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58 Cards in this Set

  • Front
  • Back
Which is better to image the heart AP or PA?

(this is AP)

(this is PA)
lateral decubitus
what position is this?
L1(top): L brachiocephalic v
L2: R brachiocephalic v
L3: trachea
L4(bottom): esophagus
What are the lines pointing to?
L1 (top): SVC
L2: trachea
L3: esophagus
R1 (top): sternum
R2: aortic arch
What are the lines pointing to?
L1(top): sternum
L3: right main bronchus
L4: esophagus
R1(top): ascending aorta
R2: pulmonary trunk
R3: left pulmonary artery
R4: left main bronchus
R5: descending aorta
What's what?
L1(top): ascending aorta
L3: R pulmonary artery
L4: R main bronchus
L5: L main bronchus
R1: Main pulmonary artery
R2: L superior pulmonary vein
R3: L pulmonary artery
R4: Descending aorta
What's what?
L1(top): R atrium
L2: R inferior pulmonary vein
R1: R ventricle
R2: Region of aorti valve
R3: L atrium
R4: top of left hemidiaphragm
R5: Descending aorta
What's what?
L1(top): R ventricle
L2: esophagus
L3: Descending aorta
L4: Azygos vein
R1: Pericardium
R2: IV septum
R3: L ventricle
R4: Stomach
R5: Spleen
What's what?
What color is rapid flowing blood on MR w/o contrast?
Left: LV diastole

Right: LV systole
What are the arrows pointing at and what state is the object in?
(left and right)
The LCA suppiles what?
Most of the Left atrium

Most of the Left Ventricle

Most of the Interventricular Septum
The RCA supplies what?
Right Atrium
Right Ventricle
Portions of the left atrium and left ventricle
1/3 of the Interventricular septum
SA and AV nodes
tetralogy of Fallot
In what disorder is the apex of the heart "flipped up" to look like a boot?
if more than 50% of the anterior space is filled
How do can you tell if the RV is enlarged?
Barium esophagus will have a dent in it
how can you tell if you have LA enlargement from an image like this?
What does the short axis view look like (Nuclear imaging)?

horizontal long axis view?

vertical long axis view
o, u, sideways u
What is the contrast used for nuclear imaging?
Tc-sestamibi (99m)

(goes to muscle in proportion to blood flow)
Where do you not see much tecnesium activity?
what is the contrast medium used in PET scans?
Flurodeoxyglucose (FDG)
Which imaging technique can tell if heart muscle is stunned, hibernating, or dead?
How do you diagnose cardiac chamber enlargement?
cardio-thoracic ratio > 50%

widest part of heart / widest part of rib cage
what musculoskeletal disorder can cause a factitious heart enlargement?
pectus excavatum
(also, straight back syndrome)
ascending aorta
What's the bulge on the pt's right?
Aortic knob is > 35mm from trachea - aortic enlargement
The aortic knob is on the pt's left. What is the criteria for diagnosing aortic enlargement?
draw a line from aortic knob left-most heart. If bulge projects beyond the line, then main pulmonary artery is enlarged.
Main pulmonary artery here is bulging on the pt's left. How do we know it's not normal?
If the heart is enlarged and the main pulmonary artery is enlarged, which ventricle is enlarged?
right ventricle
If the heart is enlarged and the AORTA is enlarged, which ventricle is enlarged?
Left ventricle
Once one ventricle is enlarged, is it easy/impossible to tell if the other ventricl is also enlarged
In erect position, blood flow to bases > or < than flow to apices?
more flow to bases
Size of vessels at bases is normally > or < than size of vessels at apex?
bases vessels > apex vessels
What heart condition causes cephalization of blood vessels in lung?
venous hypertension
The right descending pulmonary artery is normally < ___mm wide.
term used to describe when the normally gradual tapering of the size of central to peripheral lung vessels becomes more dramatic
pruning is seen in pulmonary arterial or venous HTN?
During "increased flow," describe the lung blood vessels.
lung blood vessels are bigger everywhere.
Normal, Pulmonary venous HTN, Pulmonary arterial HTN, or Increased flow?
increased flow
Normal, Pulmonary venous HTN, Pulmonary arterial HTN, or Increased flow?
pulm venous HTN
Normal, Pulmonary venous HTN, Pulmonary arterial HTN, or Increased flow?
pulm art HTN
Normal, Pulmonary venous HTN, Pulmonary arterial HTN, or Increased flow?
what about "decreased flow"
it's mostly unrecognizable
signs of CHF caused by left heart failure
Shortness of breath
Paroxysmal nocturnal dyspnea
signs of CHF caused by right heart failure
X-ray patterns of CHF
Pulmonary Interstitial Edema X-ray Findings
Thickening of the interlobular septa
-Kerley B lines
Peribronchial cuffing
-Wall is normally hairline thin
Thickening of the fissures
-Fluid in the subpleural space in continuity with interlobular septa
Pleural effusions
pulmonary interstitial edema
interstitial or alveolar?
kerley b lines
Notice anything on the right?
What heart problem are kerley B lines seen (classic)?
mitral stenosis
kerley a and c

a: oblique, near hilum, seen in edema
b: chicken wire
peribronchial cuffing
- when fluid-thickened bronchial walls become visible = donuts
What's this?
Acinar shadow
Outer third of lung frequently spared
Bat-wing or butterfly configuration
Lower lung zones more affected than upper
Pt has CHF. What is this?
pleural effusion (more on the right)
Cause of most mitral stenosis?
rheumatic heart disease
X-Ray Findings of MS Cardiac Findings
Usually normal or slightly enlarged heart
Enlarged atria do not produce cardiac enlargement; only enlarged ventricles
Straightening of left heart border
Or, convexity along left heart border 2° to enlarged atrial appendage
Only in rheumatic heart disease
Small aortic knob from decreased cardiac output
Double density of left atrial enlargement
Rarely, right atrial enlargement from tricuspid insufficiency
X-Ray Findings of MS Calcifications
Calcification of valve--not annulus-- seen best on lateral film and at angio
Rarely, calcification of left atrial wall 2° fibrosis from long-standing disease
Rarely, calcification of pulmonary arteries from PAH
X-Ray Findings of MS Pulmonary Findings
Elevation of left mainstem bronchus (especially if 90° to trachea)
Enlargement of main pulmonary artery 2° pulmonary arterial hypertension
Severe, chronic disease
Multiple small hemorrhages in lung
Pulmonary hemosiderosis
triad of aortic stenosis
chest pain
Aortic Stenosis X-Ray Findings
In adults
Normal heart size
Until cardiac muscle decompensates
Enlarged ascending aorta 2° post-stenotic dilatation 2° turbulent flow
Normal pulmonary vasculature
What can cause Prominence of ascending aorta?
Post-stenotic Dilatation of Aorta - From turbulent flow just distal to any hemodynamically significant arterial stenosis
Jet effect also plays role