Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
39 Cards in this Set
- Front
- Back
On a PA film, what structure forms the right margin of the superior mediastinum?
|
Superior Vena Cava
|
|
What structure forms the left margin of the superior mediastinum?
|
left subclavian artery
|
|
what is the most common mass
|
thyroid goiter in the substernal area
|
|
how much fluid do you need in order to see it on CXR
|
300cc
|
|
if the trachea is bowed what do you think?
|
think that there is a mass present -- asymmetry leads you to think of a superior/anterior mediastinal mass (4 T's)
|
|
what is commonly seen below and above the diaphragm?
|
lymphoma -- dont usually have calcification
-- can have a more benign course -- dont cause a problem right away |
|
if there is paradoxical movement of the diaphragm with the sniff test what does that lead you to think?
|
paralysis of the phrenic nerve
-- do an inspiration and expiration CXR -- see paralysis of L hemidiaphragm if the diaphragm is higher on inspiration |
|
what are the two hiatal hernias and which one is more dangerous?
|
sliding (99%) and paraesophageal which is rare but more dangerous
|
|
if you see a double density towards the back near the spine what do you think?
|
bachdelek hernia -- double density due to extra tissue from the hernia
|
|
what happens with a pneumothorax?
|
there is potential space -- theres a hole with filling
|
|
if you see an empyema on CXR what do you do>
|
if they are there long enough you need to surgically remove them -- can be due to infection
|
|
where do you find mesothelioma?
|
parietal pleura
|
|
when do you see a "meniscus sign"
|
when there is plueral effusion
-- silhouette sign present |
|
** what do you do to look for effusion/
|
do a decubitus view with the suspected side down
-- high hemidiaphragm suggest effusion |
|
where do you look if you suspect a pneumothorax? where do you look if you suspect pleural effusion?
|
pneumothorax -- apical
pleural effusion -- base of the lungs |
|
how can you exclude malignancy?
|
look for calcification in the tumor
|
|
when can you have abscess formation?
|
with long standing pneumonia
|
|
what are the most common causes for diffuse alveolar pneumonia (2)?
|
1- pneumocystis
2- CMV |
|
what group of individuals have a problem with aspergillosis?
|
asthmatics
|
|
Not all air space disease is pneumonia -- what can cause a pulmonary hemorrhage?
|
good pastures syndrome -- bilateral cloudy appearance
-- life span at this point is 6 months |
|
what is the most common benign lung tumor?
|
hamartoma
|
|
what three tissue elements are involved with primary lung tumors?
|
(1) bronchial epithelium
(2) glandular epithelium (3) undifferentiated |
|
what type of tumor is found in the bronchial?
|
squamous cell (35%) -- central -- obstructing
|
|
what type of tumor is found glandular?
|
adenocarcinma -- peripheral -- mid to upper lung zones
|
|
how do you stage lung tumors
|
TNM system
|
|
where does metastasis usually occur?
|
adrenal glands, liver, bone, and brain
|
|
metastasis to the lungs can be nodular or interstitial. if you have nodular where is it from? if you have interstitial where is it from?
|
nodular = colon, sarcoma, trophoblastic, kidney
interstitial = breast, prostate, and stomach |
|
what diagnostic tool can be used to look for metastatic disease
|
PET scan
|
|
what is an example of an upper lobe tumor? What type of people can this be seen in?
|
superior vena cava syndrome
-- presentaiton --> smoker that cant get good drainage (face appears swollen) |
|
which tumor has cavitation associated with it?
|
squamous cell
|
|
where do thromboemboli originate?
|
deep veins of the thigh, pelvic veins, right atrium
|
|
where do thromboemboli travel?
|
inferior vena cava, right atrium, right ventricle, pulmonary arteries to the mid and lower lungs
|
|
what are 3 things that can happen with thromboembolism?
|
(1) thromboembolism without infarction or necrosis -- nearly impossible to detect with imaging
(2) thromboembolism with infarction but without necrosis -- clot in segmental or subsegmental branch, collateral circulation (3) thromboembolism with infarction and necrosis -- large pulmonary arteries, underlying lung disase, permanent tissue destriction |
|
should you do a CXR (PA and lateral) if you suspect a PE
|
NO! its useless because CXR will usually be negative
|
|
what is the fleishner's sign?
|
enlargement of the right interlobar pulmonary artery (associated with PE)
|
|
normal CXR, perfusion scan shows one or more defects, normal ventilation
High, intermediate, or low probability of a PE |
HIGH
|
|
CXR is normal/abnormal, perfusion scan shows defects not corresponding to the CXR, ventilation defects not corresponding to perfusion defect
High, intermediate, or low probability of a PE |
intermediate
|
|
Normal CXR or COPD, perfusion and ventilation defects match and there is normal perfusion
High, intermediate, or low probability of a PE? |
LOW
|
|
what is a wedge like defect associated with?
|
PE -- hampton hump
|