radpatho

Ventilation

involves the movement of air in an out of the lungs

Diffusion

relates to the gas exchange between the lungs and the circulatory system.

consists of the right and left pleura cavities and the mediastinum.

additive

are harder than normal to penetrate

subtractive (destructive)

they are easier than normal to penetrate.

erect posteroanterior (PA) and left lateral

The standard projections for chest radiography

Mediastinal emphysema

occurs when there has been a disruption in the esophagus or airway and air is trapped in the mediastinum. It may result from chest trauma, endoscopy, or violent vomiting.

subcutaneous emphysema.

When the pneumomediastinum is extensive, air may pass from the mediastinum into the subcutaneous tissues of the chest or neck,

endotracheal (ET) tube

a large plastic tube inserted through the patient’s nose or mouth into the trachea.

chest tube

a large plastic tube inserted through the chest wall between the ribs.

Central venous pressure (CVP) lines

are usually inserted via the subclavian vein, but they may also be placed through the jugular vein, antecubital vein, or femoral vein.

pulmonary artery catheter (Swan-Ganz catheter)

usually inserted via the subclavian vein, but other injection sites include the antecubital vein, jugular vein, and femoral vein.

Hickman catheters

open to the outside of the body with the tip of the catheter placed in the SVC.

Port access devices

are placed under the skin, just below the clavicle. Because these devices are not open to the outside, a port access device is less likely to become infected and requires little maintenance.

intraaortic balloon pump (IABP) catheter

a specialized device typically inserted in surgery or percutaneously at the bedside in critical care units. A 40-mL balloon at the distal end of the catheter allows inflation and deflation by a pump that is synchronized to the patient’s cardiac cycle to provide mechanical support of the left ventricle.

Ventricular pacing electrodes

may be placed for temporary or permanent purposes. Temporary pacing electrodes are inserted via the antecubital vein into the right ventricle.

Cystic Fibrosis (mucoviscidosis)

• Genetic Defect

• Affects the function of the exocrine glands

• Most common inherited disease in the respiratory system

Barrel-chest deformity

clubbing of fingers, and cyanosis occur as the disease progresses.

hyaline membrane disease

• also known as respiratory distress syndrome (RDS)

• affects infants and is a disorder of premature infants or those born at less than a 37-week gestation

Croup

• Primarily a viral infection of young children that produces inflammatory obstructive swelling localized to the subglottic portion of the trachea

• edema causes inspiratory Stridor or Barking cough

Epiglottitis

• Acute infection of the epiglottis commonly caused by Haemophilus influenza in children

• Hospitalization may be required to monitor the patient

• Intubation may be necessary to restore normal respiration

Pneumonia

• Most frequent type of lung infection

• resulting in an inflammation of the lung (pneumonitis)

• compromised pulmonary function

Pneumococcal (lobar) pneumonia

• Most common bacterial pneumonia

• Bacteria is often present in healthy throats.

• When the body defenses are weakened, the bacteria multiply, work their way into the lungs, and inflame the alveoli without affecting the bronchi.

• Usually accompanied by chills, cough, and fever.

Bronchopneumonia

• This type of pneumonia is caused by a bacterial infection that originates in the airway and spreads out to the alveoli.

• Inflammation and subsequent patchy consolidation of one or more secondary lobules of a lung in response to bacterial pneumonia.

Staphylococcal pneumonia

• Occurs sporadically except during epidemics of influenza, when secondary infection with staphylococci is common.

• A pneumatocele (a thin-walled, air-containing cyst) is the characteristic radiographic lesion and is more typically seen in children. These may enlarge and form abscesses in the later stages of the disease.

Legionnaires’ disease

• Is the name given to a severe bacterial pneumonia that became known after it caused the deaths of four people attending an American Legion convention in Philadelphia in 1976.

• The causative bacterium (L. pneumophila) thrives in warm, moist places and may be transmitted through heating and cooling systems.

Mycoplasma pneumonia

• Is caused by mycoplasmas, the smallest group of living organisms. They have characteristics of both bacteria and viruses.

• Mycoplasma pneumonia is most common among older children and young adults.

Aspiration (chemical) pneumonia

• Is caused by acid vomitus aspirated into the lower respiratory tract, resulting in a chemical pneumonitis.

• It may follow anesthesia, alcoholic intoxication, or stroke that causes loss of the cough reflex.

Viral (interstitial) pneumonia

• Is caused by various viruses, most commonly influenza virus A and B.

• It is more common than bacterial pneumonia but less severe.

• Inflammatory process predominantly involves the walls and lining of alveoli and interstitial supporting structures of the lung, the alveoli septa

Anthrax

Caused by sporelike microbes – bacillus antrhacis

 Inhalation of the microbe can induce production of toxins

 Toxins cause cellular edema and disruption of normal cell function

 Early signs are similar with that of influenza

 Progression may cause labored breathing, shock, or even death

Lung Abscess

• A necrotic area of pulmonary parenchyma containing puslike materials

• Most common cause is aspiration

• Frequently occurs in the right lung because the right main bronchus is more vertical and larger in diameter than the left

Bronchiectasis

• Permanent, abnormal dilatation of one or more large bronchi as a result of destruction of the elastic and muscular components of the bronchial wall

• Pathogenesis: Congenital or acquired weakness

• Most common symptom is a chronic cough; may be asymptomatic

Pulmonary Tuberculosis

• An infection caused by inhalation of Mycobacterium tuberculosis

• M. tuberculosis - captured by macrophages within the alveoli but are not killed

• Eventually result in necrosis, fibrous scarring, and calcifications

Primary TB

• This refers to the initial attack of TB and it does not cause noticeable symptoms in the early stages.

• Victim is not contagious at this point

• Immune system will take the mycobacteria to lymph nodes where it will be neutralized

Secondary or Reinfection TB

• The proliferation of dormant mycobacteria within the tubercles marks the onset of secondary TB

• Large scars and cavitation will form within the lungs as the body struggles to once again contain the infection.

Miliary or Hematogenous TB

• The mycobacteria can enter the circulatory system by eroding the pulmonary vein

• If this occurs, it can seed in such organs as the liver and spleen through the systemic circulation.

• Since it is now bloodborne, the bacteria may enter the blood flow to the lung and produce innumerable fine densities uniformly distributed in both lungs.

Multi-drug Resistant TB

• This is a type of TB that is resistant to two or more of the medications used to combat TB.

• This type of TB is often found in HIV positive patients and is due to their already compromised immune system.

• It can also occur when patients do not take their prescriptions properly.

TB Treatment: Plumbage

• Prior to the discovery of isoniazid, early methods to treat patients with TB relied heavily upon rest and isolation in sanatoriums.

• A common treatment was to collapse the lung in order to allow it to “rest.”

TB Treatment: Thoracoplasty

• This technique involved removing some of the ribs from the chest wall in order to cause the upper lobe of the lung to collapse.

• Ideally, a total of 7 to 8 ribs would be removed.

• Physicians generally would only remove 2 or 3 at a time and as a result, the patient would have to endure several surgeries.

Histoplasmosis

• This condition occurs as the result of inhaling soil and/or bat/bird droppings that have been infected with a fungus called Histoplasma capsulatum.

• It has a similar radiographic appearance to TB.

• Most cases of histoplasmosis are self limiting but in some extreme cases, anti-fungal medications may be indicated

Chronic Obstructive Pulmonary Disease

• Is a term used to describe two lung diseases, chronic bronchitis and emphysema

• These two diseases tend to coexist.

• They also both pertain to an obstruction of the normal flow of air within the lungs.

• As a result, physicians collectively refer to them as COPD.

• Smoking is the primary risk factor for COPD.

• Up to 90% of COPD related deaths are related to smoking.

Emphysema

• a type of COPD that is characterized by a chronic destruction of bronchi and alveoli.

• The destruction and rupture of the alveolar walls will lead to the formation of large pockets of empty space within the lungs called bulla.

• The net result is a decrease in air flow, hyperaeration (barrel chest), and dyspnea.

Chronic obstructive bronchitis

Arises from long-term, heavy cigarette smoking or prolonged exposure to high levels of industrial air pollution.

Pneumoconioses

• This is an occupational disease where dust or particulate matter is inhaled.

• This causes the formation of pulmonary fibrosis.

Silicosis

is caused by inhaling silicon dioxide (sand).

Asbestosis

occurs as the result of inhaling asbestos dust.

Pulmonary Embolus (PE)

• are often caused by blood clots that break off from veins in the legs.

• These clots form emboli that can obstruct the lumen of the pulmonary arteries.

Lung Cancer

• represents approximately 35% of all cancer deaths and it is

• the most common cause of death in both men and women.

• The average onset is age 60.

Bronchogenic Carcinoma

This is a primary lung cancer that arises from the respiratory epithelium.

Pulmonary Metastasis

is much more common than primary lung cancer.

It primarily occurs via the lymphatic system or the circulatory system.

Pulmonary Edema

occurs when air within the lungs is replaced with fluid.

It leads to a decrease in gas exchange and may cause respiratory failure.

It often occurs secondary to congestive heart failure (CHF) or renal failure.

Atelectasis

refers to a condition where either a portion of or the entire lung has collapsed and is without air.

Pneumothorax

• a condition occurs when air is introduced into the pleural space.

• The net result of this phenomena is a collapsed lung.

Subcutaneous Emphysema

Air escaping the patients lungs following a traumatic pneumothorax may enter the patients surrounding tissues.

This condition is know as subcutaneous emphysema and if palpated, it will make a very distinct crackling or popping noise that is referred to as crepitation.

This air is eventually absorbed by the body

Pleural Effusion/Hydrothorax

Excess fluid that accumulates within the pleural space is known as a pleural effusion.

It can be caused by a myriad of conditions such as congestive heart failure (CHF) or pulmonary emboli.

Pleurisy

• Inflammation of the pleura

• Often indicative of a serious condition such as pneumonia, pulmonary embolism, TB, or malignant disease.

• Pain is usually distributed to one side or the other and along the intercostal nerve roots.

Sinusitis

The communication with the nasal cavities that subjects the paranasal sinuses to infection and inflammation