Imaging of the soft tissues Week 3

What are the patient instructions for evaluating the cardiac shadow?

Full inspiratory effort

What is the normal cardiothroacic ratio?

Heart : Thorax - 1 : 2

What can cause an enlarged cardiac silhouette?

Cardiomegaly

Pericardial effusion

Anterior mediastinal mass

Expiratory radiograph

T or F: Epicardial fat fades are an abnormal, pathological finding

False (normal)

What conditions can cause excess deposits in the pericardial fat pad?

Cardiovascular disease

Diabetes

What is the Catch-all term for heart enlargement?

Cardiomegaly

What can cause cardiomegaly?

Congestive heart failure

Hypertension

Valve disease

Cardiomyopathy

Congenital heart disease

Pulmonary disease

Myocarditis

Systemic disease

What is the term for fluid in the pericardial sac?

Pericardial effusion

What are the symptoms of pericardial effusion?

Dyspnea

Reduced exercise tolerance (early)

What are the ddxs of pericardial effusion?

Inflammatory disease

Infection

Post-surgical

Traumatic

Pulmonary

Hypertension

Malignancy

Endocrine dysfunction (hypothyroidism)

What nerve innervates the diaphragm?

Phrenic nerve

What is the diaphragm attached to?

Chest wall and spine

What level is the diaphragm found at with full inspiration?

Rib 9-10 interspace

Which muscle is known as the "umbrella muscle"

Diaphragm (flattens when it contracts, domes when it relaxes)

Which side of the diaphragm should be higher?

Right

What is the term for abnormality of the contour of the diaphragm?

Enventration

What are the potential causes of diaphragm elevation?

Enventration

Phrenic nerve palsy

Lung disease (masses, collapse, scarring)

hepatomegaly/splenomegaly

Abdominal mass

What is the term for the Gutter via attachment of diaphragm to chest wall?

Costophrenic angles

What is the normal shape of the costophrenic angles?

Deep "V" Contour

Which costophrenic angles should be adressed on radiograph?

Lateral and Posterior

Which costophrenic angles are most sensitive to pleural effusion?

Posterior

What is the term for accumulation of fluid in the pleural space?

Pleural effusion

What shape is the diaphragm with pleural effusion?

Meniscus shape

What volume of fluid must accumulate in the pleural space to cause meniscus sign on x-ray?

250-600 mL

What is the term for transudate/exudate in the pleural space?

Hydrothorax

What is the term for blood in the pleural space?

Hemothorax

What is the term for lymphatic fluid in the pleural space?

Chylothorax