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Airway Disease

Airway Disease. Airway Disease. Airway obstruction – increased volume Acute: foreign body, aspiration Chronic: chronic obstructive pulmonary disease (COPD) Partial or ball valve obstruction: Over-inflation, emphysema Airway obstruction – decreased volume

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Airway Disease

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  1. Airway Disease

  2. Airway Disease • Airway obstruction – increased volume • Acute: foreign body, aspiration • Chronic: chronic obstructive pulmonary disease (COPD) • Partial or ball valve obstruction: Over-inflation, emphysema • Airway obstruction – decreased volume • Complete obstruction: collapse, atelectasis • Complications: pneumonia, abscess

  3. Overinflation, Overexpansion Increased aeration with expanded volume • Commonly Due to: • COPD • Asthma • Emphysematous bullae or bleb • X-ray signs • Decreased lung density • Scanty pulmonary vascularity

  4. Overinflation, Overexpansion Increased aeration with expanded volume • Volume expansion manifestations • Mediastinum and trachea shift towards normal side (when unilateral) • Depressed diaphragm • Widening of thoracic cage and intercostal spaces

  5. Foreign Body Aspiration • Peanut aspiration • Radiolucent FB left main bronchus • FB not seen • Inspiration film normal

  6. Foreign Body Aspiration • Expiration film • FB causes ball valve • Air trapping on the left • Left lung increased lucency • Shift of heart and mediastinum to right

  7. Emphysema • PA chest • Increased lung volume • Low, flat diaphragm • Narrow heart • Widened intercostal spaces

  8. Emphysema • Lateral view • Flattened diaphragm • Increased AP diameter

  9. Pulmonary Bullae • PA film • Air spaces with arcuate walls right lower lobe • Bullae expanded within lung parenchyma • Bullae – air containing spaces in parenchyma • Bleb – air space on the surface of lung

  10. Pulmonary Bullae • Lateral view • Curvilinear opacity inferior wall of bullae

  11. Atelectasis • Decrease aeration with volume loss (collapse) • Commonly due to bronchial obstruction of various causes • X-ray signs • Increased lung density (grey or white)

  12. Atelectasis • Volume loss manifestations: • Shift of hilum and/or fissure towards the collapsed segment / lobe • Elevation of ipsilateralhemidiaphragm • Mediastinum and trachea shift toward affected side • Ipsilateral narrowing of thoracic cage and intercostal space

  13. RUL Collapse Asthmatic • Mucous plug • Increased density area right upper lung • Minor fissure shifted up • Right diaphragm and hilum elevated

  14. RML Collapse • Poor definition of right heart border • Subtle area of increased density • Representing collapsed right middle lobe

  15. RML Collapse • Lateral view • Band-like opacity over the cardiac shadow • Represents the collapsed middle lobe

  16. LUL Collapse • PA film • Left diaphragm slightly elevated • Slight shift of heart to left due to volume loss • Upper left hilum obscured by partially collapsed LUL • Right lung hyperareated

  17. LUL Partial Collapse • Lateral film • Opacity in upper anterior chest area representing the LUL • Anterior displacement of the left major fissure

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