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380 Cards in this Set
- Front
- Back
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How should a radiograph be placed on the viewing screen?
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The same way every time
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How should VD and DV films be placed on the viewing screen?
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So right side is to left in both views
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What recumbency is the animal in for VD and DV views?
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VD: dorsal recumbency
DV: sternal recumbency |
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How should lateral views be palced on teh viewing screen?
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Cranial side to the left
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What does a R or L on a lateral film of the trunk mean?
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Animal in right or left side, respectively (right or left lateral recumbency), so represents view also
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What do R and L markers tell you in DV or VD films?
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Side of animal
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What is the 1st rule when shooting radiographs of the thorax?
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All of the thorax in the film
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List 3 differences of the cat thorax compared to the dog.
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- thorax more triangular
- heart more upright - thorax more lucent |
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How are lateral thoracic films evaluated for rotation?
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Costochondral junctions and shoulder joints - same level
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How is the VD or DV projection of the thorax evaluated for rotation?
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Sternum and spinal column superimposed
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List 4 of 5 things evaluated when reading thoracic films.
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- Technical quality
- all of the thorax in film - symmetrical positioning - expiratory or inspiratory film - structures |
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What is the main thing to evaluate for technical quality of a film?
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Over or underexposure
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What structure is used to tell an expiratory from an inspiratory film?
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Position of diaphragm
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List a couple of methods for evaluating the structures of the thorax?
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- diagonally from the upper caudal end to the cranial ventral
- center and moving outward, - outside to the inside - by organs |
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Oce you have picked a method to evaluate films, what should you do each time you evaluate a film?
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Always read in the same manner every time
- get into a routine |
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List the structures looked at in the organ apporach to evaluating thoracic radiographs.
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- borders of the thorax
- heart - vessels - trachea - tracheal carina - bronchial tree - pulmonary vessels - mediastinum - lungs - pericardial cavities |
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What are the borders of a thoracic radiograph?
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Chest wall, thoracic spine, sternum, diaphragm, and any of thoracic limb in film
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For what is the heart evaluated?
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Shape, size, position, opacity, and changes in silhouette
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For what is the mediastinum evaluated?
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Shifts, width, abnormal density, or masses
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For what is the pericardial cavity evaluated?
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For fluid or air
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What is the cranial limit of the abdomen?
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Diaphragm
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Why is the cranial surface of the diaphragm easily visualized?
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Water density contrasted by adjacent air density of the lungs.
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What is the junction between the two crura?
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Intercrural cleft
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How does the intercrural cleft appear in a lateral radiograph?
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Line between the two crural lines
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What can contrast the abdominal side of the ventral diaphragm and the liver? Why?
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Falciform ligament; fat filled
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What can contrast the abdominal side of the dorsal diaphragm?
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Air in fundus of the stomach
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What mediastinal structures are normally seen in the lateral view?
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Trachea, aorta, heart in the pericardium, caudal vena cava
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What mediastinal structures can be seen in the VD view?
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Trachea, heart in the pericardium, caudal vena cava, sternopericardiac ligament, left edge of the descending aorta
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Is the esophagus usually visible on radiograph? When is it visible?
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No, only if it contains swallowed air or contrast material
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What oblique soft tissue opacity in the cranial mediastinum is normally seen in VD or DV views of cats and young dogs?
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Sail sign (thymus)
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The sail sign is a normal finding in ____ and young ____>
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Cats and young dogs
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Where are the cranial mediastinal lymph nodes located?
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Cranial mediastinum
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The pleura of the caudal mediastinum is ______, allowing air or fluid to pass between the pleural cavities.
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Fenestrated
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What structure connects the pericardium to the floor of the thorax and diaphragm?
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Sternopericardiac ligament
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What is the thick dark line in a radiograph of the cranial mediastinum?
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Trachea
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What is the dark oval over the heart base in a lateral radiograph?
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Tracheal bifurcation, "carina"
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What term do radiologists use for the tracheal bifurcation?
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"Carina"
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What should be the position of the trachea in the DV view?
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Superimposed over spine
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The tracheal normally makes a ____ angle to the vertebral column in a lateral view.
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15*
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What are the 2 continuations of the trachea into the lungs?
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Main stem bronchi or primary bronchi
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Do the cranial or caudal bronchi show up better? Why?
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Caudal, because of thicker lung (water density) around them
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How many divisions does the left bronchus have?
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2: 1 - cranial lobe, 1 - caudal lobe
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How many secondary bronchi (lobar) arise from the right bronchus?
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4: cranial, middle, caudal, and accessory
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What is the best view to see the primary bronchi?
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DV view
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Which is the most ventral (dependant) of the bronchi?
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Right middle bronchus
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What is the normal relationship of the caudal right and left vronchi in the lateral view?
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Normally superimposed
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What is seeing air in the bronchi called?
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Bronchogram
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List the divisions of the right bronchi.
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Cranial, middle, caudal, and accessory
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List the divisions of the left bronchi.
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Cranial (to cranial part and cranial lobe), middle (to caudal part of cranial lobe), caudal
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What are the normal longitudinal water densities in the lungs?
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Pulmonary vessels, not bronchi
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What is a lobar bronchus and associated lobar pulmonary artery and vein?
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Pulmonary triad
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The vessels of a pulmonary triad appear, radiographically, as a pair of ______ lines separated by an _____ line (bronchus)
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water, air
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What is the normal relative size of the artery and vein of a pulmonary triad?
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About the same size
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Where do the lobar artery of a pulmonary triad come from?
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Cranially located right ventricle
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Veins are always ______ and ______ (_____) to the arteries of pulmonary triads in the lateral and DV views respectively.
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Veins to Arteries - Ventral and Central (Medial)
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In the VD/DV films, what is the position of the lobar arteries to the caudal lungs?
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4 & 8 o'clock positions
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What should be the shape of vessels and bronchi of the lungs?
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Smooth walled and tapered
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Collapsed lung will show a lobular pattern because air is lost and the lung now has a ____density.
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water
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What conditions will result in visible lung fissures (lobular pattern)?
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Collapsed lungs, pleural fluid and pleural thickenings.
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Lungs should not be seen on radiographs because they are _____ densities.
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Air (black)
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The sail sign is a normal finding in ____ and young ____>
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Cats and young dogs
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Where are the cranial mediastinal lymph nodes located?
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Cranial mediastinum
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The pleura of the caudal mediastinum is ______, allowing air or fluid to pass between the pleural cavities.
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Fenestrated
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What structure connects the pericardium to the floor of the thorax and diaphragm?
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Sternopericardiac ligament
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What is the thick dark line in a radiograph of the cranial mediastinum?
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Trachea
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What is the dark oval over the heart base in a lateral radiograph?
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Tracheal bifurcation, "carina"
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What term do radiologists use for the tracheal bifurcation?
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"Carina"
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What should be the position of the trachea in the DV view?
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Superimposed over spine
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The tracheal normally makes a ____ angle to the vertebral column in a lateral view.
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15*
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What are the 2 continuations of the trachea into the lungs?
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Main stem bronchi or primary bronchi
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Do the cranial or caudal bronchi show up better? Why?
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Caudal, because of thicker lung (water density) around them
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How many divisions does the left bronchus have?
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Two
1 cranial lobe 1 caudal lobe |
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How many secondary bronchi (lobar) arise from the right bronchus?
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4 - cranial, middle, caudal, accessory
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What is the best view to see the primary bronchi?
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DV view
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Which is the most ventral (dependent) of the bronchi?
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Right middle bronchus
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What is the normal relationship of the caudal right and left bronchi in the lateral view?
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Normally superimposed
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What is seeing air in the bronchi called?
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Bronchogram
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List the divisions of the right bronchi
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Cranial
Caudal Middle Accessory |
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List the divisions of the left bronchi.
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Cranial (cranial part of cranial lobe)
Middle (caudal part of cranial lobe) Caudal |
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What are the normal longitudinal water densities in the lungs?
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Pulmonary vessels, not bronchi
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What is a lobar bronchus and associated lobar pulmonary artery and vein?
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Pulmonary triad
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The vessels of a pulmonary triad appear, radiographically, as a pair of _____lines separated by an ____line (bronchus).
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water, air
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What is the normal relative size of the artery and vein of a pulmonary triad?
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About the same size
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Where do the lobar artery of a pulmonary triad come from?
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Cranially located right ventricle
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Veins are always _____ and ____ (____) to the arteries of pulmonary triads in the lateral and DV views respectively.
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Veins to Arteries - Ventral and Central (Medial)
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In the VD/DV films, what is the position of the lobar arteries to the caudal lungs?
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4 & 8 o'clock positions
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What should be the shape of vessels and bronchi of the lungs?
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Smooth walled and tapered
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Collapsed lung will show a lobular pattern because air is lost and the lung now has a _____density.
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Water
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What conditions will result in visible lung fissures (lobular pattern)?
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Collapsed lungs, pleural fluid, and pleural thickenings.
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Lungs should not be seen on radiographs because they are ____ densities.
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Air (black)
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The cranial lobe of the left lung is divided into cranial and caudal parts, instead of 2 separate lung lobes by anatomists, because one ______ _______ supplies the air to both parts.
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1 lobar (secondary) bronchus
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How many left lung lobes are there anatomically and radiographically?
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Anatomically: 2
Radiographically: 3 |
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Why do radiologists speak of 3 lung lobes?
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Look like 3 radiographically
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What is the radiologist left medial lung lobe anatomically?
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Caudal part of cranial lobe
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List the lobes of the right and left lungs radiographically (anatomically).
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Right lung: cranial, middle, caudal, and accessory (anatomically the same)
Left lung: cranial (cranial part of cranial lobe, middle (caudal part of cranial lobe) and caudal lobe |
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The cranial lobe of ____lung is seen in front of the cranial lobe of the _____lung on a lateral view as a separate round air filled structure.
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Left, right
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What are the three zones of the lung?
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Central (hilar), middle and peripheral
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The pleural cavities are potential, not real,spaces because ____ _____ holds the visceral pleura of the lungs to the parietal pleura of the thoracic wall.
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Serous tension
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What is located in the normal pleural space?
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Scant amount of serous fluid
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Are the pleural cavities visible radiographically in normal conditions?
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No
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What is the cranial extent of the pleural cavity?
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Pleural cupula
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The pleural cupula normally extending cranially past the ____ _____.
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First rib (thoracic inlet)
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The lungs are basically evaluated by the presence or absence of ____ and ____.
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Fluid and air
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What is the appearance of a normal lung field?
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Black background with fluid (soft tissue) structures (vessels) passing through it
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What is located between the vessels of the lungs?
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Interstitium, parenchyma
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For what should the parenchyma of the lungs be evaluated?
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Increase (more radiopaque) or decrease (more radiolucent) opacity
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Disease processes can cause the structures of the interstitium to enlarge and show up, making the interstitium more _____.
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Opaque
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The 2 sides of the thorax should be compared for differences in _____ in the VD/DV views.
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Opacity
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Should the VD or the DV view be taken if a dog is dyspnic (trouble breathing)?
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DV
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Why don't you see the chambers of the heart in survey radiographs?
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Hear is muscle, chambers filled with blood (both water densities)
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Since you can't see the chambers of the heart in surbey radiographs how do you evaluate the heart?
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Evaluate the borders or silhouette
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Why is the DV preferred by a lot of cardiologists?
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Heart more consistently positioned and dorsal lung field more aerated
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What are the lateral radiographic locations of the different compartments of the heart listed below:
a. Right atria b. Right ventricle c. Right auricular outflow tract d. Right auricular appendage e. Pulmonary trunk or main pulmonary artery (MPA) f. Cranial vena cava g. Cranial waist h. Caudal vena cava |
a. Upper part of cranial edge
b. Lower part of cranial edge c. High on cranial part of heart d. High on cranial part of heart e. Superimposed over high cranial part of heart. f. Cranially to high part of cranial heart g. Junction between cranial vena cava and right atrium h. Caudal to upper caudal heart |
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What wraps around the front of the outflow tract (aorta)?
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Right auricle
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What is a radiographic term for the pulmonary trunk?
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Main pulmonary artery (MPA)
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What is the location of the main pulmonary artery in a lateral projection?
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Superimposed over cr. part of upper heart.
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What is usually all that can be see of the cranial vena cava in the lateral projection?
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Ventral edge
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What will enlargement of arch of the aorta, right auricular appendage, or pulmonary trunk cause?
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Loss of the cranial cardiac waist.
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Where is the caudal vena cava seen in a lateral projection?
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Caudal - heart to diaphragm
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The pulmonary arteries are located over the _____ of the heart.
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Base
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What is the normal relationship of the pulmonary arteries in the lateral projection?
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Left over right
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The right pulmonary artery is often seen on _____.
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On "end"
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Give the locations of the different parts listed below:
a. Left atrium b. Caudal waist c. Left auricular appendage d. Aortic arch e. Aortic valve and sinuses f. Brachiocephalic trunk and left subclavian artery g. Descending aorta h. Left ventricle |
a. Upper caudal part of heart
b. Between left atrium and left ventricle (level of bottom of CVC) c. Middle of upper heart - not seen d. Out of base of heart - not seen e. Base of aorta - not seen f. Of arch of aorta - not seen g. Dorsal thorax - well seen h. Caudal heart |
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What is a radiographic term for the coronary (atrioventricular) groove between the left atrium and left ventricle?
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Caudal waist
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Is the left auricular appendage visualized on a lateral radiograph and why?
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No; located in middle of heart (superimposed)
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What large vessel comes out of the center of the base of the heart?
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Aortic Arch
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What are located at the base of the aorta as it comes out of the ventricle?
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Aortic valve and sinuses
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When can the brachiocephalic trunk and left subclavian artery be visualized in a lateral radiograph?
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Air in mediastinum (pneumomediastinum)
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Tell if the structures are seen and where they are located in a DV view or VD view.
a, Cranial vena cava b. Caudal vena cava c. Atria d. Auricles e. Right atria f. Right ventricle g. Pulmonary trunk h. Left atria i. Left ventricle j. Apex k. Aortic arch l Descending aorta m. Phrenicopericardiac ligament |
a. Only edge of it; cranial mediastinum
b. Yes; right side, heart to diaphragm c. No; superimposed over heart d. No unless enlarged, point to left e. No; superimposed over cranial end of right ventricle f. Yes; cranial half of heart g. Yes; Cranial left side of heart h. No; superimposed over caudal heart, just caudal to tracheal bifurcation i. Yes; caudal half of heart j. Yes; point to left k. No; cranial mediastinum l. Yes; left lateral edge m. Yes; left margin of caudal mediastinum |
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On what side of a DV view is the caudal vena cava seen? VD view?
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Right, right
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Why can't the atria be seen on a VD view?
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Summated over the heart
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On which side of the DV view will enlarge atria be seen?
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Extending to the left
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What part of the DV silhouette does the right ventricle make up?
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Right side from apex around cranial side to cranial left side
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The left atrium is over the ____ heart directly above the left ventricle. It is located just caudal to the _____ ______.
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Caudal, tracheal bifurcation
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What is the pulmonary trunk called by radiologists?
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Main pulmonary arterty (MPA)
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What arises on the left cranial side of the heart?
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Pulmonary trunk
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The left ventricle makes up the ____ half of the ______ silhouette of the heart.
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Caudal, left
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On wha side of the heart is the apex, a radiographic landmark, located?
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Left
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Why is the aortic arch no visible in the DV view?
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Summated over cranial mediastinum and spine
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How does the descending aorta appear on a DV view?
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A line to left = left edge of aorta
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What makes up the left margin of the caudal mediastinum?
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Phrenicopericadiac ligament
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What is found on the VD view at each time area according to the clock faced analogy?
VD: 11-1 o'clock VD: 1-2 o'clock VD: 2-3 o'clock VD: 2-6 o'clock VD: 5 o'clock VD: 6-9 o'clock VD: 9-11 o'clock |
- Aortic arch (covered by spine, so not seen)
- Pulmonary trunk (MPA) - Left atrium - Left ventricle - Apex - Right ventricle - Right atria |
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What is found on the lateral view at each of the below areas according to the clock faced analogy?
Lat: 2 and 9 o'clock Lat: 11-12 o'clock Lat: 1-2 o'clock Lat: 2-6 o'clock Lat: 5 o'clock Lat: 6-9 o'clock Lat: 9-11 o'clock |
- Waist of heart
- Aortic arch - Left atrium - Left ventricle - Apex - Right ventricle - Right atria |
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How are radiographs of the heart checked for rotation?
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Costochondral junctions and shoulder joints - level
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The normal heart is approximately ____ intercostal spaces (ICS) wide.
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3
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When is the heart bigger than normal? When is it smaller than normal?
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Big > 3 1/2 ICS
Small < 2 1/2 ICS - Rule of thumb |
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What is the normal amount of sternal contact of the heart?
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Three sternebrae (rule of thumb)
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What is air in the thorax called?
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Pneumothorax
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When closing an intercostal approach to the thorax with sutures around the ribs, what should be avoided?
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Intercostal vessels and caudal ribs
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When opening and closing a split sternum what vessel should be avoided?
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Internal thoracic vein and artery
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How is the vacuum of the pleural cavity regained when closing the thoracic wall?
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Maximally inflate the lungs during last part of closure
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What is the surgical opening of the thoracic cavity?
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Thoracotomy
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What is pleurocentesis / thoracocentesis?
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Surgical puncture of the chest wall for drainage of fluid
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Where is thoracocentesis done?
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In middle of the intercostal space just dorsal to the costochondral junction, craniodorsal to the diaphragmatic line of pleural reflection.
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The cardiac notch of the lung are _____ _____ considered during cardiocentesis.
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Usually not (shively)
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What do radiologists call the area representing the bifurcation of the trachea for lab work?
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Carina
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What is the injection and aspiration of material into and from the trachea for lab work?
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Transtracheal wash (TTW)
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What is the surgical opening of the trachea to the outside?
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Tracheostomy
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Where is a good place for a tracheotomy and why?
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Cranial neck, trachea covered only be strap muscles
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What tracheal disease causes respiratory distress in small dogs?
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Collapse of trachea
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What is percussion?
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Striking a part with shor, sharp blows and listending for the sounds generated.
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What is pneumonia?
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Inflammation of the lungs with consolidation
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What is aspiration pneumonia?
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Swallowing foreign material intothe lungs and subsequent pneumonia
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Which lobe is the most common site for aspiration pneumonia?
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Right middle lung lobe (most dependent); 2nd - cranial right lung lobe
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To which lung lobe will a light, inhaled foreign body (grass awn), which moves by air flow and not gravity, tend to go?
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Right caudal lobe - straight shot
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What is hyaline membrane disease?
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Parturition before the lungs mature with insuffiecient surfactanct produced
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What is the listening to the lungs with a stethoscope?
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Auscultation of the lungs.
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What are the boundaries of the auscultation triangle?
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Cranial: caudal border of the triceps brachii m.
Dorsal: epaxial muscels Caudoventral: curved line from the olecranon to next to the last dorsal intercostal space |
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Generally in relationship to what structure is a lung biopsy performed?
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Craniodorsal to the basal border of the lung
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What is the removal of a lung lobe?
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Lobectomy
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What is a surgeon's pericardium?
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Sac opened to access epicardial covered heart.
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What are the layers of the surgeons pericardium?
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a. mediastinal (pericardial) parietal pleura
b. fibrous pericardium c. parietal layer of serous pericardium |
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What is filling up of the pericardial sac with blood?
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Cardiac tamponade
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What is done with the pericardium after open heart surgery?
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Left unsutured or only loosely approximated
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Why is the pericardium left unsutured after it has been surgically opened?
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To avoid cardiac tambonade
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What is the difference between a congenital and a hereditary defect?
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Congenital: present at birth, can be due to hereditary or environmental causes. H
Hereditary: passed on to offspring, may or may not be present at birth. |
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All cardiac congenital defects should be considered ______ until proven otherwise and the owners should be advised to:
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Hereditary, advise not to breed
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What is failure of the interventricular septum to close?
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Interventricular septal defect (VSD)
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List the developmental anomalies making up Tetralogy of Fallot.
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Pulmonic stenosis; overriding aorta, VSD, hypertrophy of right ventricle
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What does PRAA stand for?
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Persistent right aortic arch
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What is a developmental constriction of a valve?
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Valvular stenosis
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What ventricles can be used ofr cariocentesis (needle into heart)?
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Either right or left
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Is the cardiac notch considered when putting a needle into the heart?
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Usually not
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How is cardiocentesis performed into the left ventricle?
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Palpate strongest pulse on left (lower left 5th intercostal space), direct needle toward the opposite shoulder
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What parasite may reside in the right ventricle of the dog's heart?
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Heartworms
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What changes to the heart do heartworms cause?
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Enlargement of right ventricle, pulmonary trunk, and pulmonary arteries
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What are cardiomyopathies ?
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Progressive cardiac disease
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What is inflammation of the heart muscle?
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Myocarditis
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What causes bacterial vegetative growths on the heart valves?
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Bacterial endocarditis
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Where does blood back up into when the right heart is damages?
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Body (venae cavae - ascites, jugular pulse)
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What is ascites? What causes it?
|
Fluid in abdomen, caused by right heart failure
|
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What does a prominent jugular pulse indicate?
|
Right heart problems, blood backing up into cranial vena cava.
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Where does blood back up into in left heart failure?
|
Lungs
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What is heart auscultation?
|
Listening to the heart with a stethoscope
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Where is the heart located in relationship to intercostal space?
|
Between 2(3)-5(6) intercostal space
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How does the olecranon and the intercostal spaces relate when standing?
|
Olecranon at 5th intercostal space or 5th rib
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What is the puncta maxima or point of maximum intensity (PMI)?
|
Point on the thoracic wall where a valve sound is loudest.
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What is a memory aid for the heart valve's point of maximum intensity
|
PAM 345, right AV: low 5th right
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What are abnormal sounds caused by blood flow turbulence?
|
Heart murmurs.
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What are the two types of murmurs related to location in heart cycle?
|
Diastolic or systolic murmurs
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Which is more common, diastolic or systolic murmurs?
|
Systolic murmurs are more common
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What cause valvular murmurs?
|
Leaky (insufficient) or narrowed (stenotic) valves.
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What causes a leaky (insufficiency) murmur?
|
Turbulence of back flow through a not fully closed valve.
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What is the cause of a narrowing (stenosis) murmur?
|
Turbulence past constriction
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What is heard over a stenotic valve?
|
Crescendo-decrescendo murmur
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When does a systolic murmur occur?
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Between 1st and 2nd heart sound
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What coud cause a systolic murmur?
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Stenosis (aortic or pulmonic), insuffiency (left > right AV)
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What can cause a diastolic murmur?
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Semilunar insufficiency
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When does a diastolic murmur occur?
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Between 2nd and 1st heart sound
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At what age would you expect a AV or semilunar insufficiency?
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Older dogs
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What age dog have semilunar valvular stenosis usually?
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Young, congenital
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What are three common locations of clinical blockage of the esophagus?
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Thoracic inlet, base of heart, esophageal hiatus of diaphragm (start of esophagus)
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What is a common name for clinical blockage of the esophagus?
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Choke
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Which side of the aorta does the thoracic esophagus normally cross?
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Right side of aortic arch
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Where is the esophagus in realtionship to the aorta in a persistent right aortic arch?
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To left of the aorta instead of right
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What structures constrict the esophagus in a persistent right aortic arch (PRAA)?
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Aorta, ligamentum arteriosum, pulmonary trunk, and base of heart
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The constriction due to a persistent right aortic arch causes food to be stopped and the esophagus to balloon cranial to the _____ ___ ______
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Base of the heart
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Name a dilation of the caudal cervical and thoracic esophagus.
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Megaesophagus
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Where is the intercostal space incised to open the thorax and why?
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In center to avoid the vessels caudal to ribs
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What vessels are of concern in midsternal thracotomies?
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Internal thoracic artery and vein
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Where will a severed intercostal artery bleed and why?
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Both ends of cut, originate from the aorta and the internal thoracic a.
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What is it called if the ductus arteriosus doesn't close after birth?
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Patent ductus arteriosus (PDA)
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Early in patent ductus arteriosus, which direction is the shunt during systole? During diastole? Why?
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To right in both (aorta to pulmonary trunk): aorta has higher pressure
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What should be done if a PDA is diagnosed?
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Surgically correct it early (ligate)
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What type of murmur is heard with a PDA?
|
Washing machine / machinery murmur / continuous murmur
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Why does a PDA have a washing machine murmur?
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Blood flows through ductus during both systole and diastole
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What does the right ventricle do to compensate for the extra pressure of a PDA?
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Hypertrophies (bulks up)
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Where does blood back up into due to PDA?
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Into the right ventricle and the body (ascites, jugular pulse)
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What would happen if a reversed PDA was tied off?
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Blow out lungs, pressure above left ventricle
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Where does the ductus arteriosus join the aorta in relationship to the brachiocephalic trunk and left subclavian arteries?
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Past them
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Why will the tongue be pink in a reverse PDA? Why are the rear toe nails blue?
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Brachiocephalic trunk to tongue, toe nails from aorta caudal to ductus arteriosus.
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What does cyanosis mean?
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Bluish discoloration of tissues due to poor oxygenation
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What are the three bumps seen on a DV view of a dog with PDA?
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MPA, left auricle, and aorta
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What is a patent ductus venous?
|
Venous duct that doesn't close after birth
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Of what is a patent ductus venosus an example?
|
Portosystemic shunt (bypasses liver)
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What is a common developmental defect of the atrial septum?
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Atrial septal defect (ASD)
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What is a possible sign of ASD due to blood flow from left to right?
|
Cyanosis (poor oxygenation of blood)
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What results from rupture of the thoracic duct?
|
Chylothorax
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How is rupture of teh thoracic duct treated?
|
Surgically ligate the duct on both sides of the defect.
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Why is surgery of the thoracic duct usually less than satisfactory?
|
Presence of multiple channels and difficulty in finding
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How can the location of the thoracic duct be facilitated?
|
Feed a fatty meal before surgery
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What is the clinical significance of the line of pleural reflection?
|
Demarcates the pleural from the peritoneal cavity
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What is thoracocentesis?
|
Thoracic puncture to withdraw fluid.
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During which part of the repiratory cycle should a thoracocentesis be done?
|
Expiratory phase
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What is peurocentesis / thoracocentesis?
|
Surgical puncture of the thorax for drainage of fluid
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Where is thoracocentesis done?
|
In the middle of the intercostal space just dorsal to the costochondral junction, 7-8 (craniodorsal to the diaphrgamatic line of pleural reflection)
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How can the pleural cupula be clinically important?
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Can open the pleural cavity with an incision near the thoracic inlet.
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What is the surgeon's pericardium?
|
Mediastinal pleura + fibrous pericardium + parietal serous pericardium
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What is the term for inflammation of the pleura?
|
pleuritis
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Why is pneumothorax or pyothorax usually bilateral in the carnivores?
|
Mediastinum is fenestrated (holes)
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What is hyaline membrane disease?
|
Premature parturition before the lung mature with insufficient surfactant produced
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What is air or gas in the pleural space?
|
pneumothorax
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What is accumulation of pus in the thorax?
|
Pyothorax
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What occurs if the tracheal duct ruptures?
|
Chylothorax
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What theoretically allows a unilateral pneumothorax or pyothorax to become bilateral?
|
Fenestration in the mediastinum, common in the dog.
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Is acute unilateral pneumothorax fatal in dogs?
|
No, even with the mediastinal fenestrations
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In what could a tear in the thoracic part of the trachea result?
|
Pneumomediastinum
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Why is the endothoracic fascia clinically significant?
|
Continuous with the deep fascia of the neck.
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How can infections of the neck migrate to the thorax?
|
Down the deep fascia to the endothoracic fascia
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What is the normal blood pressure of the dog?
|
120/80
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|
List the pressures in the different chambers of the heart.
|
LV - 120
RV - 25 LA - 4 RA -3 |
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With what can the opacity of expiratory thoracic films be confused?
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Pathology
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Expiratory films can be used to bring out subtle ______
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Pathology
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List some problems needing thoracic radiographs.
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Cough, heart problems, dyspnea, abnormal lung sounds, etc.
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Of what does the chest wall consist?
|
Sternum, ribs, costal cartilages, and intercostal muscles
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How many views are needed to evaluate rib fractures?
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2
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Rib fractures usually involve _____, ______ ribs.
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Multiple, sequential
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What are common sequelas to rib fractures?
|
SQ emphysema, pneumothorax, and pulmonary laceration
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What is the term for segmental fractures of a number of sequential ribs causing the chest wall to move in during inspiration?
|
Flail chest
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What is the most common organ that enters the thorax through a diaphragmatic hernia?
|
Liver
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What is a radiographic indication of a diaphragmatic hernia?
|
Entire diaphragm can't be seen
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When are the medaistinal lymph nodes visible?
|
When enlarged (i.e. lymphosarcoma, common in cats)
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What is air in the mediastinum?
|
Pneumomediastinum
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Where can pneumomediastinum come from?
|
Lungs, fascial planes of neck or esophagus
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What increases the radiolucency of the mediastinum and thus making normally invisible structures evident?
|
Pneumomediastinum
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To where can air in the mediastinum move?
|
Fascial planes to neck or retroperitoneal space
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What is moving of the mediastinum to the right or left?
|
Mediastinal shift
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What can change the shape and density of the mediastinum?
|
Mediastinal masses
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What can cause dorsal deviation of the trachea?
|
Cranial mediastinal mass or excess fat, heart enlargement and expiratory films (artifact)
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When is the shape of the mediastinum clinically important?
|
Pleural effusions
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Which is the most common lung lobe site for aspiration pneumonia? What is the second?
|
Right middle lung lobe (most dependant); Cranial right lung lobe
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To which lung lobe will a light, inhaled foreign body (grass awn), which moves by air flow and not gravity, tend to go?
|
Right caudal lobe - straight shot
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What is the common term for bowing of the principle bronchi in VD and DV views?
|
"Cowboy legs"
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What causes "cowboy legs" to the principle bronchi?
|
Enlargement of left atrium or tracheobronchial lymph nodes
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Left atrial enlargement will do what to the caudal bronchi in a lateral view?
|
Separate right and left caudal bronchi by elevating left one.
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Fluid or air in the pleural space will eliminate the _____ pressure of the space and cause the lungs to collapse away from the chest wall.
|
Negative
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What is excess fluid in the pleural space?
|
Pleural effusions
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|
List the types of fluid that can be found in the pleural space?
|
Water (hydrothorax), air (pneumothorax), chyle (chylothorax), pus (pyothorax)
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|
What is the main radiographic sign of pleural effusion?
|
Separation of lungs and body wall allowing visualization of lung borders and fissure lines.
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What else will pleural effusion do to a radiograph besides showing borders and fissures of the lungs?
|
Loss of detail obscuring the heart and diaphragm.
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|
Pleural effusion can be confused with a _____ _____ which also results in loss of detail of the thorax.
|
Diaphragmatic hernia
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|
How do radiographic signs relate to lung disease in terms of time?
|
Lag behind the development and resolution of clinical signs
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|
An acutely, clinically ill dog with lung disease may appear radiographically_____
|
Normal
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A dog that is responding to treatment for lung disease may appear ____ radiographically then when he was ill.
|
Worse
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|
What are the 4 basic opague lung patterns?
|
Interstitial, alveolar, peribronchiolar, and vascular
|
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|
What characterizes each of the opaque lung patterns?
|
Interstitial: opaque lungs
Alveolar: air bronchogram Peribronchiolar: "donuts and tram lines" Vascular: increased, decrease or normal |
|
|
What are three possible distributions of lung patterns?
|
Lobar: isolated to one lobe
Diffuse: over whole lung Hilar: around the hilus |
|
|
What is the goal when determining lung patterns?
|
Determine which is the most predominate lung pattern or patterns.
|
|
|
How is a interstitial pattern distinguished from an alveolar pattern?
|
Interstitial: air still seen in the lung
|
|
|
What is the number one cause of an interstitial pattern?
|
Expiratory film (normal)
|
|
|
What causes an alveolar lung pattern?
|
Alveoli filling with fluid
|
|
|
What is the visualization of teh air in bronchi in an alveolar pattern called?
|
Air bronchogram
|
|
|
Why do the vessels disappear in an alveolar pattern?
|
Surrounding lung filled with fluid
|
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|
Give three findings of an interstitial pattern.
|
- Opaque lung field
- Air evident in interstitium - Vessels fuzzy but evident |
|
|
Give four signs of an alveolar pattern.
|
- Opaque lung field
- No air in the interstitium - No vasculature - Air bronchogram |
|
|
What happens to the vessels in an alveolar pattern? Why?
|
Disappear, soft tissue around them is filled with fluid
|
|
|
Why is the air in the bronchi so prominent in an alveolar pattern?
|
Water replaces air in interstitium and contrast air in bronchi
|
|
|
List some causes of an alveolar lung pattern
|
Pneumonia, pulmonary edema, blood, neoplasm
|
|
|
What is the characteristic of a bronchial pattern?
|
Enlarged bronchiolar walls / peribronchiolar cuffing
|
|
|
Give two signs of a peribronchial pattern.
|
Perivascular cuffing
- donuts - tramlines |
|
|
What are "donuts"?
|
Round end on views of bronchi with pervascular cuffing in peribronchial pattern
|
|
|
What are the sagittal sections of bronchi with perivascular cuffing called in a peribrochiolar pattern?
|
"Tram lines"
|
|
|
What lung pattern has enlarged bronchiolar walls?
|
Bronchiolar pattern
|
|
|
What is thickening of the bronchiolar wall and space around it?
|
Peribronchiolar cuffing
|
|
|
Calcified bronchial wall will result in _____, ______, white sagittal lines and cirular cross sections.
|
sharp, thin
|
|
|
Chronic air way disease can change the shape of the bronchi by _____ ______ their wall, and the bronchi will become bigger.
|
Breaking down
|
|
|
What is an air filled pocket in lung?
|
Bulla
|
|
|
What is an aif filled pocket on the edge of the lung?
|
Bleb
|
|
|
What kind of radiographic vascular patterns are there?
|
Normal, increased (hypervascular), or decrease (hypovascular)
|
|
|
What should be the first thing that comes to mind when enlarged arteries of the lungs are seen?
|
Heart worm disease
|
|
|
Large pulmonary veins indicate ____ heart failure causing fluid to back up into the lungs by the pulmonary veins.
|
Left
|
|
|
Give the three vascular patterns.
|
- Enlarged vessels (hypervascularity)
- Smaller vessels (hypovascular) - Normal |
|
|
What can be easily confused with a pulmonary vessel because they travel in the same direction?
|
Calcified costal cartilage
|
|
|
What is the term for larger than normal vessels? Smaller?
|
- Hypervascularity
- Hypovascularity |
|
|
What configuration can the vessels in a hypervascular pattern have?
|
Tortuous
|
|
|
______ vessels seen passing dorsal is a good sign of heart worm disease. They are normally not seen.
|
Tertiary
|
|
|
What is fluid in the lungs?
|
Pulmonary edema
|
|
|
Pulmonary edema results in increased radiographic ______
|
Opacity
|
|
|
What is the mechanism of cardiogenic pulmonary edema?
|
Left heart failure backing up into the lungs
|
|
|
What are the 2 types of pulmonary edema?
|
Cardiogenic
Non-cardiogenic |
|
|
What is the mechanism of non-cardiogenic pulmonary edema?
|
Increased leaking of lung capillaries or increased pressure in capillaries
|
|
|
The increased radiographic opacity of pulmonary edema can be either a _____ or _____ pattern or both depending on where the fluid is.
|
Interstitial or alveolar
|
|
|
List 2 causes of non-cardiogenic pulmonary edema.
|
Toxins, snake venom, trauma
|
|
|
How does the right ventricle respond to stresses (pressure or volume)?
|
Dilates quite readily
|
|
|
Why do the atria respond to stresses readily with dilation?
|
Thin walled
|
|
|
What signs are seen on a lateral film of right atrial enlargement?
|
Elevation of trachea, loss of cranial waist
|
|
|
What is a sign on a DV projection of right atrial enlargement?
|
Enlargement of 9-11 o'clock area
|
|
|
Right ventricular enlargement is seen as a _____ bulging on the lateral view. This will cause the heart to have more _____ _____
|
Cranial; sternal contact
|
|
|
On VD view, right ventricular enlargement will bulge to the right. How is this shape often referred to?
|
Backwards or reverse "D"
|
|
|
Where does fluid back up into in right heart failure?
|
Abdomen, liver, extremities
|
|
|
Give a cause of right ventricular enlargement.
|
Pulmonic stenosis and heartworm disease.
|
|
|
Give 2 radiographic findings of right ventricular enlargement on a lateral projection.
|
- Increased sternal contact
- elevation of trachea - elevation of caudal vena cava - elevation of apex off sternum |
|
|
Give two findings of right ventricular enlargement on a DV projection.
|
- Rounded right cardiac border
- reversed "D" sign with marked enlargement - apex more to left |
|
|
Where are heart worms normally located?
|
Pulmonary trunk and aa and right ventricle
|
|
|
The left ventricle usually respondes to stresses initially with concentric ______
|
Hypertrophy
|
|
|
Wil left ventricular hypertrophy be noticed on survey films?
|
Not acutely, in late stages
|
|
|
Heart worms will cause enlargement of the _____ ____ and also effect _____ _____.
|
Right ventricle, Pulmonary vessels
|
|
|
What clinical condition should you think of if you see tortuous dilated pulmonary arteries?
|
Heart worm disease
|
|
|
What will cause tracheal and left main stem bronchi elevation?
|
Left atrial enlargement
|
|
|
What is a possible effect on the main stem bronchi in left atrial enlargement in a VD film?
|
Spread out "cowboy legs"
|
|
|
List three findings of left atrial enlargement in the lateral projecion.
|
- Elevated trachea and carina
- separation of main stem bronchi (left dorsal to right) - enlarged atrium (projects caudodorsally) |
|
|
List three findings of left atrial enlargement in teh DV projection.
|
- Auricle projects at 2-3 o'clock position.
- Increased opacity of left atrium (centrally over the heart) - "cowboy legs" |
|
|
List three findings in left ventricle enlargement on a lateral projection.
|
- Loss of caudal waist
- Caudal bulging to caudodorsal border of heart - Elevated trachea |
|
|
List two findings in left ventricle enlargement on a DV projection.
|
- Rounding of left ventricle border (3-5 o'clock)
- Apex shifted to right sometimes |
|
|
True or False: Tracheal and left main stem bronchi elevation due to left atrial enlargement are very noticeable in the cat.
|
False
|
|
|
In the DV view the left atrium will project beyond the normal cardiac border between the ___ to ____ o'clock position.
|
2-3 and sometimes all around from 9-3
|
|
|
What is seen as a caudoventral bulging on the lateral view which elminates the caudal waist of the heart?
|
Straight and vertical
|
|
|
What causes the elevation of the heart, which in turn will elevate the trachea?
|
Enlargement of ventricles
|
|
|
What position, in DV films, on the clock faced analogy bulges in left ventricular enlargement?
|
2 to 5 o'clock
|
|
|
On a VD view, left ventricular enlargement will bulge caudally and to left and right, often moving the apex to the ____.
|
Right
|
|
|
What is one cause of left ventricle enlargement?
|
Mitral valve insufficiency
|
|
|
What does elevation of the apex of the sternum indicate?
|
Right or left ventricle enlargement, could also be pneumothorax or seen normally in some breed in left lateral recumbency
|
|
|
What does loss of caudal cardiac waist indicate?
|
Left ventricular or left atrial enlargement
|
|
|
What does bowing out of the caudal border indicate?
|
Left ventricular enlargement
|
|
|
What does a reverse "D" indicate on the DV view?
|
Right ventricular enlargement
|
|
|
What do "cowboy legs" indicate?
|
Left atrial enlargement or severe lymphadenopathy
|
|
|
What is an opened ductus arteriosus between the aorta and the pulmonary trunk called?
|
Patent ductus arteriosus (PDA)
|
|
|
What is the early treatment of PDA?
|
Tie off the ductus arteriosus
|
|
|
Where does the ductus arteriosus join the aorta in relationship to the brachiocephalic trunk and left subclavian arteries?
|
Past them
|
|
|
Between what 2 structures does a ductus arteriosus or ligamentum arteriosum extend?
|
Aorta and pulmonary trunk
|
|
|
What are the three bumps seen on a DV view of a dog with PDA?
|
Aorta, MPA, and left auricle
|
|
|
What is pulmonic stenosis?
|
Constriction of the pulmonary artery outflow tract
|
|
|
What type of murmur will pulmonary stenosis give? why?
|
Systolic; pumping through constriction causes turbulence
|
|
|
Where is a pulmonic stenotic murmur best heard?
|
Cranial left side (PAM 345)
|
|
|
How does the pulmonary trunk (MPA) appear in pulmonic stenosis?
|
Bulges
|
|
|
What causes bulging of the MPA in pulmonic stenosis?
|
Turbulent flow caused by increased velocity (non-laminar flow). Post-stenotic dilation.
|
|
|
What happens to the right ventricle in pulmonic stenosis?
|
Enlargement
|
|
|
What causes the enlargement of the right ventricle in pulmonic stenosis?
|
Resistence of teh smaller outflow (stenosis) causes it to push harder and dilate
|
|
|
Way on down the line n pulmonic stenosis, the right AV valve can be compromised by the ____ right ventricle resulting in volume overload into the right atria and enlargement.
|
Enlarged
|
|
|
What type of lung pattern would you expect to see in pulmonic stenosis?
|
Normal to hypovascular
|
