Unit 2 (Respiratory)

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Unit 2 (Respiratory)
2013-03-03 19:27:21

Unit 2: Respiratory
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  1. name the anatomy that makes up the upper respiratory system:
    • nose
    • mouth
    • pharynx
    • larynx
  2. name the anatomy that makes up the lower respiratory system:
    • trachea
    • bronchi
    • lungs
  3. the process by which air is moved from the atmosphere to the terminal units of the lung:
  4. the process of gas passing from the air, across tissue, to the blood, and back again:
  5. name two parts of anatomy found in the anterior mediastinum:
    • thymus
    • thyroid
  6. name three parts of anatomy found in the middle mediastinum:
    • heart and great vessels
    • esophagus
    • trachea
  7. name two parts of anatomy found in the posterior mediastinum:
    • descending aorta
    • spine
  8. the diaphragm is higher on the ________ side due to the position of the __________.
    • right
    • liver
  9. name six general soft tissue parts that should be included in a chest radiograph:
    • lungs
    • the lower neck
    • soft tissue of thoracic wall
    • mediastinum
    • diaphragm
    • upper abdomen
  10. name seven general bony structures that should be included in a chest radiograph:
    • ribs
    • t-spine
    • lower c-spine
    • sternum
    • clavicles
    • scapulae
    • shoulder girdles
  11. depressed sternum that can displace the heart:
    pectus excavatum
  12. a bony tubular density in the posterior thorax:
    • intrathoracic rib
    • (usually seen on lateral view)
  13. factors that affect the height of the diaphragm:
    • rotation of pt
    • obesity
    • scoliosis
    • loss of lung volume
    • abdominal pressure due to supine position
  14. on a chest x-ray, rotation of pt will affect:
    • height of diaphragm
    • hilar region
    • magnification of one lung
    • heart size
  15. what is a "sail sign"?
    when the thymus of an infant is large and shaped like a sail on a chest x-ray (mostly on right side)
  16. a condition in which air is trapped in the mediastinum because of a disruption to the esophagus or airway:
    pneumomediastinum (mediastinal emphysema)
  17. name some causes of pneumomediastinum:
    • trauma to the chest
    • endoscopy
    • violent vomiting
  18. a condition in which air is located in the soft tissues of the neck or chest:
    subcutaneous emphysema
  19. name a cause of subcutaneous emphysema:
    a severe pneumomediastinum
  20. the trachea may be displaced on a chest x-ray if:
    there is an enlargement of the thyroid
  21. while not common, fluoro of the chest can be done to:
    • evaluate fixation of the diaphragm
    • differentiate between a lung nodule and a pseudonodule
    • evaluate cardiac valvular calcifications
    • (tomography was once used)
  22. what is the "rule of thumb" about lesions in the chest?
    • less than 1cm is usually benign, larger than 1 cm may be malignant
    • calcium in the middle of a lesion usually means benign
    • eccentric calcification may indicate malignancy
  23. common reasons for a CT of the chest:
    • evaluation of pulmonary adenopathy
    • analysis of questionable pathology
    • detect emboli in thoracic vessels
    • percutaneous transthoracic needle aspiration
  24. common reason for a nuclear medicine test of the chest:
    performs perfusion and ventilation studies especially in cases of obstructive disease and pulmonary emboli
  25. common reasons for a PET scan of the chest:
    • gives information about the metabolic activity in the chest
    • can distinguish benign from malignant lesions
    • uses fluorodeoxyglucose for injection
  26. describe the placement and function of an ET tube (endotracheal tube):
    • inserted through the mouth or nose into the trachea and positioned below vocal cords, 4-5cm above carina
    • helps to manage airway
    • allows suctioning
  27. large plastic tube inserted through the chest wall between ribs into the lungs:
    chest tube
  28. describe the function and placement of a chest tube:
    • inserted through chest wall between ribs and into lungs
    • the container the tube connects to MUST be kept below chest level
    • allows drainage of air from a pheumothorax
    • allows drainage of fluid from a pleural effusion or hemothorax
  29. how is a chest tube placed during open-heart surgery and why?
    • in the mediastinum
    • for drainage
  30. define a CVP and some aspects about it:
    • —it is a catheter for the injection of fluids and allows measurement of central venous pressure
    • usually placed through the subclavian vein, but may go in through the jugular, antecubital or femoral vein
    • the tip is placed in the distal super vena cava (SVC)
    • —CXR is done to R/O pneumothorax or hemothorax 
    • incorrect placement can cause arrythmias
  31. define a swanz ganz catheter and some aspects about it:
    • a multi lumen catheter that evaluates cardiac function such as left atrial pressure
    • positioned in the PULMONARY ARTERY
    • has a balloon that is inflated to allow it to float into a smaller pulmonary artery
    • put in through the subclavian usually, but may be put in through the anticubital vein, jugular vein, or femoral vein
    • has taken the place of CVP catheters because of accuracy
  32. what is another name for a swanz ganz catheter and what is its most common use?
    • pulmonary artery catheter
    • the diagnosis and management of heart failure resulting from myocardial infarction and cardiac shock
    • (checks left-atrial pressure!!!!!!)
  33. name two access catheters and their placement and function:
    • hickman catheter and port-a-cath
    • inserted through subclavian vein
    • used for making injections
  34. what is the main difference between a hickman catheter and a port-a-cath?
    the hickman catheter is open to the outside (placed in subclavian vein) and the port-a-cath is not open to the outside, so has less chance of infection (under skin, just below clavicle)
  35. between a hickman catheter and a port-a-cath, which is most often used for chemo patients and why?
    • port-a-cath
    • because it is less prone to infection since it is not open to the outside
  36. describe an IAPB:
    • intra-aortic balloon pump catheter
    • put in surgically or percutaneous at bedside
    • has a 40cc balloon on the end allowing it to be inflated and deflated by a pump that is synchronized to the pt's cardiac cycle to provide support of the left ventricle
    • balloon is put in the descending aorta
  37. describe ventricular pacing electrodes:
    • temporary or permanent
    • temporary: inserted through the antecubital vein into the right ventricle for bradycardia
    • permanent: the pacemaker generator is inserted under the skin, below the right clavicle, and the electrodes are in the right ventricle
  38. when there is a lack of respiratory function or exchange of gases:
    • respiratory failure
    • (may be within lungs or just impaired breathing)
  39. low levels of oxygen in arterial blood:
  40. the inability to move air into and out of the lungs, in which there is an increase in carbon dioxide:
  41. causes of hypoxemia:
    • toxic gas or smoke inhalation
    • high altitudes
    • hypoventilation
    • impaired diffusion
    • congenital heart defects
  42. when the right side of heart shunts blood directly to left side of heart without going through pulmonary circulation (general):
    a congenital heart defect
  43. constriction of the pulmonary arteries:
    pulmonary stenosis (can require surgery)
  44. respiratory failure resulting in hypoxia and/or hypercapnia may be caused by:
    • obstructed airway
    • insufficient respiratory drive
    • respiratory muscle fatigue
    • intrinsic lung disease
    • a dysfunction of the central nervous system
  45. respiratory failure signs and symptoms:
    • tachypnea
    • tachycardia
    • paradoxic abdominal motion
    • for acute failure cardiac arrhythmias
  46. diagnosis of respiratory failure is by:
    arterial gas measurements (CXR can help)
  47. respiratory failure treatment:
    • oxygen therapy with specialized non-ventilator masks called continuous positive airway pressure (CPAP) and bilevel positive airway pressure devices (BIPAP)
    • patients may be intubated and put on mechanical positive pressure ventilator (PPV)
  48. a genetic disorder which consists of a defect in the exocrine glands causing abnormal secretions:
    • cystic fibrosis
    • —in the respiratory system secretions increase from hypertrophy of bronchial glands and this leads to obstruction
  49. be familiar with some specifics of cystic fibrosis (who's at risk, diagnosed by, etc.):
    • it's the most common lethal genetic disease in white children
    • life span is 20-30 years (improving with medicine)
    • diagnosed by elevated levels of sodium and chloride in a sweat test
    • involves many organs in addition to respiratory
  50. be familiar with symptoms and radiographically relevant aspects of cystic fibrosis:
    • thickening of linear markings throughout the lungs (bronchial thickening and hyperinflation)
    • CXRs get worse over time
    • pts develop bronchiectasis, cysts, lobar atelectasis, scarring, pulmonary artery and right ventricle enlargement
    • prone to staph infections
    • signs: chronic cough and wheezing with recurring or chronic pulmonary infection
  51. complications associated with cystic fibrosis:
    • pneumothorax
    • hemoptysis (coughing up blood)
    • right heart failure (corpulmonal)
  52. a life-threatening condition that causes incomplete maturation of the surfactant producing system causing unstable alveoli:
    • hyaline membrane disease
    • aka respiratory distress syndrome
  53. what does respiratory distress syndrome result in, who does it affect, how is it treated, etc?
    • results in alveolar collapse with widespread atelectasis; rapid and labored breathing immediately or shortly after birth
    • if severe, respiratory and metabolic acidosis occurs
    • common in premature babies with less than a 37 week ingestion
    • treated with: warmth, oxygen regulation, and intrathecally introduced surfactant
  54. an agent that reduces surface tension:
  55. the most frequent type of lung infection, 6th leading cause of death, and most frequent lethal nosocomial infection:
    • pneumonia
    • additive disease
  56. the most common nosocomial infection:
    urinary tract infection
  57. most common causes of pneumonia in adults:
    • bacteria such as:
    • streptococcus
    • staphylococcus
    • pneumococcus
    • haemophilus influenza
    • chlamydia pneumoniae
    • legionella pneumophilia
  58. most common cause of pneumonia in adolescents and teens:
    mycoplasma pneumoniae
  59. most common cause of pneumonia in infants and children:
    viral pathogens
  60. most common cause of pneumonia in the immunodepressed:
    fungal, such as pneumocystis carinii
  61. name the four classifications of pneumonia:
    • lobar/pneumococcal pneumonia (entire lobe)
    • segmental pneumonia (segment of lung)
    • bronchopneumonia (bronchi and associated alveoli)
    • interstitial pneumonia (interstitial lung tissue)
  62. which classification of pneumonia is the most common?
    lobar/pneumococcal (entire lobe)
  63. how does pneumonia appear, radiographically?
    soft, patchy, ill-defined alveolar infiltrates or pulmonary densities
  64. results when the alveolar air spaces are filled with fluid or cells:
    alveolar infiltration
  65. signs/symptoms of pneumonia:
    • fever/chills
    • prostration (extreme exhaustion)
    • cough/sputum production
    • tachypnea
    • dyspnea
    • crackles in chest with bronchial breath sounds
  66. what tests are routinely performed to confirm pneumonia?
    • sputum tests for bacterial cultures
    • blood tests for elevated # of lymphocytes
    • **bacterial pneumonia causes leukocytosis, viral does not
  67. what does lobar pneumonia look like on radiograph and how is it treated?
    • affected lobe looks like a cloudy area, lateral shows collection of fluid in one or more lobes
    • pleural effusion best seen lateral decub
    • air bronchogram visible
    • chills/fever/cough
    • about a week of antibiotics
  68. where is the bacteria that causes lobar pneumonia normally found?
    found in normal healthy throats. when the body's defenses are down, it travels to the lungs. usually follows an upper respiratory infection.
  69. a thin-walled air-containing cyst that is a radiographic characteristic seen in children:
  70. how does bronchopneumonia present radiographically? list some other attributes as well:
    • looks like patchy spreading areas localized in and around the bronchi
    • occurs sporadically
    • common secondary effect of the flu
    • fatal in infants
    • a pneumatocele may present (in children), forming an abcess
    • may use chemotherapeutic agents as treatment
  71. how do streptococcal pneumonias appear radiographically? list some other attributes as well:
    • appearance is localized around the bronchi, usually of the lower lobes
    • fewer than 1% of pneumonias
    • rarer than staphylococcal
  72. a severe bacterial pneumonia named after the death of four people attending an american legion convention in philadelphia in 1976:
    legionnaires disease
  73. what bacteria causes legionnaires disease?
    causative bacteria is legionella pneumophila which thrives in warm places and believed to be transmitted through heating-cooling systems
  74. list symptoms of legionnaires disease:
    • malaise
    • muscular aches
    • chest pain with a nonproductive cough
    • occasional vomiting and diarrhea
  75. list who is most at risk for legionnaires disease, additional risk factors, where it occurs, and how is it treated:
    • middle-aged men most frequently
    • smoking, alcohol abuse, immunosupression from corticosteroids
    • occurs in large buildings such as hotels and hospitals usually in late summer/early fall
    • treated with antibiotics and oxygen
  76. how does legionnaires disease appear radiographically and what two tests are used to diagnose it?
    • appears similar to bacterial pneumonia with patchy infiltrates throughout the lungs
    • diagnose with a culture from sputum or bronchoscopy brushing
    • diagnose by performing urinary antigen assays
  77. how does mycoplasma pneumonia appear radiographically? list more attributes as well:
    • appears as a fine reticular pattern in a segmental distribution, followed by patchy areas of air space consolidation; severe cases resemble TB
    • caused by microplasms (smallest living organisms)
    • characteristics of both bacteria and viruses, but classified as bacterial
    • most common in older children and young adults
  78. how does pneumocystis carinii pneumonia appear radiographically?
    shows ground-glass appearance
  79. how does aspiration pneumonia/chemical pneumonia appear radiographically? list more attributes as well:
    • (edema produced by the irritation of the air passages) appearing as densities radiating from one or both hila into the dependent segments, possible air bronchogram sign
    • results from aspiration of foreign object
    • irritates bronchi, produces edema
    • occurs in upper, posterior portion of lower lobes
  80. list some causes of aspiration/chemical pneumonia:
    • acid vomitus aspirated into lower respiratory tract, resulting in chemical pneumonitis
    • anesthesia
    • alcoholic intoxication
    • loss of cough reflex due to stroke
  81. list treatments for aspiration/chemical pneumonia:
    • strictly supportive, including correction of hypoxic control of secretions and replacement of fluids
    • antimicrobial drugs (further treatment)
  82. which pathologies may exhibit an air bronchogram sign?
    • pneumococcal or lobar pneumonia
    • hyaline membrane
    • sometimes aspiration/chemical pneumonia
  83. how does interstitial pneumonia appear radiographically? list more attributes as well:
    • develops a more linear pattern with some areas of infection appearing as small nodular densities
    • caused by viruses, most commonly the flu
    • more common but less severe than bacterial
    • it is an inflammation of the alveoli and supporting structures of the lung
    • symptoms similar to lobar pneumonia, except cough is usually dry, hacking with fever
  84. a congenital or acquired condition  of chronic inflammation of the bronchi causing the walls to weaken and permanently dilate:
    • bronchiectasis
    • tram lines visible radiographically
    • some have chronic cough, some asymptomatic
  85. list some symptoms and occurrences common with bronchiectasis:
    • persistant cough with foul smelling, mucopurulent secretions
    • low-grade fever, malaise, fatigue
    • wheezing
    • dyspnea
    • pleuretic pain
    • bronchial wall is destroyed as infection grows, resulting in abscess
  86. two ways to diagnose bronchiectasis:
    • bronchograms
    • CXR demonstrates peribronchial thickening-areas of retained secretions and atelectasis
  87. name a disease that was once nearly eradicated from the U.S. but is now on the rise:
  88. describe some basic aspects of tuberculosis (cause, how it's spread, what it affects, who it affects, etc.):
    • caused by mycobacterium tuberculosis
    • spread by inhalation of infected material
    • mostly affects lungs
    • may affect genitourinary skeletal system and CNS also
    • 8 in 100,000 developed TB annually in the 90s
    • mostly in the elderly and HIV infected pts
  89. what are the symptoms of tuberculosis:
    • fever
    • weight loss
    • weakness
    • early morning cough producing minimal mucous
    • advanced: more productive cough, dyspnea, spontaneous pneumothorax or pleural effusion
  90. how is early pulmonary tuberculosis detected?
    it is asymptomatic, detected with a skin test
  91. where to TB lesions usually occur radiographically?
    • in the apical region of the lungs
    • scarring of the lungs is common with TB
  92. what form of TB is presenting when a pt is showing active signs?
    • fibrocaseous tuberculosis
    • necrosis is prominent; affects lung parenchyma
  93. what often occurs if TB is in a dormant state?
    • it can reactivate and remain undiagnosed for weeks or months
    • a persistent pneumonia may develop
  94. in fibrocaseous TB, ______________ occurs when infiltration expands and produces the formation of a cavity.
    • cavitation
    • if the cavities spread to communicate with the bronchus, the bacteria spreads throughout
  95. a type of TB resulting from persistent pneumonia in the lobar or segmental bronchus that is resistant to antibiotics:
    miliary tuberculosis
  96. a type of TB that occurs when the bloodstream picks up the tuberculosis and large numbers of bacteria are carried throughout the body:
    miliary tuberculosis
  97. how does miliary tuberculosis appear radiographically?
    small, distinct nodules throughout the lung fields
  98. a complication of TB that occurs when the infection overwhelms the immune system and progresses through the lungs at a rapid rate and the infection spreads to the lobar or segmental bronchus, causing a persistent
    • tuberculosis pneumonia
    • the infection spreads quickly because the body does not develop fibrous tissue to surround the bacteria
  99. what are current treatments for tuberculosis?
    • pulmonary TB patients are in respiratory isolation because TB is spread through sputum and airborne droplets expelled on coughing
    • modern treatment of tuberculosis consists primarily of various chemotherapeutic agents 
    • it must be treated with at least two antiTB drugs including both bacteriostatic drugs that act through different mechanisms
    • if resistant to drugs may have to do a surgical resection
  100. name four common causes of COPD:
    • chronic bronchitis
    • emphysema
    • asthma
    • bronchiectasis
  101. give statistical data on COPD:
    • mortality rate has increased over past 20 yrs
    • in the top most common causes of death in US
    • diagnosed cases increased 60% since 80s
  102. predisposing factors to COPD:
    • smoking (the most predominant factor)
    • infection
    • air pollution
    • occupational exposure to harmful substances like asbestos, silica, etc.
  103. name three early symptoms of COPD:
    • dyspnea
    • mild persistant cough with sputum production
    • fatigue
  104. name a prominent physical symptom of COPD:
    clubbing of the fingers
  105. how does COPD appear radiographically?
    • emphysema
    • elongated heart shadow
    • aortic arch predominantly visible
    • diaphragm flattened, instead of dome-shaped
  106. how does COPT usually progress?
    • develops into pulmonary edema
    • eventually leads to congestive heart failure
  107. name main symptoms of chronic bronchitis:
    • persistant cough and expectoration (main)
    • wheezing
    • SOB
    • arterial hypoxemia...leads to:
    • right heart hypertrophy and failure
  108. who most often develops chronic bronchitis?
    • long-term heavy cigarette smokers
    • pts exposed to high levels of industrial air pollution
  109. right heart hypertrophy and failure:
    cor pulmonale
  110. how does chronic bronchitis appear radiographically?
    no dependable radiographic criteria exists for a definitive diagnosis
  111. patients with chronic bronchitis are known as: (nickname)
    • "blue-bloaters"
    • lack of oxygen gives skin bluish tint
    • body swells from fluid accumulation from COPD
  112. while not definitively diagnosed by CXR, name some radiographic occurrences that may present:
    • hyperinflation of lungs
    • increase in bronchovascular markings mostly in lower lungs ("dirty chest")
    • possible tram lines
  113. a condition in which the lung’s alveoli become distended, usually from loss of elasticity or interference with expiration:
  114. name some symptoms of emphysema:
    • dyspnea (primary...first during exertion only)
    • flattened diaphragm
    • abnormally radiolucent lungs
    • increased retrosternal air space (barrel shape)
    • large bullae, prominent hilar markings, or blisters filled with air may occur
  115. patients with emphysema are known as: (nickname)
    • "pink puffers"
    • tend to have pink skin and barrel-shaped chests
  116. occupational diseases in which inhalation of foreign inorganic dust results in pulmonary fibrosis:
  117. name the radiographic appearance of pneumoconioses:
    • lesions that vary in appearance (may include:)
    • nodules
    • cavitation
    • pleural thickening
  118. what does the effect of pneumoconioses depend on?
    • size of particles
    • the amount inhaled
    • chemical properties
    • site of inhalation
  119. concerning pneumoconioses, describe the effects of different particle sizes:
    • less than 1 micrometer: stays suspended in air and is exhaled
    • between 1-5 micrometers: more easily trapped
    • greater than 10 micrometers: filtered out in nasal passages or mucous lining of bronchial tree
  120. causes of pneumoconiosis:
    • fibrogenic inorganic dusts:
    • silica
    • coal
    • asbestos
    • beryllium
  121. name the three types of pneumoconiosis:
    • silicosis
    • anthracosis (deals with coal, not anthrax!!)
    • asbestosis
  122. give specific aspects of silicosis (cause, who gets it, radiographic appearance, treatment):
    • most widespread/serious pneumoconiosis
    • cause: inhaling silica (quartz) dust (10-30yr)
    • common among: miners, grinders, sandblasters
    • looks like: multiple small, rounded, opaque nodules throughout the lungs; egg shell calcifications
    • treatment: none available
  123. give specific aspects of anthracosis (cause, treatment, etc.):
    • "black lung disease"
    • cause: inhalation of coal dust (over 20 yrs)
    • treatment: none available
    • coal macules develop around bronchioles and cause their dilation
    • airflow not affected
  124. give specific aspects of asbestosis (cause, results, etc.):
    • cause: inhalation of asbestos dust; chronic injury to the lung
    • the dust found in building materials/insulation
    • appears as diffuse, small irregular or linear opacities in lower lungs
    • also, diaphragmatic pleural calcification
    • pleural thickening may occur
  125. what is a possible development that can occur from prolonged asbestosis?
    • mesothelioma (rare malignant neoplasm of the pleura)
    • after at least 15yrs after a high exposure
  126. plants without chlorophyll that are widely found in nature:
  127. who is most susceptible to fungal diseases resulting in serious illnesses?
    • patients undergoing therapy with corticosteroids or immunosuppressants
    • AIDs pts
    • diabetesmellitus pts
    • bronchiectasis pts
    • emphysema pts
    • TB pts
    • lymphoma pts
    • leukemia pts
    • pts with serious burns
  128. —a systemic fungal infection caused by a fungus that thrives in soil, especially that fueled by bird or bat excreta and is endemic to the Ohio and Mississippi River valleys:
  129. give symptoms and radiographic appearance of histoplasmosis:
    • dyspnea, cough, fatigue
    • small calcification in later stages
  130. give the name of histoplasmosis that has spread from the lungs how it is diagnosed:
    • progressive disseminated histoplasmosis
    • diagnosis made by laboratory analysis
  131. what condition that can occur from histoplasmosis is fatal?
    chronic cavitary histoplasmosis
  132. —a systemic, fungal infection caused by a fungus that thrives in semiarid soil, particularly the southwestern US and northern Mexico:
  133. give some aspects of coccidioidomycosis (who's at risk, radiographic appearance, etc):
    • agriculture and construction workers at risk
    • may go unrecognized
    • radiographically, small area of pulmonary consolidation is most common
  134. a localized area of necrotic or diseased tissue
    surrounded by inflammatory debris (pus):
    lung abscess
  135. lung abscess causes:
    • periodontal disease
    • pneumonia
    • neoplasms
    • organisms that invade the lungs
  136. give clinical manifestations and radiographic appearances of a lung abscess:
    • fever, cough, expectoration of pus, foul sputum
    • appears as a consolidation that becomes globular in shape as pus accumulates
    • may appear as a round, thick-walled capsule containing air and fluid
  137. a condition that consists of an accumulation of pus in the pleural cavity usually caused by some primary lung infection and may be caused by the invasion of a lung abscess,
    resulting in a bronchopleural fistula:
  138. inflammation of the pleura that is not visible radiographically where the pain is usually to one side and the parietal layer of the lung is involved:
  139. pleurisy can be an indication of the following conditions:
    • pneumonia
    • pulmonary embolism
    • tuberculosis
    • malignant disease
  140. types of pleural effusion:
    • exudate
    • transudate
    • hemothorax
    • chylothorax
  141. the type of pleural effusion caused by inflammation (pleurisy), pulmonary embolism, or —neoplasm:
  142. the type of pleural effusion caused by— microvascular changes associated with heart failure and/or ascites:
  143. the type of pleural effusion containing blood:
  144. —the type of pleural effusion caused by injury or blockage of the main lymphatic duct; the fluid is milky:
  145. Infection and inflammation of the paranasal sinuses most commonly affecting the ethmoid sinus:
    • sinunitis
    • symptoms:nasal discharge, headache
  146. causes of acute sinusitis:
    • streptococcal
    • pneumococcal
    • h. influenza
    • staphyloccal
    • often followed by viral infection of respiratory tract
  147. —a condition that is considered benign but is classified as lung cancer because it tends to invade local tissues, sometimes metastasize, and is treated much like other malignant neoplasms:
    bronchial adenoma
  148. —the most common fatal primary mallignancy in the US:
    bronchogenic carcinoma
  149. four types of bronchogenic carcinoma:
    • squamous cell
    • small (oat) cell
    • large cell
    • adenocarcinoma
  150. —a condition that arises in the major bronchi near the hilar area and metastasize via lymph nodes, the bloodstream, or both and presents as an airway obstruction of unilateral hilar mass and as it grows it produces atelectasis and neumonitis:
    bronchogenic carcinoma
  151. symptoms of bronchogenic carcinoma include:
    • persistent cough
    • bloody sputum
    • dyspnea
    • weight loss
    • coin lesion (2nd most common appearance)
    • —poor prognosis with a 5-year survival rate of only 12% to 14%
  152. —more common than primary lung neoplasms:
    pulmonary metastases
  153. —routes in which malignancy is spread:
    • hematogenous metastases
    • lymphogenous metastases
    • direct extension in local invasion
    • bronchogenic
    • direct implalnatation form biopsies or other surgical procedures
  154. what are the treatment options for neoplastic diseases:
    • surgery
    • chemotherapy
    • radiation therapy
    • a combination of both
  155. an inflammatory process characterized by laryngitis and laryngeal spasm, can cause complete obstruction of the airway, usually caused by a virus, and produces a barklike cough:
  156. throat cultures are taken to rule out:
    • bacterial infection
    • diptheria
    • foreign body obstruction
  157. soft tissue neck radiographs are taken to:
    demonstrate spasm and constriction of the upper airway
  158. the collapse or partial collapse of a lung leading to decreased gas exchange and hypoxia:
  159. two main causes of atelectasis:
    • obstruction
    • compression
  160. radiographic occurrences with atelectasis:
    • thin, linear streaks
    • larger areas of increased opacity
    • elevation of the ipsilateral diaphragm
    • displacement of the heart, hilum, and mediastinum toward the atelectatic side
    • overinflation of the remainder of the ipsilateral lung
    • a honeycombing effect in upper lung fields
  161. a blood clot or other material that obstructs the pulmonary artery or a branch of it, blocking the blood flow through the lung tissue:
    pulmonary emboli
  162. common predispositions for pulmonary emboli:
    • immobilization
    • surgery
    • fracture
    • malignancy
    • trauma
    • obesity
    • myocardial infarction
  163. symptoms of pulmonary emboli:
    • dyspnea
    • pleuritic pain
    • cough
  164. radiographic manifestations of pulmonary emboli:
    • atelectasis
    • pulmonary edema or hemorrhage
    • pleura effusions
    • hampton’s hump
    • elevated hemi-diaphragm
    • pulmonary arteries may appear enlarged
    • rounded opacity without calcification in the upper lobes of the lung - known as a coin lesion
    • hilum region appears enlarged on one side
    • cavitation is common
    • metastases most frequently involves the bones
  165. _________________ causes tissue destruction and some bleeding.
    inflammatory exudate
  166. a bronchitis of both lungs caused by either the streptococcus or the staphylococcus bacteria in which bronchioles fill up with mucous and become infected and abscesses may develop and airway obstruction may lead to atelectasis:
    • bronchopneumonia
    • no air bronchogram sign
    • not visible on CXR
  167. the inability to breathe properly; does not show up radiographically:
  168. typical asthmatic attacks are characterized by:
    • wheezing
    • cough
    • dyspnea
  169. asthmatic patients are sensitive to:
    • emotional stress
    • changes in the humidity
    • exposure to fumes or airborne allergens (dust, pollen)
  170. what happens when an asthmatic patient is exposed to irritants?
    the mucous membranes swell, secrete excess mucous, and cause spasm and narrowing of the airways
  171. during an asthmatic attack, what might a CXR include?
    • hyperinflation of the lungs
    • flattened diaphragms
    • secretions and bronchial thickening may cause an opaque area on the film
    • recurrent pulmonary infections may lead to pulmonary fibrosis throughout the lung with increased interstitial markings giving it the “dirty chest” appearance