Radiology - Pulmonary

Front 1

When are exposures for pulmonary radiographs made?

Back 1

-inspiration

Front 2

Why is anesthesia contraindicated for pulmonary radiology?
-how can this be corrected for?

Back 2

-the lungs are poorly aerated (atelectasis)

-can be corrected for by bagging the animal and providing positive pressure aeration

Front 3

What are the usual radiographic views for a thorax?

Back 3

-lateral
-VD

Front 4

What are the radiographic views of the thorax if a metastatic disease is the concern?

Back 4

-left lateral
-right lateral
-VD

Front 5

Radiographic view that is best for visualization of the caudal lobar arteries?

Back 5

-DV

Front 6

Thoracic radiograph borders

Back 6

-thoracic inlet to beyond the diaphragm

Front 7

Number of lung lobes in the dog/cat

Back 7

-6

-4 right
-2 left

Front 8

Most cranial lung lobe

Back 8

-left cranial

Front 9

Where should pulmonary vessels be clearly visible?

Back 9

-perihilar
-middle lung

Front 10

Pneumonic for location of pulmonary arteries and veins

Back 10

-arteries are up and away
-veins are ventral and central

Front 11

Radiographic view best for visualizing cranial lobar vessels

Back 11

-lateral view

Front 12

How should the lobar vessels (cranial and caudal) be evaluated for size?

Back 12

Compare to width of ribs:
-Cranial lobar = 4th rib
-Caudal lobar = 9th rib

Front 13

Normal geriatric change to bronchial walls

Back 13

-mineralization

Front 14

Lung lobe that does not extend dorsally past the carina

Back 14

-right middle

Front 15

Normal location of the dorsal margin of the accessory lung lobe

Back 15

-between the aorta and caudal vena cava

Front 16

Proper exposure for lung assessment

Back 16

-slightly underexposed to examine existing vertebrae

Front 17

Structures that can cause artifact on thoracic cavity radiographs

Back 17

-scapula
-skin folds
-costochondral mineralization
-nipples
-subcutaneous fat

Front 18

Radiographic view to minimize summation of the scapulae on VD

Back 18

-humanoid view

Front 19

How can you tell if an artifact is a skin fold?

Back 19

-ventral location
-extends beyond the boundary of the thoracic cavity

Front 20

How to assess pulmonary fields

Back 20

-opacity (normal, decreased, increased)
-distribution (diffuse, localized)
-location (which lung lobes/portions of lung lobes)
-pattern (bronchial, interstitial, alveolar, vescular)

Front 21

Abnormal Pulmonary opacity
-general patterns

Back 21

-interstitial
-alveolar
-bronchial
-vascular

Front 22

Interstitial pattern
-types

Back 22

-unstructured
-structured

Front 23

Unstructured interstitial pattern
-morphology

Back 23

-hazy
-no apparent form

Front 24

Structured interstitial pattern
-morphology

Back 24

-nodules

Front 25

Interstitial pattern
-causes

Back 25

-fluid
-cells
-fibrosis

Front 26

Interstitial pattern
-general morphology

Back 26

-increase in background opacity
-vessels visualized because airways remain aerated

Front 27

Classify the pulmonary pattern

Back 27

-unstructured interstitial

Front 28

Classify the condition

Back 28

-metastatic neoplasia

Front 29

Classify the pulmonary pattern

Back 29

-miliary
-due to histoplasmosis (fungal disease)

Front 30

Masses vs. Miliary Pattern

Back 30

-masses: > 3 cm in diameter
-miliary: < 2 cm in diameter

Front 31

Classify the condition

Back 31

-hemangiosarcoma

-overlap of fungal and metastasis

Front 32

Unstructured interstitial patterns
-causes

Back 32

Spread from vessels/lymphatics:
-interstitial fibrosis
-interstitial pneumonia
-interstitial edema
-interstitial hemorrhage
-some neoplasia

Front 33

Nodular interstitial patterns
-causes

Back 33

Conditions that could lead to cellular aggregations:
-metastatic neoplasia
-mycotic granulomas
-abscesses
-ossifying metaplasia

Front 34

Nodular interstitial pattern
-look a likes

Back 34

-end on vessels
-pulmonary osteomata
-costochondral junctions
-subcutaneous nodules

Front 35

End on vessels
-largest where?
-smallest where?

Back 35

-largest: perihilar
-smallest: middle lung zone
-not visible: peripheral 1/3

Front 36

-Structures seen here
-how can you tell

Back 36

-end on vessels
-sitting over linear vessels

Front 37

Unstructured interstitial patterns
-look a likes

Back 37

-underexposed radiograph
-expiratory radiograph
-partial atelectasis

Front 38

Cavitary lesion differentials

Back 38

-neoplasia
-granuloma
-parasites
-abscess
-bulla
-cyst
-bronchiectasis

Front 39

Cavitary lesion differentials with thick, irregular walls

Back 39

-neoplasia
-granuloma
-parasites
-abscess
-bronchiectasis

Front 40

Cavitary lesion differentials with thin walls

Back 40

-bulla
-cyst

Front 41

Classify the Lesion

Back 41

-cavitary pulmonary carcinoma

Front 42

Alveolar pattern
-radiographic morphology

Back 42

-fluffy to solid opacity due to fluid/cells filling alveolar spaces
-more opaque than interstitial pattern

Front 43

Nodular Interstitial Pattern vs. Patchy Alveolar Pattern

Back 43

-nodular interstitial: opacities appear relatively circumscribed

-patchy alveolar: opacities with fluffy, cotton ball appearance

Front 44

Alveolar pattern
-radiographic appearance of pulmonary vessels

Back 44

-border effaced
-no longer visible because the air-filled lung is no longer surrounding vessels

Front 45

Air bronchograms
-definition

Back 45

-air-filled airways surrounded by opacified alveolar tissue
-indicate alveolar pattern
-not always present with alveolar disease

Front 46

Lobar sign
-definition

Back 46

-distinct line between normal and abnormal lung

Front 47

Alveolar pattern
-causes

Back 47

-cardiogenic/noncardiogenic edema
-hemorrhage
-contusion
-bacterial pneumonia
-thromboembolic disease and infarcts
-atelectasis of the lung
-occasional neoplasia

Front 48

What are the arrows pointing to?

Back 48

-lobar sign

Front 49

Reasons why Arteries > Veins

Back 49

-heartworm
-pulmonary hypertension

Front 50

Reasons why Veins > Arteries

Back 50

-CHF

Front 51

Reasons why Arteries and Veins are both enlarged

Back 51

-fluid overload
-left to right cardiac shunt (PDA, VSD, ASD)
-disease combination

Front 52

How to know if a pulmonary vessel is distended

Back 52

-4th rib on lateral
-9th rib on VD

Front 53

Vascular pattern
-look a likes

Back 53

-underexposed
-expiratory radiograph

Front 54

What are the arrows pointing to?
What disease is this indicative of?

Back 54

-large tortuous caudal lobar arteries

-indicative of: Heartworm disease

Front 55

What are the arrows pointing to?
What disease is this indicative of?

Back 55

-Venous congestion

-indicative of: cardiogenic edema; hypertrophic cardiomyopathy

Front 56

Hypoperfused Vascular Pattern
-radiographic morphology

Back 56

-small vessels
-small cardiac silhouette
-radiolucent lung fields

Front 57

Hypoperfused Vascular Pattern
-causes

Back 57

-dehydration
-hypovolemic shock
-hypoadrenocorticism (Addisons)
-pulmonic stenosis
-right to left shunt

Front 58

Hypoperfused Vascular Pattern
-look a likes

Back 58

-overexposed radiograph
-over-inflated lungs
-deep chested dogs

Front 59

Classify the Condition
-why

Back 59

-Pulmonic stenosis

-enlarged pulmonary a.
-D-shaped heart

Front 60

Location where bronchial walls are usually only visible

Back 60

-close to the hilus

Front 61

Bronchial pattern
-definition

Back 61

-increased prominence of bronchial walls at middle and peripheral lung fields to to increased opacity and thickness

Front 62

How does a bronchial pattern appear on a radiograph?

Back 62

-either a track or a train

Front 63

Bronchiectasis
-definition

Back 63

-bronchial dilation and loss of normal tapering

Front 64

Bronchial pattern
-causes

Back 64

-mucosal thickening
-debris in lumen
-hyperplasia of glandular tissue
-hypertrophy of smooth muscle
-peribronchial infiltration by fluid or cells

Front 65

Bronchial vs. Peribronchial disease

Back 65

-Bronchial: increased opacity and thickness of the bronchial walls

-Peribronchial: larger lumen diameter in comparison to vessel diameter

Front 66

Mineralization of bronchial walls
-due to

Back 66

-chronic inflammation
-geriatric change

Front 67

Describe the pattern

Back 67

-Bronchial pattern

Front 68

Why does this depict bronchiectasis?

Back 68

-bronchus is not tapering

Front 69

Patterns of Pneumonia

Back 69

-Interstitial-non-structured
-Alveolar
-Interstitial-structured

Front 70

Interstitial-non-structured pneumonia
-causes

Back 70

-viral
-bacterial

Front 71

Alveolar pneumonia
-causes

Back 71

-aspiration pneumonia
-bronchopneumonia

Front 72

Interstitial-structured
-causes

Back 72

-mycotic

-often occurs with lymphadenopathy

Front 73

Interstitial pneumonia
-origin

Back 73

-bloodstream

Front 74

Pattern associated with a secondary bacterial infection

Back 74

-mixed interstitial-alveolar pattern typical of bronchopneumonia

Front 75

Causes of aspiration pneumonia

Back 75

-megaesophagus
-recumbency in anesthetized patients
-vomition

Front 76

Causes of bronchopneumonia

Back 76

Bacterial pneumonia via airway origin secondary to:
-aspiration
-viral pneumonia
-foreign body inhalation
-decreased immune function

Front 77

Alveolar pneumonia
-clinical vs. radiographic signs

Back 77

-radiographic signs may lag behind clinical signs

Front 78

Higher bacterial pneumonia
-causes

Back 78

-Nocardia
-Actinobacillus

Front 79

Higher bacterial pneumonia
-lesions

Back 79

-mutiple granulomas and abscesses
-lymphadenopathy
-pleural effusion

Front 80

Patterns of Neoplasia

Back 80

-Solitary mass
-Multiple nodules
-Interstitial, Non-structured

Front 81

Primary pulmonary neoplasia
-rare in

Back 81

-domestic animals

Front 82

Primary pulmonary neoplasia
-usually is a

Back 82

-bronchiolar carcinoma

Front 83

Primary neoplasia
-morphology

Back 83

-solitary mass
-multicentric nodules

Front 84

Primary neoplasia
-most common lung lobes affected

Back 84

-caudal lung lobes

Front 85

Metastatic neoplasia
-morphology

Back 85

-multiple large nodules
- > 10mm

-can occasionally appear as miliary

Front 86

Classify the condition
-why

Back 86

-primary pulmonary neoplasia

-well circumscribed, opaque nodule

Front 87

Classify the condition
-why

Back 87

-osteosarcoma

-multiple, diffuse soft tissue nodules

Front 88

Pulmonary edema
-defintion

Back 88

-abnormal accumulation of fluid in the alveoli and interstitium of the lung

Front 89

Pulmonary edema
-types

Back 89

-cardiogenic
-non-cardiogenic

Front 90

Cardiogenic edema in dogs
-radiographic morphology

Back 90

-starts as a mixed interstitial alveolar patter in the perihilar region then diffuses

-No typical pattern in cats

Front 91

Classify the condition
-why

Back 91

-Cardiogenic edema

-Backpack sign on the heart
-increased opacity in the lungs

Front 92

Noncardiogenic edema
-radiographic morphology

Back 92

-interstitial to alveolar
-symmetrical
-caudodorsal

Front 93

Classify the condition
-why

Back 93

-Noncardiogenic edema

-caudodorsal distribution

Front 94

Hemorrhage/Pulmonary Contusion
-radiographic morphology

Back 94

-asymmetric
-no specific location
-mixed interstitial to alveolar pattern
-changes rapidly over time

Front 95

Lower airway disease
-when are the radiographs normal

Back 95

-acute tracheobronchitis (kennel cough)
-acute allergic airway disease (feline asthma)

Front 96

Lower airway disease
-radiographic morphology from chronic bronchitis

Back 96

-mineralization of bronchial walls
-increased thickness of bronchial walls with luminal narrowing
or
-increased luminal size (bronchiectasis)

Front 97

Calcified Pulmonary Lesions
-small nodules (<3 mm)

Back 97

-usually incidental findings
-hypertropic bone
-osseous metaplasia
-microlithiasis
-pulmonary osteomata/osteoma

Front 98

Calcified pulmonary lesions
-large nodules (>3 mm)

Back 98

-mineralized granulomas
-metastasis from osteosarcoma
-primary lung tumor

Front 99

Calcified pulmonary lesions
-Causes of diffuse mineralization

Back 99

-hyperadrenocorticism
-hyperparathyroidism
-chronic uremia
-idiopathic