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Endotracheal Tube- 5-7 cm above the carina. - Finely granular appearance of Central Venous Catheter- device inserted into pulmonary parenchyma. a large, central vein (internal jugular, subclavian, - Peripherally extending air bronchogram femora...

Endotracheal Tube- 5-7 cm above the carina. - Finely granular appearance of Central Venous Catheter- device inserted into pulmonary parenchyma. a large, central vein (internal jugular, subclavian, - Peripherally extending air bronchogram femoral).-administer medications, provide develops because small airways dilate nutrition, conduct medical tests. and stand out against atelectasis. Tip of catheter- superior vena cava. Surfactants- mixture of lipids, proteins, and Swan-Ganz Catheterization- right heart carbohydrates, creates high surface tension, catheterization or pulmonary artery requires less force to inflate, and maintain the catheterization; right side of heart and arteries to alveoli. (Post-Surfactant; 7 hours) lungs. -monitor heart and blood flow. Alveolar cell walls- produce lipoprotein- Right or left main pulmonary vein. maintains the surface tension within the alveoli. Transvenous Endocardiac Pacing- method for maintaining cardiac rhythm with heart block or INFLAMMATORY DISORDERS OF brady arrhythmias.; pacemakers and automatic RESPIRATORY SYSTEM implantable cardioverter - defibrillators 1. Croup- viral infection of young children (AICD/ICD). that produces inflammatory obstructive Tip of pacemaker- apex of the right swelling localized to the subglottic ventricle. portion of the trachea. Lung Abnormal Appearance Edema causes inspiratory stridor or barking Reticular Densities cough, depending on the degree of laryngeal Hazy Densities obstruction. Consolidation or Solidification - Smooth fusiform, tapered narrowing (hourglass shape) of the subglottic CONGENITAL/HEREDITARY DISORDERS airway. 1. Cystic Fibrosis (Mucoviscidosis)- secretion of excessive viscous mucus 2. Epiglottitis- caused by Haemophilus by all exocrine glands. Influenzae in children. - Caused by a defective gene; - Cause; thickening of epiglottic tissue chromosome 7. and the surrounding pharyngeal - Thick mucus (imbalance of sodium, structures. chloride production, and reabsorption) - Incidence decreased since the secreted by mucosa in the trachea and Haemophilus Influenzae type B vaccine. bronchi block the air passages. - Lateral Projection: rounded - Multiple small cysts superimposed thickening of the epiglottic shadow; on diffuse, coarse, reticular pattern. aprrox size- adult’s thumb. - Normal: narrow epiglottic shadow- 2. Hyaline Membrane Disease adult’s little finger. (Idiopathic Respiratory Distress Syndrome IRDS)- common cause of 3. Pneumonia- infection in one or both respiratory distress in newborns. lungs. Primarily premature infants, who have - Causes inflammation in the alveoli. diabetic mothers, and have been - Body filters organisms, keeps the lungs delivered by cesarean section. from becoming infected, but sometimes - Hypoxia and increasing respiratory organisms enter the lungs and cause distress are not immediately evident at inflections. birth but always appear within 6 hours Alveoli are filled with fluid or pus, making it of delivery. difficult to breathe. - Cause; lack of surfactant and immature lungs.  4. Alveolar (air space) Pneumonia- 8. Antrax- serious infectious disease produced by an organism that causes caused by gram-positive, rod-shaped an inflammatory exudate that replaces bacteria known as Bacillus Anthracis. - Naturally in soil and commonly affects air in the alveoli so the affected part of domestic and wild animals. the lung is no longer air containing but - Inhalation anthrax causes mediastinal appears solid or radiopaque. widening and often pleural effusion - Inflammation spreads from one alveolus without infiltrates on a chest image. to the next by communicating channels. Rarely, infiltrates may develop. - May involve pulmonary segments or - Vaccines are highly effective and entire lobe (lobar pneumonia). available for limited use. They are not employed routinely in the United States - Consolidation or Solidification of the because the last known reported lung parenchyma with little or no incidence was 1976 (until the previously involvement of the airways. mentioned 2001 attacks). 5. Bronchopneumonia- typified by 9. Lung Abscess- necrotic area of staphylococcal infection. pulmonary parenchyma containing - Inflammation that originates in the purulent (puslike) material. bronchi or bronchiolar mucosa and - Complication of bacterial pneumonia, spreads to adjacent alveoli. bronchial obstruction, aspiration, foreign - Small patches of consolidation may body, or hematogenous spread of be seen radiographically as organisms to the lungs either in a opacifications. patient with diffuse bacteremia or as a - If consolidation causes obstructed result of septic emboli. airways, atelectasis is evident. - Aspiration, which is the most common cause of lung abscesses. 6. Interstitial Pneumonia- produced by - Common on the right lung. viral and mycoplasmal infections. - Spherical density that characteristically - Inflammatory process predominantly has a dense center with a hazy, involves the walls and lining of the poorly defined periphery. alveoli and the interstitial supporting structures of the lung, the alveoli septa. 10. Tuberculosis- caused by - Linear or reticular pattern. Mycobacterium Tuberculosis. - Seen on end- thickened interstitium- - Rod-shaped bacterium with a protective multiple small nodular densities. waxy coat that permits it to live outside - Left untreated- honeycomb lung/ CT- the body for a long time. cyst like spaces and dense fibrotic - Tuberculosis spreads mainly by droplets walls. in the air, which are produced in huge numbers by the coughing of an infected 7. Aspiration Pneumonia- aspiration of patient. esophageal or gastric contents into the - The organisms may be inhaled from lung can lead to the development of sputum that has dried and turned into pneumonia. dust. - Occurs in patients with esophageal - Tuberculosis may also be acquired by obstruction (tumor, stricture, and drinking the milk of infected cows. achalasia), diverticula (zenker’s), - Mantoux Test. neuromuscular swallowing disturbance. - Multiple alveolar densities, which may 11. Primary Tuberculosis- considered be distributed widely and diffusely disease of children and young adults. throughout both lungs. - Dramatic decrease in the prevalence of Bilateral inhomogeneous patchy airspace tuberculosis. opacities mainly in the lower zones. - Self-limited disease - Combination of a focal parenchymal Effacement of the costophrenic recesses lesion and enlarged hilar or mediastinal consistent with aspiration. lymph nodes.  - Lobar or segmental air-space - Most common; Histoplasmosis and consolidation. Usually homogeneous, Coccidioidomycosis. dense, and well-defined. Histoplasmosis- caused by the fungus - Apical Lordotic Projection. Histoplasma capsulatum, is a common disease - Associated enlargement of hilar or that often produces a radiographic appearance mediastinal lymph nodes is very simulating that of tuberculosis. common. - Pulmonary histoplasmosis frequently “Ghon Lesion” or focus is a granuloma in the manifests as a solitary, sharply lung from a previous tuberculous infection. circumscribed, granulomatous - Abnormality of primary tuberculosis. nodule (histoplasmoma), which is usually less than 3 cm in diameter and 12. Miliary Tuberculosis- dissemination of found most often in a lower lobe. the disease by way of the bloodstream. Central, rounded calcification within - Development produces innumerable fine the mass (the target lesion) is virtually discrete nodules (granulomas) pathognomonic (characteristic) of this distributed uniformly throughout both disease. lungs. Coccidioidomycosis- caused by a fungus, - Fine discrete nodules uniformly Coccidioides immitis, which is found in the throughout both lungs. desert soil of the southwestern United States. - Coccidioidomycosis typically produces 13. Tuberculous Pneumonia- May resolve small pulmonary consolidations in the completely and leave a normal lung. periphery of the parenchyma that However, if necrosis and caseation resemble those in extensive pneumonia. develop, some fibrous scarring occurs. - Calcification may develop within both Chronic Obstructive Pulmonary Disease the parenchymal and the nodal lesions. Bronchitis - Multiple large cavities with air– fluid Emphysema levels in both upper lobes. Asthma Bronchiectasis 14. Secondary (Reactivation) Advanced bronchiectasis Tuberculosis- Reactivation of organisms from previously dormant 1. Chronic Bronchitis- excessive tubercles is termed a secondary lesion tracheobronchial mucus production, or reinfection tuberculosis. leading to the obstruction of small - The tuberculosis bacillus may remain airways. inactive for many years before a - Generalized increase in secondary lesion develops, often bronchovascular markings “dirty because of a decrease in the body’s chest” lower lung. immune defense. - Thickening of bronchial walls and - Affects the upper lobes, especially the peribronchial inflammation “tram lines” apical and posterior segments. or thickening of bronchial shadows. - It is initially seen as a nonspecific, hazy, poorly marginated alveolar 2. Emphysema- distention of distal air infiltrate that often radiates outward spaces as a result of that destruction of from the hilum. alveolar walls and the obstruction of small airways. 15. Tuberculoma- sharply circumscribed The major radiographic signs of emphysema parenchymal nodule, often containing are related to pulmonary overinflation, viable Tuberculosis Bacilli, that can alterations in the pulmonary vasculature, and develop in either primary or secondary bullae formation. disease. Sign seen on lateral chest radiographs is an - Single or multiple pulmonary increase in the size and lucency nodules, usually 1–3 cm in diameter. - The hallmark of pulmonary overinflation is flattening of the domes of the 16. Pulmonary Mycosis- fungal infection of diaphragm. the lungs.  3. Asthma- occurs when the bronchioles to the upper surfaces of the go into spasm, causing decreased diaphragm bilaterally. airflow and sometimes obstruction of the - In the lungs, round or irregular airway. opacities produce a combined linear - During an acute asthmatic attack, and nodular pattern that may obscure bronchial narrowing and difficulty in the heart border, producing the so-called expiration lead to an increased shaggy heart. volume of the hyperlucent lungs with flattening of the hemidiaphragms and 7. Solitary Pulmonary Nodule- an increase in the retrosternal air asymptomatic solitary pulmonary nodule space. seen as an incidental finding on a - Thickening of bronchial walls can screening chest radiograph poses a produce prominence of interstitial diagnostic dilemma. markings and the “dirty chest” - The presence of central dense or appearance. popcorn calcification. 4. Bronchiectasis- permanent abnormal 8. Bronchial Adenoma- Neoplasms of dilation of one or more large bronchi as low-grade malignancy that constitute a result of destruction of the elastic and approximately 1% of all bronchial muscular components of the bronchial neoplasms. wall. - Equally common in men and women. - Coarseness and loss of definition of - Younger age group than bronchogenic interstitial markings caused by carcinoma. peribronchial fibrosis and retained - Approximately 80% of bronchial secretions. adenomas occur centrally in major or - Oval and circular cystic spaces, segmental bronchi and cause which produce a honeycomb-like obstruction. pattern, are best seen in the right upper lobe. 2 Main Types of Lung Cancer 1. Small Cell 5. Silicosis- the most common and best - Small Cell Carcinoma (Oat Cell known work-related lung disease. Cancer) - The inhalation of high concentrations of - Combined Small Cell silicon dioxide (crystalline silica) Carcinoma primarily affects workers engaged in 2. Non-Small Cell mining, foundry work, and sandblasting. - Adenocarcinoma - Multiple nodular shadows scattered - Squamous Cell Carcinoma throughout the lungs. - Large Cell Carcinoma 6. Asbestosis- may develop in improperly 1. Bronchogenic Carcinoma- closely protected workers engaged in linked to smoking and to the inhalation manufacturing asbestos products, in of cancer-causing agents (carcinogens), handling building materials, or in such as air pollution, exhaust gasses, working with insulation composed of and industrial fumes. asbestos. - Major form -solitary pulmonary nodule Asbestos particles occur as long, thin fibers that within the lung parenchyma. cause little dust but produce major fibrosis in the - Most common type of lung cancer is lung. squamous carcinoma, which typically - The radiographic hallmark of asbestosis arises in the major central bronchi and is involvement of the pleura. Initially, causes gradual narrowing of the pleural thickening appears as linear bronchial lumen. plaques of opacification, which are Adenocarcinomas usually arise in the most often along the lower chest wall periphery of the lung rather than in the larger and diaphragm. central bronchi. The least common type of lung - Calcified plaques appear in the form of tumor is bronchiolar (alveolar cell) carcinoma. thin, curvilinear densities conforming  2. Pulmonary Metastases- - Analogy is between the pliable nature of Hematogenous metastases. their bones and the inability to cleanly - Multiple, well circumscribed nodules break a green twig. scattered diffusely throughout. - Easily repaired and most often corrected with a closed reduction. ______________________________________ - Sometimes associated with rickets. Torus Fracture- Latin word tori which refers to A fracture is a discontinuity of bone caused by swelling or protuberance. mechanical forces either applied to the bone or - Impact from a fall on an outstretched transmitted directly along the line of a bone. hand is usually the cause of this fracture. Trauma may injure a bone, resulting in - Commonly occurs in the distal forearm fractures. of young children. - Sometimes referred to as “buckle” Fracture- choice of treatment usually depends fracture. on the classification and severity of the fracture. - Treatment usually consists of a short - For closed and nondisplaced fractures, cast for 3 weeks in order to prevent any the most common treatment is splinting, further injury. casting, or both. Avulsion Fracture- trauma to where a ligament Closed Reduction- requires that a local or or tendon is attached to a bone. general anesthetic be given to the patient for - Occurs when the tear causes a piece of pain management. bone to be pulled off. - A splint or cast is then applied. - Can be seen anywhere in the body but a Open Reduction- required when orthopedic common site is the base of the 5th hardware is needed to maintain fracture metatarsal. reduction or when an open fracture needs to be - Most are treated as a soft tissue injury irrigated. and do not require surgical repair. - Referred to as Open Reduction Jones Fracture- occurs on the shaft of the 5th Internal Fixation (ORIF). metatarsal. Open/Compound Fracture- bone actually - Occurs without significant injury or manages to pierce the skin. impact. - Almost always require the surgical - More difficult to heal than avulsion but insertion of internal fixation devices. usually only requires the wearing of a - Fell and broke her humerus at the distal walking robot or cast for 4-8 weeks. portion of her prosthesis. Boxer’s Fracture- occurs at the head of the 4th Spiral Fracture- bone has been twisted apart. or 5th metacarpal of the hand. - Similar appearance to a spiral staircase. - Always occurs as the result of striking a - Sometimes referred to as torsion firm object with a closed fist. fracture. - Can heal with a cast but some severe - Babies and children can be a warning cases may require surgical repair. sign of abuse. Blow-Out Fracture- Following blunt trauma to Oblique Fracture- break has a slanted or the eye, contents of the orbit compress and sloped pattern. push down into the maxillary sinus. Spiral Fracture- bone has been twisted at the - Surgery may be indicated in some break point. instances in order to relieve the Transverse Fracture- horizontal fractures in symptoms of double vision or muscle relation to the long axis of the bone. entrapment. Comminuted Fracture- multiple bone Colles’ Fracture- individual falls backwards fragments. onto a hard surface and braces themselves with - Result of some type of crushing injury or an open hand. as a result of gunshot wound. - Fracture of the distal radius with - Comminuted fracture of the calcaneus posterior and lateral displacement of occurred as the result of falling feet first distal fragments. into an empty pool with no shoes on. - Treated with a closed reduction and a Greenstick Fracture- partial fracture that is cast. commonly associated with children.  - Severe may require the surgical - Ulna will require an internal fixation insertion of an internal fixation device. device and once this will usually reduce Compression Fracture- when a vertebral body the radial head dislocation. is crushed and collapses down upon itself. Galeazzi Fracture- occurs at the radial shaft - Result of trauma, cancer, or with concomitant dislocation of the distal osteoporosis. radioulnar joint (DRUJ). - Treatment depending on the severity of Salter-Harris Fractures- fractures of the growth fracture and its potential impact on the plate in children. spinal cord. 1. Type 1- epiphysis is completely Back brace- stabilizes the fracture while it dislocated from the metaphysis (shaft) heals. Surgical insertion of internal fixation of the bone. devices. - Usually only requires a cast for Vertebroplasty- may be performed; requires treatment. injection of bone cement 2. Type 2- partial dislocation of the (polymethylmethacrylate) into the vertebral epiphysis and a fracture of the body–to prevent further collapse of the vertebral metaphysis. body. - Most common type. Elbow Fracture: Fat Pad Sign- subtle fracture 3. Type 3- partial dislocation and a fracture to the elbow in the area of the distal humerus of the epiphysis. can be very difficult to visualize radiographically. 4. Type 4- result of a fracture of both the - Best position is lateral. epiphysis and the metaphysis. - Anterior surface of elbow, small 5. Type 5- impaction of the epiphysis into radiolucency-fat pad is visualized. the metaphysis. - Also located on the posterior surface of Standard for describing growth plate fractures the distal humerus not normally since the 1960's. demonstrated. Tripod Fracture- malar or zygomatic bone - Radiolucent density. articulates with the frontal bone, temporal bone, Hip Fractures- occurs on the proximal end of and the maxillary bone. femur and is usually the result of a fall from an - Trauma directly to the malar bone may elderly patient with osteoporosis. cause a fracture at each of these 1. Femoral Head Fracture- result of a articulations. high energy impact and combined with - Treatment requires surgical reduction of dislocation. the fracture sites. 2. Femoral Neck or Transcervical Fracture- blood supply to the femoral head is almost always disrupted with this type of fracture. - Many are treated with total hip replacement. 3. Intertrochanteric Fracture- do not damage the blood supply to the hip can often be reduced with the surgical insertion of a metal plate or screws. 4. Subtrochanteric Fracture- just below the level of the intertrochanteric crest; physically located on the shaft of the femur and may extend down the femur. Monteggia Fracture- usually the result of a fall on an outstretched arm. - Fracture of the proximal third of the ulna combined with a dislocation of the radial head within the elbow joint. - Very unstable injuries that usually require surgical repair.