalities including spicules and "burr" cells. Red cell fragments may be seen with renal vascular disease).
What does this ECG show and why?
No P wave - atrial fibrillation (pacemaker cells firing at different times = asynchronised and no electrical activity)
What is B in the lung?
What are the features on this CXR?
Pleural effusion (in e.g heart failure, lungs so saturated that fluid accumulates in pleural space. A step worse from pulm oedema.
Pulmonary oedema (fluid in intersitium)
Large cardiothoracic ratio
What can you see in this CXR and what does this suggest?
Visceral pleural edge, air in pleural cavity
A: pituitary stalk
C: pituitary gland
Label the parts of the sternum
A: Sternal angle
B: xiphoid process
What are these structures?
What are A-F?
A: coronary sinus
B: fossa ovalis
C: tricuspid valve
D: chordae tendinae
E: papillary muscles
F: trabeculae carnae
This is a longitudinal section of foetal trachea branching into the main bronchi. What is the tissue indicated by the arrows?
What do these CXRs show?
Pneumothorax - in 1) clearly see L lung pulled away from side, in 2) can see R visceral pleural edge
What does this CXR show? (Normal on L)
Hyperinflation - dyspnea
Identify the 3 lung cell carcinomas.
A: small cell carcinoma (small, ovoid and densely packed, dark stained, disseminate widely)
B: squamous cell carcinoma (large esinophill cells/central whorling)
C: Adenocarcinoma (G = gland)
What are A and B?
A: azygos vein
B: hemiazygos vein
What condition is this? Explain the colour.
Lower lobe shows lobar consolidation.
What has happened in this Xray?
List possible causes.
collapse of lobe, loss of lung volume, consolidation, fibrosis
Label the major and accessory muscles involved in inspiration, A-F
B: Pectoralis major
C: Rectus abdominis
D: Pec minor
E: Serratus anterior
F: External intercostal muscles
Comment on this ECG. What could have caused it?
AMI = STE: II, III, aVF. Blocked RCA.
Label A and B
A: basilic vein
B: cephalic vein
NB: deep veins take same name as arteries.
If body is A, remember it as A -> B -> C in anatomical position
A: Frontal sinus
B: ethmoid air cells
C: sphenoid air sinus /opening of
D: maxillary air sinus (opening of)
E: frontonasal duct
F: semi lunar hiatus