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95 Cards in this Set
- Front
- Back
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The larynx and trachea is best evaluated on the ______ radiograph.
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Lateral
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True or false. Mineralization of the larynx and trachea may be seen w/ age.
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True
-Especially w/ chondrodystrophic breeds |
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Laryngeal structures may not be well seen in ______ animals.
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Young animals (2-3 months of age)
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Mineralization of the epiglottis is a normal age related finding and can occur in animals as young as _______. It is seen earlier in ______ breeds and ______ breeds.
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2-3 years of age
Large breeds and chondrodystrophic breeds |
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The _____ cartilage is usually the first laryngeal structure to mineralize.
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Cricoid cartilage
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The pharynx is divided by the _______ into a nasopharynx and oropharynx.
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Soft palate
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What are the 6 components of the hyoid apparatus?
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Stylohyoid
Epihyoid Ceratohyoid Basihyoid Thyrohyoid Tympanohyoid cartilage |
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What is type of imaging is good to diagnose roars?
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Ultrasound, can see the vocal folds
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How can you make sure the trachea is positioned correctly in a lateral thoracic radiograph?
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1) Trachea is parallel to spine in the cervical region
2) Trachea deviates ventrally in thoracic region (~40 degree decline) |
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Why is the position of the neck crucial when evaluate the trachea and larynx on a radiograph?
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the tracheal position can be altered by the neck position
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What lymph nodes sit just above the trachea in the neck?
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Retropharyngeal lymph nodes
-commonly enlarge w/ disease -Common location for dogs that have a stick go through the mouth --> abscesses on side of neck |
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What are 3 differentials for laryngeal soft tissue masses?
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1) Regional tumors
2) Infection -Abscess -Cellulitis -Foreign body 3) Inflammation -Sialocoele |
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What are 5 regional tumors that can result in laryngeal soft tissue masses?
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1) Squamous cell carcinoma
2) Thyroid carcinoma 3) Oncocytoma 4) Carotid body tumor 5) Lymphoma |
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What are the 4 possible radiographic signs of laryngeal neoplasia?
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1) Mass effect
2) Mineralization of mass 3) Partial or incomplete luminal occlusion 4) Thickening of normal tissue |
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Tracheal hypoplasia can be congenital and is common in _______ breeds.
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Brachycephalic
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Tracheal hypoplasia may predispose an animal to what 3 things?
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1) Recurrent airway infection
2) Exercise intolerance 3) Chronically to cor pulmonale (right sided heart enlargement bc working against pressure) |
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What are 2 Roentgen signs of tracheal hypoplasia?
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1) Decreased diameter w/ normal shape
2) Entire length should be affected |
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The normal tracheal is approximately equal to the diameter of the _________.
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Cricoid cartilage
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How can you determine if the trachea is the normal diameter?
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Ratio of tracheal diameter to thoracic inlet
-Non-brachiocephalic dogs: -.2 +/- 0.03 -~equal to cricoid cartilage |
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What is the normal ratio of tracheal diameter to thoracic inlet in non-brachycephalic breeds? Brachycephalic breeds? Bulldogs?
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Non-brachycephalic: 0.2+/- 0.03
Brachycephalic: 0.16 +/- 0.03 Bulldogs: 0.13 +/- 0.03 |
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Tracheal collapse is most commonly an acquire disease of _____ breeds.
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Small
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Tracheal collapse may involve cervical, thoracic trachea or _______.
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Mainstem bronchus
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What do we mean by tracheal collapse is dynamic?
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Varies w/ phase of respiration
-When breathe in= more pressure on neck -When breath out=more pressure on thorax |
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We need ______ and _______ films to evaluate tracheal collapse. ______ (imaging) is the gold standard for tracheal collapse.
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Inspiratory and expiratory
Fluoroscopy=gold standard! |
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Upon maximum inspiration tracheal collapse occurs _____ and upon maximum expiration tracheal collapse occurs _____.
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Cervical trachea=inspiration
Thoracic trachea=expiration |
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What is the Roentgen sign of tracheal collapse?
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More than 50% narrowing during respiration or coughing
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Tracheal collapse is common at _______ and ______ sites.
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Thoracic inlet
Mainstem bronchus |
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"_______" of the dorsal trachealis membrane may be an incidental finding in older dogs.
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Redundancy
-Significance assessed in light of clinical signs |
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What are 2 Roentgen signs of tracheal masses?
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1) Disruption of the continuous air-filled tracheal lumen
2) Visualization of a well-marginated intraluminal mass |
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What is the most common tracheal mass, especially in cats?
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Lymphoma -likes area of thoracic inlet
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What are the 2 Roentgen signs of a tracheal foreign body?
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1) Disruption of the continuous air-filled tracheal lumen
2) Visualization of a well-marginated intraluminal mass -Same signs as tracheal mass |
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What can cause tracheal rupture? What region is most commonly affected
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External or internal trauma
Cervical region is most common |
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What are 3 Roentgen signs of tracheal rupture?
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1) Subcutaneous emphysema
2) Pneumomediastinum 3) +/- visible disruption of trachea |
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True or false. Mineralization of the costochondral cartilages is normal.
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True, in most older dogs and some younger dogs
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What is the clinical significance of spondylosis of the sternebrae?
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Nothing, normal & common
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Nipples, small papillomas, masses, and ticks may superimpose on lungs. how do you tell them from pulmonary nodules?
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They will be more sharply demarcated than pulmonary nodules
-Can place barium on them to see if they correlate w/ the lesion |
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What is the purpose of carefully inspecting each rib on a thoracic radiograph?
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Look for rib fractures, tumors, may see incidental healed fractures
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What are 3 radiographic signs of primary rib tumors?
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1) Lysis more common than sclerosis
2) +/- enlarged in the intrathoracic direction-means its extrapleural 3) +/- pleural effusion |
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What are 3 types of primary rib tumors?
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1) Osteosarcoma
2) Chondrosarcoma 3) Fibrosarcoma |
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What 2 tumors like to metastasize to the ribs?
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Prostatic or mammary carcinoma metastases
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What's the point of biopsying an infected rib?
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To determine if fungal or bacterial
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What is the "extrapleural sign" (pertains to ribs)?
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Extension of the thoracic wall mass into thoracic cavity
=Intrathoracic mass effect -Means mass is growing from outside of thorax--> inside of thorax |
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What are 2 radiographic signs of the extrapleural sign?
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1) Parietal pleura and lung displaced medially
2) Broad based junction b/w mass and wall -Cat under rug appearance-pushes pleura up |
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How come what looks like lysis in the sternum can not be an aggressive lesion?
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Degenerative changes in the sternum are common
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True or false. Tumors are uncommon in the sternum.
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True
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What are 2 types of infection that occur at the sternum?
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Discospondylitis
Local infection from direct injury |
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The mediastinum is everything between the right & left ________ and is bound by the _________.
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Pleural sacs
Mediastinal pleura |
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What are 2 types of infection that occur at the sternum?
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Discospondylitis
Local infection from direct injury |
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The mediastinum extends from ______ to ______
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Thoracic inlet to diaphragm
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The mediastinum is everything between the right & left ________ and is bound by the _________.
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Pleural sacs
Mediastinal pleura |
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Why may the mediastinum not contain a unilateral disease?
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It is fenestrated
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The mediastinum extends from ______ to ______
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Thoracic inlet to diaphragm
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What 2 structures does the mediastinum communicate with?
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Neck
Retroperitoneal space -So mediastinum disease can effect left and right and retroperitoneal space |
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Why may the mediastinum not contain a unilateral disease?
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It is fenestrated
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What 2 structures does the mediastinum communicate with?
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Neck
Retroperitoneal space -So mediastinum disease can effect left and right and retroperitoneal space |
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What are the regions of the mediastinum?
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1) Cranial region
-ventral, middle and dorsal areas seen on lateral 2) Perihilar region 3) Caudal region -Each region has its own list of differential diagnoses based on structures located there |
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What are 6 mediastinal organs that are normally seen on radiographs?
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1) Heart
2) Trachea 3) CVC 4) Aorta 5) Thymus (young animals) 6) Esophagus (on left lateral) |
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What is the cranioventral mediastinal reflection?
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Border b/w right cranial lung lobe and the cranial part of the left cranial lobe
-Mediastinum is pushed to the left b/w the lobes bc left lung lobe extends further cranial |
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The "______" sign is a normal thymus in a young animal.
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Sail
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If you see an enlarged thymus in an adult dog, what's your top differential?
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Thymoma
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If you see an enlarged thymus in a cat, what's your top differential?
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Lymphoma
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If you see an enlarged (more than normal) thymus in a young dog, what's your top differential?
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Hemorrhage, but fat mimics thymus too..
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If you see an enlarged thymus in a cat, what's your top differential?
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Lymphoma
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Why isn't the thymus visible on a lateral radiograph?
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Fat in the mediastinum overlaps with the thymus
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If you see an enlarged (more than normal) thymus in a young dog, what's your top differential?
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Hemorrhage, but fat mimics thymus too..
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What is the normal width of the mediastinum?
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Width of first pair of ribs
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Why isn't the thymus visible on a lateral radiograph?
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Fat in the mediastinum overlaps with the thymus
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When there's a mid-cranial mediastinal mass, what 5 structures are displaced by the mass effect?
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1) Trachea
2) Esophagus 3) Heart 4) Lungs 5) Ribs in cat |
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What is the normal width of the mediastinum?
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Width of first pair of ribs
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When there's a mid-cranial mediastinal mass, what 5 structures are displaced by the mass effect?
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1) Trachea
2) Esophagus 3) Heart 4) Lungs 5) Ribs in cat |
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What happens to the heart when there's a mid-cranial mediastinal mass? How do you tell what's normal?
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Caudal displacement of heart and bifurcation of trachea
Heart normally extends caudl 5 to 6 rib spaces |
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Radiologic signs of a perihilar (middle) mediastinum mass can involve what 7 structures?
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1) Lymph nodes
2) Tracheal bifurcation (carina) 3) Main bronchi 4) Large pulmonary vessels 5) Left atrium 6) Esophagus 7) Root of aorta |
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What are the 3 locations of mediastinal lymph nodes?
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Cranial mediastinal lymph nodes
Hilar lymph nodes Sternal lymph nodes |
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What lymph nodes drain the muscles of the neck, thorax and abdomen, thoracic vertebrae, ribs, trachea, esophagus, thyroid, thymus, mediastinum, heart and aorta?
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Cranial mediastinal lymph nodes
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What lymph nodes drain the lungs, aorta, esophagus, trachea, heart and diaphragm?
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Tracheobronchial lnn.
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Peritoneal disease may cause_______ lymphadenopathy.
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Sternal lymphadenopathy
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What mediastinal lymph nodes drain the ribs, thymus, mammary glands and peritoneum?
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Sternal lymph nodes
-Obviously also drains sternum |
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What mediastinal lymph nodes respond to thoracic disease? Mammary or abdomenal disease?
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Thoracic: cranial mediastinal & hilar lnn.
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What can cause the cowboy sign other than left atrial enlargement?
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Bronchial lymph node enlargement
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What are 3 things that can be confused with mediastinal lymphomegaly?
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1) Heart base mass
2) Mediastinal cyst 3) Some other mediastinal masses |
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What are 3 possible radiographic signs of a heart base mass?
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1) Marked enlargement of cardiac silhouette
2) Shift in carina 3) Mass effect in left cranial aspect |
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Are mediastinal cysts clinically significant?
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Often not especially if they're small but if large enough they can compress surrounding structures or can leak fluid into mediastinum
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What are 5 possible pathologies seen in the caudal mediastinum?
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1) Esophageal obstruction cranial to the cardia
2) Esophageal neoplasia or granuloma are rare -Except areas enzootic for spirocercalupi 3) Hiatal hernia of stomch 4) Paraesophageal hernia, rare 5) Gastroesophageal intussusception |
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What causes a mediastinal shift?
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Unequal pressures in the left and right pleural cavities
-Displaced heart |
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Mediastinal shifts displace _____.
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Heart
-*Towards or away from the lesion causing it |
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If there's a mediastinal shift away from the lesion then what's the most likely diagnosis?
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Neoplasia-anything associated w/ more volume
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What can cause a mediastinal shift towards the lesion causing it?
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Lung collapse-loss of volume
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What are 4 possible causes of unilateral lung collapse?
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1) Anesthesia
2) Unilateral pneumonia 3) Obstructed main bronchus e.g. neoplasm, granuloma, abscess, or lymph node, foreign body 4) Lung contusion |
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What are 5 differentials for a mediastinal shift away from the lesion causing it?
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1) Unilateral tension pneumothorax (positive pressure in the affected pleural space)
2) Unilateral pleural effusion when the mediastinum has become sealed 3) Mass lesion enlarging lung e.g. neoplasm 4) Diaphragmatic hernia 5) Pectus excavatum -Unequal size of the 2 sides of thoracic cavity |
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What is a radiographic sign other than a mediastinal shift of unilateral tension pneumothorax?
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Will see flattening of the diaphragmatic cupula on the affected side
-If bilateral, have a flat diaphragmatic cupula |
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Mediastinal fluid is not common, but are 2 possible fluids and what are differentials for each?
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1) Hemorrhage
-Coagulopathy 2) Exudate -FIP -Esophageal rupture |
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What is a radiographic sign of pneumomediastinum?
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Mediastinal structures are easy to see
(-) silhouette sign |
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True or false. Pneumomediastinum is very unlikely to lead to pneumothorax.
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False, pneumomediastinum can progress to pneumothorax if distension is severe, but pneumothorax is very unlikely to progress to pneumomediastinum
-Works one way bc mediastinum is fenestrated so can go into thorax, but not other way |
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What are 3 possible causes of pneumomediastinum?
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1) Hole in trachea
2) Neck wound 3) Retrograde flow along airways from intrapulmonary rupture |
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What are 4 possible causes of a hole in the trachea?
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1) Bite wound
2) Jugular vein puncture 3) Transtracheal aspirate 4) Endotracheal tube cuff overinflation |
