1

Video Summaries

Name

Affiliation

Course

Date
 2

Video 1: Respiratory Pathology

https://www.youtube.com/watch?v=QMEikTHtbXk

The video explains what is generally showed in a chest X-ray and how to interpret and

act on emergency findings of the Xray. In the video, it is emphasized that X-rays display

variations in the density of the structures being imaged. The denser an object, the less X-rays can

pass through, resulting in a whiter appearance on a chest X-ray. Understanding the order of

increasing densities is important: air appears black, fat appears dark grey, bones appear off-

white, and metals appear bright white. Before interpreting a chest X-ray, several key factors

should be considered, such as confirming the correct patient, identifying the side and view of the

X-ray. It is also crucial to grasp the labels used, such as PA (posteroanterior) and AP

(anteroposterior), which indicate the direction in which the X-rays passed through the patient.

Different views can affect the appearance of certain structures, particularly the heart, which may

falsely appear larger on an AP view, leading to a misinterpretation of enlargement. Therefore,

the PA view is generally preferred.

The video also covers various lung lesions and the corresponding scanning techniques.

Abdominal X-rays can capture lesions by starting in the right upper quadrant and scanning across

the upper abdomen. Thoracic and soft tissue lesions can be examined by starting from the base of

the right lung and scanning the soft tissue, chest wall, ribs, and shoulder girdle. Lesions in the

mediastinum, which includes the trachea, carina, aorta, heart, and hilum, are scanned through

two sweeps. The lungs can be scanned unilaterally, beginning from the right costophrenic angle,

and examining each lung individually. Alternatively, a bilateral scan can be performed, starting

from the right costophrenic angle, and simultaneously examining both the right and left lungs.
 3

Video 2: Difference between obstructive and Restrictive (fibrosis) lung disease

https://www.youtube.com/watch?v=VGch3ElpKEY

The video explains the difference between obstructive and restrictive lung disease. In the

video, a restrictive lung disease, which is attributed by reduced amount of air entering the lungs

is seen in an X-ray where the lung seems to have shrunk. The lungs appear smaller than normal

because they are not able to expand as much as they should when one has restrictive lung

disease. There are also increased interstitial markings, which show up on x-rays between the air

sacs in the lungs. In cases of restrictive lung diseases, there is usually pleural effusion, which is a

collection fluid between the layers of tissues surrounding the lungs. This may develop making

the lungs look abnormal on an X-ray. On the other hand, obstructive lung disease shows enlarged

lungs on the Xray as they appear larger than normal because of hyperinflation and that lungs are

filled with more air than usual, which happened when airways are narrowed. Moreover, there is a

flattened diaphragm due to hyperinflation making it difficult for one to breathe. In the X-ray, air

bronchograms can be seen as if they are caused by the air leaking into the space around the

bronchi. As such, air bronchograms are an element of obstructive lung disease as they occur

because of the narrowing of airways making it difficult for air to flow freely through them.

Lastly, obstructive lung disease is attributed to large air-filled sacs that form in the lungs

showing severe emphysema, which makes lungs less elastic.

Video3: Diffuse lung Disease

https://www.youtube.com/watch?v=mNLd4DKtGs4&t=69s
 4

The video explains how to identify and differentiate low lung volumes and

hyperinflation, identify pulmonary edema and other features that can be used to identify

cardiogenic from non-cardiogenic etiologies as well as classify interstitial processes.

An Xray showing reduced lung volume suggests several factors including poor

inspiratory effort, suboptimal timed exposure, and restrictive lung disease, subpulmonic

effusions. Poor inspiratory effort occurs when the patient is not able to take deep enough breaths.

Also, it can suggest suboptimal timed exposure meaning that the Xray was not taken at the right

time during the patients breathing cycle. A restrictive lung disease could be an attribute which

makes it difficult for the lungs to expand and subpulmonic effusion, which is a collection of fluid

between the lungs and diaphragm. ON the contrast, there is hyperinflation, which is assessed by

on the subjective impression that the total lung capacity increased based on the number of ribs

seems, flattening of the diaphragm and diffusely increased latency of the lungs. Hyperinflation

can be attributed to conditions such as COPD and Asthma.

The video also mentions radiographic categories of diffuse lung opacities including

alveolar opacities and interstitial opacities. Alveolar opacities are caused by fluid accumulation

within the alveoli and termina bronchioles such as blood, pus, or edema. These opacities are hazy

with poorly defined margins but can respect lobar boundaries unless diffused. These opacities

can be linked with cardiogenic pulmonary edema, which is any cause of congestive heart failure

such as acute MI, arrhythmia myocarditis. Another opacity is the non-cardiogenic pulmonary

edema, which is attributed to acute lung injury, acute respiratory distress syndrome. The

radiographic factors used to differentiate cardiogenic from non-cardiogenic edema include air

bronchograms peribranchial cuffing, Kerley lines, cephalization, and Bat’s wing pattern. The

video also mentions the subtypes of interstitial opacities based on pattern, which include reticular
 5

opacities showing too many lines, nodular opacities showing too many dots and reticulonodular

opacities attributed to too many lines and too many dots.

Video4: Focal lung Disease

https://www.youtube.com/watch?v=fiGgpY2GXsk

The video’s objective is to identify, localize and restrict focal opacities, particularly

pneumonia. The video begins with lobar anatomy and radiographic zones of the chest. The lobar

anatomy includes the horizontal fissures, oblique fissures, right middle and low lobe, left upper

and lower lobe. The lung zones are four including apical zone extending to the upper lobe then to

mid zone and lower zone. The narrator mentioned the importance of understanding opacity

versus infiltrate versus consolidation. He mentioned that consolidation means a relatively large,

dense, homogenous opacifications that frequently involves the whole lobe. Others recommend

against using infiltrate as I t is biased as it may be perceived as an etiology as an infection

although it is qualitatively used in describing alveolar, nodular, interstitial or cavitary. Moving

on, the narrator explains the silhouette signs including loss of normally visible border of an

intrathoracic structure resulting from an adjacent pulmonary density. A spine sign, on the other

hand, is the abnormal increase in opacification overlying the spine while moving superior to

inferior on the lateral view, which suggests lower lobe infiltrates or opacities.

Some of the etiologies of focal opacities include infections such as pneumonia which can

be bacterial, viral fungal and mycobacterial. There is also malignancy such as primary lung

cancer, metastatic disease, and lymphoma. Others include pulmonary hemorrhage, pulmonary

infarction, vasculitis, and Eosinophilic Pneumonia. Focusing on radiographic patterns of

pneumonia, some of the subtype pneumonia include lobar pneumonia which has radiographic

features such as homogenous consolidation, air bronchograms common and harp borders

corresponding to fissures that can be cause by streptococcus pneumoniae. Another subtype is

segmental pneumonia with features such as patchy o [pacification, air bronchograms uncommon,

vague borders and frequently bilateral caused by haemophiles influenzas. Other subtypes are

interstitial pneumonia, with reticular patterns and no air bronchograms and round pneumonia

which is easily mistaken for tumor or other lung mass.