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99 Cards in this Set

  • Front
  • Back
When are exposures for pulmonary radiographs made?
-inspiration
Why is anesthesia contraindicated for pulmonary radiology?
-how can this be corrected for?
-the lungs are poorly aerated (atelectasis)

-can be corrected for by bagging the animal and providing positive pressure aeration
What are the usual radiographic views for a thorax?
-lateral
-VD
What are the radiographic views of the thorax if a metastatic disease is the concern?
-left lateral
-right lateral
-VD
Radiographic view that is best for visualization of the caudal lobar arteries?
-DV
Thoracic radiograph borders
-thoracic inlet to beyond the diaphragm
Number of lung lobes in the dog/cat
-6

-4 right
-2 left
Most cranial lung lobe
-left cranial
Where should pulmonary vessels be clearly visible?
-perihilar
-middle lung
Pneumonic for location of pulmonary arteries and veins
-arteries are up and away
-veins are ventral and central
Radiographic view best for visualizing cranial lobar vessels
-lateral view
How should the lobar vessels (cranial and caudal) be evaluated for size?
Compare to width of ribs:
-Cranial lobar = 4th rib
-Caudal lobar = 9th rib
Normal geriatric change to bronchial walls
-mineralization
Lung lobe that does not extend dorsally past the carina
-right middle
Normal location of the dorsal margin of the accessory lung lobe
-between the aorta and caudal vena cava
Proper exposure for lung assessment
-slightly underexposed to examine existing vertebrae
Structures that can cause artifact on thoracic cavity radiographs
-scapula
-skin folds
-costochondral mineralization
-nipples
-subcutaneous fat
Radiographic view to minimize summation of the scapulae on VD
-humanoid view
How can you tell if an artifact is a skin fold?
-ventral location
-extends beyond the boundary of the thoracic cavity
How to assess pulmonary fields
-opacity (normal, decreased, increased)
-distribution (diffuse, localized)
-location (which lung lobes/portions of lung lobes)
-pattern (bronchial, interstitial, alveolar, vescular)
Abnormal Pulmonary opacity
-general patterns
-interstitial
-alveolar
-bronchial
-vascular
Interstitial pattern
-types
-unstructured
-structured
Unstructured interstitial pattern
-morphology
-hazy
-no apparent form
Structured interstitial pattern
-morphology
-nodules
Interstitial pattern
-causes
-fluid
-cells
-fibrosis
Interstitial pattern
-general morphology
-increase in background opacity
-vessels visualized because airways remain aerated
Classify the pulmonary pattern
Classify the pulmonary pattern
-unstructured interstitial
Classify the condition
Classify the condition
-metastatic neoplasia
Classify the pulmonary pattern
Classify the pulmonary pattern
-miliary
-due to histoplasmosis (fungal disease)
Masses vs. Miliary Pattern
-masses: > 3 cm in diameter
-miliary: < 2 cm in diameter
Classify the condition
Classify the condition
-hemangiosarcoma

-overlap of fungal and metastasis
Unstructured interstitial patterns
-causes
Spread from vessels/lymphatics:
-interstitial fibrosis
-interstitial pneumonia
-interstitial edema
-interstitial hemorrhage
-some neoplasia
Nodular interstitial patterns
-causes
Conditions that could lead to cellular aggregations:
-metastatic neoplasia
-mycotic granulomas
-abscesses
-ossifying metaplasia
Nodular interstitial pattern
-look a likes
-end on vessels
-pulmonary osteomata
-costochondral junctions
-subcutaneous nodules
End on vessels
-largest where?
-smallest where?
-largest: perihilar
-smallest: middle lung zone
-not visible: peripheral 1/3
-Structures seen here
-how can you tell
-Structures seen here
-how can you tell
-end on vessels
-sitting over linear vessels
Unstructured interstitial patterns
-look a likes
-underexposed radiograph
-expiratory radiograph
-partial atelectasis
Cavitary lesion differentials
-neoplasia
-granuloma
-parasites
-abscess
-bulla
-cyst
-bronchiectasis
Cavitary lesion differentials with thick, irregular walls
-neoplasia
-granuloma
-parasites
-abscess
-bronchiectasis
Cavitary lesion differentials with thin walls
-bulla
-cyst
Classify the Lesion
Classify the Lesion
-cavitary pulmonary carcinoma
Alveolar pattern
-radiographic morphology
-fluffy to solid opacity due to fluid/cells filling alveolar spaces
-more opaque than interstitial pattern
Nodular Interstitial Pattern vs. Patchy Alveolar Pattern
-nodular interstitial: opacities appear relatively circumscribed

-patchy alveolar: opacities with fluffy, cotton ball appearance
Alveolar pattern
-radiographic appearance of pulmonary vessels
-border effaced
-no longer visible because the air-filled lung is no longer surrounding vessels
Air bronchograms
-definition
-air-filled airways surrounded by opacified alveolar tissue
-indicate alveolar pattern
-not always present with alveolar disease
Lobar sign
-definition
-distinct line between normal and abnormal lung
Alveolar pattern
-causes
-cardiogenic/noncardiogenic edema
-hemorrhage
-contusion
-bacterial pneumonia
-thromboembolic disease and infarcts
-atelectasis of the lung
-occasional neoplasia
What are the arrows pointing to?
What are the arrows pointing to?
-lobar sign
Reasons why Arteries > Veins
-heartworm
-pulmonary hypertension
Reasons why Veins > Arteries
-CHF
Reasons why Arteries and Veins are both enlarged
-fluid overload
-left to right cardiac shunt (PDA, VSD, ASD)
-disease combination
How to know if a pulmonary vessel is distended
-4th rib on lateral
-9th rib on VD
Vascular pattern
-look a likes
-underexposed
-expiratory radiograph
What are the arrows pointing to?
What disease is this indicative of?
What are the arrows pointing to?
What disease is this indicative of?
-large tortuous caudal lobar arteries

-indicative of: Heartworm disease
What are the arrows pointing to?
What disease is this indicative of?
What are the arrows pointing to?
What disease is this indicative of?
-Venous congestion

-indicative of: cardiogenic edema; hypertrophic cardiomyopathy
Hypoperfused Vascular Pattern
-radiographic morphology
-small vessels
-small cardiac silhouette
-radiolucent lung fields
Hypoperfused Vascular Pattern
-causes
-dehydration
-hypovolemic shock
-hypoadrenocorticism (Addisons)
-pulmonic stenosis
-right to left shunt
Hypoperfused Vascular Pattern
-look a likes
-overexposed radiograph
-over-inflated lungs
-deep chested dogs
Classify the Condition
-why
Classify the Condition
-why
-Pulmonic stenosis

-enlarged pulmonary a.
-D-shaped heart
Location where bronchial walls are usually only visible
-close to the hilus
Bronchial pattern
-definition
-increased prominence of bronchial walls at middle and peripheral lung fields to to increased opacity and thickness
How does a bronchial pattern appear on a radiograph?
-either a track or a train
Bronchiectasis
-definition
-bronchial dilation and loss of normal tapering
Bronchial pattern
-causes
-mucosal thickening
-debris in lumen
-hyperplasia of glandular tissue
-hypertrophy of smooth muscle
-peribronchial infiltration by fluid or cells
Bronchial vs. Peribronchial disease
-Bronchial: increased opacity and thickness of the bronchial walls

-Peribronchial: larger lumen diameter in comparison to vessel diameter
Mineralization of bronchial walls
-due to
-chronic inflammation
-geriatric change
Describe the pattern
Describe the pattern
-Bronchial pattern
Why does this depict bronchiectasis?
Why does this depict bronchiectasis?
-bronchus is not tapering
Patterns of Pneumonia
-Interstitial-non-structured
-Alveolar
-Interstitial-structured
Interstitial-non-structured pneumonia
-causes
-viral
-bacterial
Alveolar pneumonia
-causes
-aspiration pneumonia
-bronchopneumonia
Interstitial-structured
-causes
-mycotic

-often occurs with lymphadenopathy
Interstitial pneumonia
-origin
-bloodstream
Pattern associated with a secondary bacterial infection
-mixed interstitial-alveolar pattern typical of bronchopneumonia
Causes of aspiration pneumonia
-megaesophagus
-recumbency in anesthetized patients
-vomition
Causes of bronchopneumonia
Bacterial pneumonia via airway origin secondary to:
-aspiration
-viral pneumonia
-foreign body inhalation
-decreased immune function
Alveolar pneumonia
-clinical vs. radiographic signs
-radiographic signs may lag behind clinical signs
Higher bacterial pneumonia
-causes
-Nocardia
-Actinobacillus
Higher bacterial pneumonia
-lesions
-mutiple granulomas and abscesses
-lymphadenopathy
-pleural effusion
Patterns of Neoplasia
-Solitary mass
-Multiple nodules
-Interstitial, Non-structured
Primary pulmonary neoplasia
-rare in
-domestic animals
Primary pulmonary neoplasia
-usually is a
-bronchiolar carcinoma
Primary neoplasia
-morphology
-solitary mass
-multicentric nodules
Primary neoplasia
-most common lung lobes affected
-caudal lung lobes
Metastatic neoplasia
-morphology
-multiple large nodules
- > 10mm

-can occasionally appear as miliary
Classify the condition
-why
Classify the condition
-why
-primary pulmonary neoplasia

-well circumscribed, opaque nodule
Classify the condition
-why
Classify the condition
-why
-osteosarcoma

-multiple, diffuse soft tissue nodules
Pulmonary edema
-defintion
-abnormal accumulation of fluid in the alveoli and interstitium of the lung
Pulmonary edema
-types
-cardiogenic
-non-cardiogenic
Cardiogenic edema in dogs
-radiographic morphology
-starts as a mixed interstitial alveolar patter in the perihilar region then diffuses

-No typical pattern in cats
Classify the condition
-why
Classify the condition
-why
-Cardiogenic edema

-Backpack sign on the heart
-increased opacity in the lungs
Noncardiogenic edema
-radiographic morphology
-interstitial to alveolar
-symmetrical
-caudodorsal
Classify the condition
-why
Classify the condition
-why
-Noncardiogenic edema

-caudodorsal distribution
Hemorrhage/Pulmonary Contusion
-radiographic morphology
-asymmetric
-no specific location
-mixed interstitial to alveolar pattern
-changes rapidly over time
Lower airway disease
-when are the radiographs normal
-acute tracheobronchitis (kennel cough)
-acute allergic airway disease (feline asthma)
Lower airway disease
-radiographic morphology from chronic bronchitis
-mineralization of bronchial walls
-increased thickness of bronchial walls with luminal narrowing
or
-increased luminal size (bronchiectasis)
Calcified Pulmonary Lesions
-small nodules (<3 mm)
-usually incidental findings
-hypertropic bone
-osseous metaplasia
-microlithiasis
-pulmonary osteomata/osteoma
Calcified pulmonary lesions
-large nodules (>3 mm)
-mineralized granulomas
-metastasis from osteosarcoma
-primary lung tumor
Calcified pulmonary lesions
-Causes of diffuse mineralization
-hyperadrenocorticism
-hyperparathyroidism
-chronic uremia
-idiopathic