Test 1: lecture 13 +14 Xray Flashcards
1
Q
what views are needed for heart Xray
A
dorsoventral
right and left lateral
2
Q
why DV vs VD for heart xray
A
DV: heart closer to detector= less magnification
less distortion
atelectasis of lungs
3
Q
what view is best for caudal lobar vessels and why
A
DV
magnified, less distorted, surrounded by aerated lung
4
Q
what view for a pleual effusion
A
VD (on back)
5
Q
how tall is normal heart in dog
A
<70% of thoracic height
6
Q
normal angle between trachea and spine in dog
A
7
Q
1/3 2/3 rule
A
8
Q
how wide should normal dog heart be
A
9
Q
deep or barrel chested dog will have a wider cardiac width on lateral
A
barrel
10
Q
width of heart on DV for dog
A
11
Q
cardiac width on lateral Xray for cat
A
12
Q
what happens to older cat heart
A
lazy heart (lays down)
13
Q
what happens to cat heart with age on DV
A
prominent aortic arch
old cats: lazy heart, prominent aortic arch, undulating descending aorta
14
Q
how to measure vertebral heart score
A
compare height and width of heart to
number of vertebral bodies starting at T4
then add together
normal VHS in dogs: 8.7-10.7
some breeds have VHS >10.7
15
Q
normal VHS in dogs
A
8.7-10.7
16
Q
normal VHS for cats
A
6.8-8.1
17
Q
short cut VHS
A
in cats only
heart width on VD/DV view
compared to vertebral length on lateral view
18
Q
what is pericardial fat stripe sign
A
effusion can hide heart (same density)
fat will cause shadow to be able to see where heart is
19
Q
where is LA on clock face lateral view
A
20
Q
where is LV on clock face lateral view
A
21
Q
where is RV on clock face lateral view
A
22
Q
where is aorta, Main pulmonary artery, right auricular appendage on lateral clock face
A
23
Q
where is aorta on VD clock face
A
24
Q
where is the MPA on VD clock face
A
25
where is L atrium and L auricle on VD clock face
26
where is LV on VD clock face
27
where is RV on VD clock face
5-9
28
where is right atrium on VD clock face
9-11
29
what will xray show for left atrial enlargement on lateral view
loss of caudal waist
bulge at 12-2
increased height
dorsal elevation +/- compression of the caudal mainstem bronchi
back pack
30
enlarged Left atrium has displaced and compressed the mainstem bronchus
trachea has been compressed
31
what will left atrial enlargement on VD cause
left atrium is in middle of the heart in a dog
double density superimposed
bulge at 2-3
widened angle between the caudal mainstem bronchi (bow legged cowboy sign)
32
left atrial enlargement
double density superimposed
bulge at 2-3
widened angle between the caudal mainstem bronchi (bow legged cowboy)
left atrium in middle of heart
33
left atrial enlargement in cat in lateral view
hard to see
widening of the heart base
slight bulging or rounding of caudal contour
34
left atrial enlargement on VD of cat
left atrial bulge at 2-3 (can extend cranial)
**valentine heart**
severe left **or** left and right atrial enlargement
35
left ventricular enlargement in dogs lateral
tall cardiac silhouette
dorsal tracheal displacement
**elevated** caudal vena cava
36
left ventricular enlargement in dog on VD
elongated cardiac silhouette
rounded left heart
37
right atrial enlargement lateral
bulge 9-11
not common
38
right atrial enlargement on VD
9-11 rounded contour
39
right ventricular enlargement on lateral
rounded cranial heart at 5-9
right heart >2/3 of cardiac silhouette (wide heart)
increased cardiosternal contact (may be seen in some normal dogs (barrel chested))
caudodorsal tipping of apex
40
right ventricular enlargement on VD
rounded right heart 5-9
**reverse D**
may displace the apex to the left (false impression of left sided cardiomegaly)
41
microcardia on lateral
narrow, pointed heart
apex may lose contact with sternum
pulmonary arteries and veins may be small
42
microcardia on VD
narrow, pointed heart
apex may lose contact with sternum
pulmonary arteries and veins may be small
43
microcardia
44
right ventricular enlargement
45
right ventricular enlargement
46
right atrial enlargement
47
left ventricular enlargement
Rounded left heart
Elongated cardiac silhouette
48
left ventricular enlargement
Tall cardiac silhouette
Dorsal tracheal displacement
“Elevated” Caudal Vena Cava
49
left atrial enlargement in cat
50
differentials for microcardia
shock: hypovolemia
addisons (low cortisol)
constrictive pericarditis (rare)
51
where are the pulmonary vein and artery
veins are ventral or central
52
normal vasculature on lateral should be --- the width of the proximal 1/3 of the --- rib
less then
4th
artery and vein should be the same diameter
53
where is aorta and CVC
54
caudal vena cava should be --- the diameter of the aorta and --- in length
less then 1.5 x
less then T5
55
veins and arteries
veins are ventral and central
56
on VD the width of the --- rib should be equal to the diameter of the pulmonary artery and vein
9th
57
differential for enlarged aorta
Cats: Age-related (aortic arch)
Patent Ductus Arteriosus
Post-stenotic dilatation
§ Subaortic stenosis
Aortic aneurysm (very rare)
58
enlarged caudal vena cava differential
Right heart failure
Obstruction of caudal vena cava or right atrium
§ Caval syndrome (Dirofilariasis)
§ Blood clot, Mass
Normal Variation
§ Respiration, Cardiac cycle o Evaluate on all views
59
enlarged MPA differential
Post-stenotic dilatation
§ Pulmonic stenosis
Pulmonary hypertension
Dirofilariasis or Angiostrongylosis
Left to right shunt
§ PDA, ASD, VSD
Fake-Out
§ VD projection
§ Rotated projection
§ Cardiac cycle (systole)
60
enlarged pulmonary arteries differential
Dirofilariasis
§ Pulmonary arteries often also **tortuous and blunted**
Pulmonary hypertension
Pulmonary thromboembolism (PTE)
61
enlarged pulmonary veins differential
Left heart failure
§ May not be enlarged if the patient received diuretics
Fluid/volume overload (relative vs absolute)
Left atrial obstruction
62
enlarged pulmonary arteries and veins differential
Left to right shunts
Pulmonary congestion
§ Fluid volume overload (relative vs absolute)
§ (Left heart failure - cats)
63
small pulmonary arteries and vein differential
Pulmonary Hypoperfusion
* Hypovolemia
* Right to left shunts
* Pulmonic stenosis
* Pulmonary thromboembolism
* Decreased cardiac output
§ Pericardial effusion with tamponade
§ Restrictive pericarditis
§ Right heart failure
64
4 main causes of left heart failure
volume or pressure overload (Mitral valve insufficiency)
myocardial failure
interference with filling
increased requirement for cardiac output
65
3 major signs of Left heart failure on xray
enlarged left heart (big LA, double density on VD)
pulomonary venous congestion (enlarged veins (cats get enlarged arteries)
pulmonary edema (intersititial to alveolar pulmonary pattern) (caudodorsal)
66
dogs with pulmonary edema from L CHF will cause
perihilar and caudodorsal interstitial to alveolar pulmonary pattern
can be more severe in right caudal lobe then left
dilated cardiomyopathy: can cause ventral peropheral alveolar pattern
67
what kind of pulmonary edema will cats with Left CHF have
patchy distribution
can also get pleural effusion
68
what is most common cause of Left CHF in dogs
mitral valve disease
leads to big LV, enlarged PV and edema in lungs
69
dog with Left HF, what is wrong
enlarged LA and LV (double density, long and buldge)
enlarged pulmonary vein (ventral)
caudodorsal alveolar pattern worse on the right
70
pulmonary edema from L HF in dog vs cat
dog: caudodorsal edema (R>L)
cat: diffuse or patchy
71
what are the arrows
**pleural effusion**- retraction of lung lobe from the body wall
from **left HF** in cat
72
right sided HF
enlarged Right heart (laying down, 1/3 2/3 rule)
enlarged caudal vena cava
hepatomegaly
ascites
pleural effusion
73
what are some things that cause concentric ventricular hypertrophy
AS
PS
hypertrophic cardiomyopathy
heart would appear normal on XRay
74
mitral valve disease leads to enlargement of ---
left side
75
tricuspid valve disease leads to enlargement of ---
right side
76
mitral valve disease
left artial enlargement (bulge)
pulmonary veins thicker
caused dorsal displacement of trachea, and tall cardiac silhouette
77
degenerative mitral valve disease that progressed to HF will show
double density of Left atrium
bulge from big LA and ventricle
enlarged pulmonary veins
caudodorsal alveolar pattern 9R.L)
78
doberman
dilated cardiomyopathy
left atrial enlargement (buldge and double oppasity on VD)
diffuse interstitital pattern, ventral alveolar regions
79
hypertrophic cardiomyopathy in cats will cause
LA and LV enlargement (**valentine shape** on VD)
+/- heart failure
80
cat cardiomyopathy
LA and LV enlargement (valentine shape)
left heart failure (patchy alveolar pattern)
81
what will heart worm do to the heart
Pulmonary arteries are **enlarged,
tortuous, and blunted**
* Right caudal lobar artery affected first
Enlarged main pulmonary artery
Right-sided cardiomegaly
* Cor pulmonale (secondary to pulmonary hypertension)
Enlarged caudal vena cava
* “Caval syndrome”
Right heart failure
Bronchial pulmonary pattern, Multifocal alveolar pulmonary pattern
* Pneumonitis, Thromboembolism
82
heart worm
enlarged, tortous, blunted pulmonary arteries
enlarged MPA
enlarged RV (reverse D)
diffuse bronchial pattern
83
what direction shunt for PDA
left to right
## Footnote
patent ductus arteriosis
84
PDA will cause what on Xray
triad bump: aortic arch, LA/Lauricle, MPA all enlarged
pulmonary arteries and veins also enlarged
85
PS will cause
enlarged MPA (**hat sign**)
RV enlargement (**reverse D**)
86
sub aortic stenosis
**enlarged aortic arch**
**LV enlarged** (tall sihouette, elevated caudal vena cava, dosal tracheal displacement)
+/- enlarged LA if severe (double density)
+/- Left HF
87
if left to right shunt VSD what happens to pulmonary arteries and veins
enlarged
88
if right to left shunting from VSD what happens to arteries and veins
small arteries
(skipping lungs)
89
pericardial effusion on xray
large round (globoid) cardiac silhouette
sharp outline with no motion artifact from heart beating
90
pericardial effusion can cause --- which will cause --- pulmonary vasculature
cardiac tamponade
small pulmonary vasculature
right heart failure
91
what?
Peritoneopericardial Diaphragmatic Hernia (PPDH)
abdominal organs in pericardial sac
will ahve **enlarged rounded silhouette**
