Lecture 5 - Thoracic and Skull Radiographs

What are some common diseases/problems that would warrent the need for a thoracic radiograph?

Metastasis, pulmonary edema, enlarged heart, asthma

What anatomic features are visible in a thoracic radiograph?

Heart, caudal vena cava, aorta, trachea

Where do you measure an animal for a thoracic radiograph?

The thickest portion, usually T13

What are some indications that a thoracic radiograph may be required?

Coughing, dyspnea, metastasis check trauma, exercise intolerance

Of the right and left lateral thoracic radiograph views, which provides better cardiac detail?

Right lateral

1 multiple choice option

Of DV and VD thoracic radiograph views, which provides better lung diagnostics?

VD

1 multiple choice option

Should a thoracic radiograph be taken on peak inspiration or expiration?

Inspiration

1 multiple choice option

What are the borders of taking a lateral thoracic radiograph?

Cranial: thoracic inlet,

Caudal: L1,

Center: caudal aspect of the scapula,

V/D: ~1in past edge of patient

How should the patient's limbs be manipulated to perform a thoracic radiograph?

Frotn limbs pulled out cranially and hind limbs pulled out caudally

Of the right and left lateral thoracic radiograph views, in which does the heart appear round?

Left lateral

1 multiple choice option

What are the borders of taking a VD thoracic radiograph?

Cranial: thoracic inlet,

Caudal: L1,

Center: caudal aspect of the scapula,

Lateral: ~1in past edge of patient

What are the borders of taking a DV thoracic radiograph?

Cranial: thoracic inlet,

Caudal: L1,

Center: caudal aspect of the scapula,

Lateral: ~1in past edge of patient

In which thoracic radiograph view can you see the "Mickey Mouse ears" of the diaphragm?

VD

Which thoracic radiograph view provides the best view to evaluate the lungs?

VD

Which thoracic radiograph view provides the best view to evaluate the cardiac silhouette and caudal pulmonary vessels?

DV

What is the vertebral heart score (VHS)?

The sum of the heart's long and short axes, sclaed against the length of the vertebrae behind the heart

True or False: the vertebral heart score (VHS) varies significantly between breeds

True

1 multiple choice option

What disease was the vertebral heart score (VHS) established to objectively diagnose?

Cardiomegaly

What is pneumothorax?

Gas in the pleural space

What are the clinical signs of pneumothorax?

Dyspnea, increased resp. rate, chest pain, and lung collapse

What are the three types of pneumothorax?

Traumatic, iatrogenic, and spontaneous

What is pleural effusion?

An abnormal accumulation of fluid in the chest cavity

What are some causes of pleural effusion?

Pyothorax (pus in the lungs), chylothorax (edemedous fluid in the lungs), heart failure, cancer, and more

What does pleural effusion look like on an xray?

Scalloping (wavy or undulating margins)

What are some indications that a skull xray may be required?

Head injury, trauma, tumours

What are the borders for a lateral skull radiograph?

Rostral: tip of the nose,

Caudal: C1,

Center: lateral canthus of the eye (breed specific tho)

Where do you measure a patient before doing a skull radiograph?

Zygomatic arch

What is a lateral skull radiograph good for assessing?

Nasal cavity, frontal sinus, and frontal bones

How would you manipulate a patient's limbs to get a lateral skull radiograph?

Pull front limbs caudally, leave hind limbs natural

What is a lateral oblique skull radiograph good for assessing?

Tumours and chronic ear infections

What are the borders of a lateral oblique skull radiograph?

Rostral: tip of the nose,

Caudal: C1,

Center: lateral canthus of the eye (breed specific tho)

What is a VD skull radiograph best for assessing?

Nasal passages

What are the borders of a VD skull radiograph?

Rostral: tip of the nose,

Caudal: C1,

Center: halfway between borders (patient specific)

What tools would you use to restraint a patient for a VD skull radiograph?

Tape to hold the mandible in place, a v-trough to keep the patient straight

What is a DV skull radiograph best for assessing?

Ear canals, middle ear, and temporal-mandibular joint

What are the borders of a DV skull radiograph?

Rostral: tip of the nose,

Caudal: C1,

Center: halfway between borders (patient specific)

What is a rostrocaudal foramen magnum skull radiograph view best for assessing?

Skull fractures

What are the borders of a rostrocaudal foramen magnum skull radiograph?

Rostral: tip of the nose,

Caudal: occiptal protuberance,

Center: between the eyes

What is a rostrocaudal frontal sinus skull radiograph used to assess?

Chronic sinusitis

What are the borders of a rostrocaudal frontal sinus skull radiograph?

Rostral: tip of the nose,

Caudal: occipital crest,

Center: between the eyes

What is a rostrocaudal open-mouth skull radiograph used to assess?

Tympanic bulla, looking for polyps, fluid in ear, tomours, or boney changes

Where is the beam center of a rostrocaudal open-moputh radiograph?

Commissure of the mouth

What species is more likely to require a closed mouth tympanic bulla skull radiograph?

Cats - their bulla is more caudal

3 multiple choice options

What are the borders of a closed mouth tympanic bulla skull radiograph?

Rostral: tip of the nose,

Caudal: occipital crest,

Center: commissure of the mouth

Where do you measure a patient for a closed mouth tympanic bulla skull radiograph?

Over the nasal sinuses, lateral canthus to caudal aspect of the skull