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Pulmo Defn & Imaging


Rapid, deep labored breathing Kussmaul breathing – DKA, Metabolic acidosis
Deep breathing alternating w/ apnea Cheyne-Stokes breathing – heart failure, brain damage
Cavitations, patchy infiltrates on CXR Infections – lung abscess, TB (Gohn focus)
Pleural thickening on CXR Mesothelioma
Hilar mass on CXR Lung Ca
Eggshell pattern on CXR Silicosis (Sandblasters)
Ground glass appearance on CXR Asbestosis (shipbuilders, building demolition)
CXR: reticular-nodular pattern, diffuse rounded opacities; Upper lung zones are primarily affected Coal Miner’s lung
Patchy fibrosis on CXR Farmers lung
Pediatric wheezing lower respiratory FB, asthma
Thumbprint sign Epiglottitis
Steeple sign FB, viral croup (laryngotracheobronchitis)
Inspiratory stridor FB, viral croup (laryngotracheobronchitis)
Premature infant with respiratory distress Hyaline Mb Disease
CXR of premature infant w/ hypoexpansion (ATX), air bronchograms: Hyaline Mb Disease
Smoker, chronic productive cough. NO hemoptysis, weight loss = Bronchitis (COPD)
Smoker, DOE, cough = COPD
Hyperinflation on CXR, tear drop heart Emphysema
Wheezing, prolonged expiration Asthma
Airway edema with eosinophils, neutrophils, lymphocytes Asthma
Pediatric with Hx of recurrent lung infections, pancreatitis, reproductive problems, FTT = Cystic fibrosis (Staph & Pseudomonal infections usually cause of death)
< 2 days post-op with fever = Atelectasis
Stab wound, hyperresonance to percussion, decreased breath sounds, tympany = Pneumothorax
Stab wound, dullness to percussion, decreased breath sounds = Hemothorax
Tall, skinny, male, band student, acute onset one-sided chest pain, dyspnea = Spontaneous PTX
Stab wound to chest. Hypotension, tracheal shift = Tension PTX
Poor sleeping, obese, daytime fatigue & drowsy, snoring, HTN, PM wakening Obstructive sleep apnea
s/p thoracic trauma. Multiple rib fractures. Chest wall moves in with inspiration, out with expiration. Flail chest (pain control, incentive spirometry, pulmonary toilet, intubation)
Irreversible dilation of bronchi resulting from damage of airway wall: bronchiectasis; usuallu 2/2 repeat infxn; dz of airways (not parenchyma)
ARDS on CXR = bilateral widespread pulmonary infiltrates
CXR: infiltrates in mid or lower lung fields, hilar adenopathy, cavitation = tuberculosis
CXR with upper lobe infiltrates, esp apical / posterior segments, cavitation common = reactivated TB
Saddle Nose deformity = Wegener’s Granulomatosis
A change in structure and function of the right ventricle of the heart as a result of a respiratory disorder = cor pulmonale
In Pulmonary HTN, mean pulmonary pressure is __ at rest >25 mmHg
Patients with pulmonary hypertension also have: low cardiac output
The most common secondary cause of pulmonary hypertension = connective tissue disease (scleroderma)
This should be performed in all patients suspected of pulmonary hypertension: right ventricular catheterization
Median survival after diagnosis of pulmonary hypertension = 3 years
ARDS on CXR = bilateral widespread pulmonary infiltrates
On CXR: infiltrates in mid or lower lung fields, hilar adenopathy, cavitation = tuberculosis
CXR with upper lobe infiltrates (especially apical & posterior segments); cavitation common = reactivated TB
Viral pneumonia on CXR = diffuse interstitial infiltrates & hyperinflation
Mycoplasma pneumoniae on CXR = interstitial or bronchopneumonic infiltrates, frequently in the middle or lower lobes
Hampton's hump on CXR = shallow wedge-shaped opacity in lung periphery with its base against pleural surface
Hampton's hump on CXR: Dx = PE
Westermark sx on CXR = oligemia (vasoconstriction) distal to a PE
Deer antler on CXR (large branching opaque mass, usually in L upper abdomen) = PNA 2/2 proteus
PNA on CXR = segmental infiltrates, atelectasis, pleural effusions; possible empyema
Pleura anatomy Visceral (no sensory nerves) covers lungs, parietal (+sensory nerves) outside that & covering inside of chest wall
Decreased breath sounds & tactile fremitus, decreased diaphragmatic excursion on affected side, DTP, egophony = pleural effusion
CXR in chronic bronchitis = increased AP diameter, thickened bronchial markings, large right side of heart
CXR in emphysema = low flat diaphragm, increased retrosternal space, pruning of vascular markings, long narrow heart, bullae
Most sensitive CXR view for smaller pleural effusion: Lateral. PA may miss up to 300mL
ILD on CXR Early: ground-glass appearance; later: nodular, linear, and/or honeycombed appearance
Respiratory failure (hypoxia) on CXR = small "white" lungs, patchy, diffuse infiltrates, signs of consolidation, and/or lobar atelectasis
Respiratory failure (hypercapnia) on CXR = hyperinflation, large "black" lungs, bullae, increased vascular markings (COPD); in NM dz / drug toxicity, may see small black lungs & hypoinflation
Created by: Adam Barnard Adam Barnard