1.

TB Treatment: Plumbage  Smoking is the primary risk factor for emphysema but
 Prior to the discovery of isoniazid, early methods to it can also be cause by pollution or an inherited lack of
treat patients with TB relied heavily upon rest and an enzyme called alpha-1-antitrypsin.
isolation in sanatoriums.
 A common treatment was to collapse the lung in 7.Pneumoconiosis:
order to allow it to “rest.”  This is an occupational disease where dust or
 This technique had absolutely no value in fighting this particulate matter is inhaled.
disease.  This causes the formation of pulmonary fibrosis.
 One method employed to “rest” the lung was to  Types:
surgically insert ping pong balls into the pleural space of  Silicosis is caused by inhaling silicon dioxide
the upper lung field in order to compress the lung. (sand).
 This technique was know as plumbage.  Asbestosis occurs as the result of inhaling
asbestos dust.
2. TB Treatment: Thoracoplasty  Patients who present with this disease possesses very
 Another type of treatment for TB prior to the use of distinct radiopaque pleural plaques.
effective medications was a procedure called a  Black lung disease is caused by inhaling coal dust.
thoracoplasty
 This technique involved removing some of the ribs 8.Pulmonary Embolus (PE):
from the chest wall in order to cause the upper lobe  Pulmonary emboli are often caused by blood clots
of the lung to collapse. that break off from veins in the legs.
 Ideally, a total of 7 to 8 ribs would be removed.  These clots form emboli that can obstruct the lumen
Physicians generally would only remove 2 or 3 at a of the pulmonary arteries.
time and as a result, the patient would have to endure  Many times this will resolve on its own but large
several surgeries obstructions can infarct the lung and lead to death.
 A patient with blood clots in the veins of their legs is
3. Histoplasmosis said to have a condition called deep vein thrombosis
 This condition occurs as the result of inhaling soil (DVT).
and/or bat/bird droppings that have been infected  A PE is most often seen in elderly, bedridden patients,
with a fungus called Histoplasma capsulatum. and in postoperative patients.
 It has a similar radiographic appearance to TB.  A chest X-ray may demonstrate an area of
 Most cases of histoplasmosis are self limiting but in consolidation that is commonly referred to as
some extreme cases, anti-fungal medications may be “Hampton’s Hump.”
indicated.
p The following is a list of symptoms for a PE:
4. Bronchiectasis:  Chest Pain
 Bronchiectasis is characterized by an irreversible  Dyspnea (Shortness of Breath)
dilation of the bronchi caused by a bacterial  Cough
infection.  Hemoptysis (coughing up blood)
 It usually affects the base of both lungs.  Dyspnea (difficulty breathing)
 Signs and symptoms of this disease include a chronic  Pneumothorax (lung collapse)
cough, acute pneumonia, and hemoptysis.  Cyanosis (blue discoloration)
 Treatment includes controlling infections, postural Diagnostic tests for this condition are as follows:
drainage, and surgical resection of the affected area.  Arterial Blood Gas
 Pulse Oximetry
5. Chronic Obstructive Pulmonary Disease:  Routine Chest X-ray
 Chronic obstructive pulmonary disease (COPD) is a  Ventilation/Perfusion Scan in Nuclear Medicine
term used to describe two lung diseases, chronic  Pulmonary Arteriogram
bronchitis and emphysema.  CT Angiogram of the Chest
 These two diseases tend to coexist.  Doppler Ultrasound to Detect DVT
 They also both pertain to an obstruction of the Pulmonary Embolus (PE):
normal flow of air within the lungs.  A variety of treatment options are available for a PE.
 As a result, physicians collectively refer to them as  The definitive choice is dependent upon the severity of
COPD. the condition.
 Smoking is the primary risk factor for COPD. Up to  Treatment options are as follows:
90% of COPD related deaths are related to smoking  Blood Thinners (heparin)
 Thrombolytic Therapy (streptokinase/urokinase) to
6 . Emphysema:  Dissolve the Clot
 Emphysema is a type of COPD that is  Insertion of an Inferior Vena Cava Filter
characterizedby a chronic destruction of bronchi  Surgery
and alveoli.
 The destruction and rupture of the alveolar walls 9. Lung Cancer:
will lead to the formation of large pockets of empty  Lung cancer represents approximately 35% of all
space within the lungs called bulla. cancer deaths and it is the most common cause of
 The net result is a decrease in air flow death in both men and women.
hyperaeration (barrel chest), and dyspnea.  The average onset is age 60.
 Smokers are 10 times more likely to develop lung  Spontaneous
cancer than non smokers.  Most commonly found in tall, thin, young males.
 The most common symptoms of lung cancer are  Iatrogenic
coughing, hemoptysis, dyspnea (SOB), and anorexia  May be caused during a thoracentesis or chest tube
(weight loss). insertion
 A biopsy is required to make a definitive diagnosis.  A tension pneumothorax is a life-threatening condition
 Common treatments for lung cancer include surgery, that is caused by a ball-valve type of fistula.
radiation therapy, and chemotherapy  A fistula is an abnormal passageway between two
structures that do not normally connect.
10.Bronchogenic Carcinoma  Treatment for a pneumothorax often includes the
 This is a primary lung cancer that arises from the insertion of a chest tube.
respiratory epithelium.  The chest tube will restore the normal “negative
 It is divided into the following two broad categories: pressure” within the pleural space thus providing the
 Small Cell Lung Cancer (SCLC) means for the lung to aerate.
 Non Small Cell Lung Cancer (NSCLC)  It will also remove any excess fluid that may have
 Bronchogenic carcinoma has a poor prognosis with a accumulated within the pleural space
5-year survival rate of 12 to 14%
15. Subcutaneous Emphysema:
11.Pulmonary Metastasis:  Air escaping the patients lungs following a traumatic
 Pulmonary metastasis (secondary lung cancer) is pneumothorax may enter the patients surrounding
much more common than primary lung cancer. tissues.
 It primarily occurs via the lymphatic system or the  This condition is know as subcutaneous emphysema
circulatory system. and if palpated, it will make a very distinct crackling or
 It is common from the following types of primary poppingnoise that is referred to as crepitation.
cancer:  This air is eventually absorbed by the body
 Breast Cancer
 Colon Cancer 16. Pleural Effusion/Hydrothorax:
 Prostate Cancer  Excess fluid that accumulates within the pleural space
 Treatment for pulmonary metastasis varies according is know as a pleural effusion.
to the type of primary cancer that is involved.  It can be caused by a myriad of conditions such as
congestive heart failure (CHF) or pulmonary emboli.
12.Pulmonary Edema  Large pleural effusions may require the insertion of a
 Pulmonary edema occurs when air within the lungs chest tube to remove the excess fluid.
is replaced with fluid.  Another course of treatment would be the use of a
 It leads to a decrease in gas exchange and may needle to aspirate or remove the effusion.
cause respiratory failure.  This procedure is referred to as a thoracentesis.
 It often occurs secondary to congestive heart failure
(CHF) or renal failure. 17. Infant Respiratory Distress Syndrome:
 Treatment includes the administration of oxygen and  Respiratory distress syndrome (RDS) was formerly
diuretics. referred to as hyaline membrane disease.
 Removing the underlying cause of the pulmonary  It is characterized by a lack of surfactant in premature
edema is the most important consideration for infants.
treatment.  This causes the alveoli to poorly aerate resulting in
13. Atelectasis hypoxia.
 refers to a condition where either a portion of or  RDS has a very distinctive “ground glass” radiographic
the entire lung has collapsed and is without air. appearance on a chest X-ray.
 It results from a bronchial obstruction that can be
caused by any of the following conditions: Cardiovascular System Menu
 Tumor 1. Aneurysm
 Foreign Body 2. Aortic Abdominal Aneurysm (AAA)
 Mucous Plug 3. Congestive Heart Failure
 This is a common cause for acute atelectasis 4. Dextrocardia
especially postoperatively following chest or 5. Elephantiasis
abdominal surgery. 6. Tetrology of Fallot

14. Pneumothorax: 1. Aneurysm:

 A pneumothorax is a condition occurs when air is  An aneurysm is a weakening of an arterial wall
introduced into the pleural space. that results in a bulge or balloon-like appearance.
 The net result of this phenomena is a collapsed  A rupture of this bulge is potentially fatal.
lung.  They are most commonly associated with cerebral
 Common causes of a pneumothorax include the arteries and the abdominal aorta.
following:
 Trauma
May be the result of a penetrating chest wound.
 Ruptured Bulla from Emphysema
2. Aortic Abdominal Aneurysm (AAA):  Work with diuretics ton increase cardiac output and
 Aortic abdominal aneurysms often form with minimal reduce hypertension
symptoms and are easily diagnosed with an
ultrasound.  Beta Blockers
 The average age for diagnosis is between 65 to 70.  Helps to improve left ventricular contraction
 The risk of rupture begins at 5 cm and they can swell 1. Acebutolol
to over 15 cm in diameter. 2. Bisoprolol
 Inserting an endovascular stent through the femoral 3. Nebivolol
 artery or surgically replacing the aneurysm with a graft 4. Metoprolol
or synthetic patch tube are two common means of  Positive Inotropes
treatment.  Work to increase the strength of heart contractions
 A non surgical approach for aneurysms less than 5 cm  Digoxin is commonly prescribed positive inotrope
would be to lower cholesterol levels, reduce 1. Epinephrine
hypertension, and smoking cessation. 2. Norepinephrine
3. Digoxin
3. Congestive Heart Failure ( CHF) 4. Dopamine
 Refers to a condition or conditions that result in a  Vasodilators to Reduce Hypertension
decrease of cardiac output 1. Benazepril
 For people over 65, it is leading cause for 2. Losartan (ARB)
hospitalization.
 Victims commonly suffer from dyspnea after mild Dextrocardia
physical activity.  Situs inversus is very rare congenital condition where
 Other common symptoms for patients with CHF all of the organs in the body are transported to the
include peripheral edema and ascites. opposite side; has unknown etiology
 A chest x-ray may demonstrate cardiomegaly,
pulmonary edema or pleural effusion.  Is a congenital defect where the heart is transported to
the opposite side of the body with thorax
Myriad of condition's that can cause CHF:
 Condition's affecting the left side of the heart includes: Elephantiasis
 Hypertension  thickening of the skin and underlying tissue pf the legs
 Aortic Coarctation (narrowing of the aorta) and genitalia in the form of hydrocele
 Aortic and Mitral Valve Disease
 Conditions affecting the right side of the heart includes:  Usually cause by parasite roundworms that block the
 Pulmonary Hypertension lymphatic system; can cause by persistent contact
 Pulmonary or Tricuspid Valve disease with volcanic ash

Both sides of the heart are affected by: Tetralogy Of Fallot

 Ischemic Heart Disease  very rare congenital heart defect that presents at birth
 Acute Myocardial Infraction (heart attack) Consists of 4 defects:
 Cardiomyopathy  Pulmonary stenosis -narrowing of pulmonary valve
 Cardiac Fibrosis restricts the flow of blood into the pulmonary arteries
 Anemia  Ventricular Spetal Defect
 Chronic Arrhythmia  Hole that is located between the ventricles allows
 Thyroid disease oxygenated blood to flow from left ventricle to right
ventricle instead of into the aorta and rest of the body.
Treatment for CHF is dependent upon determining the  The combination of these four heart defects causes
cause and then treating the signs and symptoms. the heart to have a very distinctive “boot-shaped”
 Improve Diet radiographic appearance.
 Moderate Physical Activity  Fortunately, the diagnosis and surgical treatment for
 Weight reduction Tetralogy of Fallot has greatly improved.
 Sodium restriction  With proper medical care, these children can live into
 Fluid restriction adulthood.
 Smoking Cessation
 Alcohol Cessation GASTROINTESTINAL SYSTEM
Zenker’s Diverticulum -A diverticulum is an outpouching
Medical Treatment for CHF includes: that occurs due to a weakening in the lining of, in this
 Diuretics to reduce Retention particular instance, the digestive system.
1. Ethacrynic acid  This is not to be confused with a neoplasm which is a
2. Aldactone new growth that usually develops in towards the
3. Indopamine lumen of the digestive system.
 ACE Inhibitors  Diverticulum are often diagnosed with barium studies
1. Benazepril or Benacepril of the digestive system.
2. Enalapril  Zenker’s diverticulum arise from the posterior wall of
3. Lisinopril the upper esophagus in the area of the pharynx.
 Although often asymptomatic, they can cause  As a result, the esophagus fills with ingested food and
dysphagia (difficulty in swallowing) and halitosis (bad fluids.
breath).  Treatment includes a bland diet, medication to relax
the LES, surgery, and an upright position to reduce
Traction Diverticulum regurgitation.
 This type of diverticulum forms in the mid esophagus
area. Esophageal Varices
 Traction diverticulum may form due to scarring from  Esophageal varices are dilated, tortuous veins of the
pulmonary tuberculosis or an inflammatory process esophagus which may rupture.
within the mediastinum.  They are commonly a result of portal hypertension
and/or liver cirrhosis.
Epiphrenic Diverticulim  Esophageal varies are often a complication of
 As the name implies, an epiphrenic diverticulum arises Alcoholism.
in the distal esophagus just superior to the lower  Esophagus cancer represents 2% of all cancers and
esophageal sphincter (LES). there is a high incidence in smokers and alcoholics.
 They may form as a complication to achalasia.  The prognosis for this cancer is very poor as it has a 5
year survival rate of 25%.
Hiatal Hernia  It presents with a very “ratty” radiographic appearance
 A hiatal hernia occurs when a portion of the stomach on a barium swallow.
protrudes (herniates) into the thorax through the  Treatment includes the following
esophageal opening in the diaphragm.  Chemotherapy
 This is known as a sliding hiatal hernia and it is the  Radiation Therapy
most common type of hiatal hernia encountered.  Esophagogastrectomy (gastric pull-up) The affected
 A rolling or paraesophageal hiatal hernia if very rare portion of the esophagus is removed and the stomach
but occurs when a portion of the stomach herniates is pulled up into the thorax.
into the thorax while the gastroesophageal junction
remains stationary. CANDIDA
 This is one of the most common findings on an UGI Candida occurs as the result of a fungus that has affected
series. the esophagus.
 It can affect up to 50% of the population as some point This is sometimes referred to as thrush.
in their lives. It is an opportunistic infection that is often found in HIV
 A hiatal hernia is usually asymptomatic but the patient positive and cancer patients due to the state of their
may experience a fullness in their chest or suppressed immune system.
regurgitation.
 This acid reflux may lead to inflammation and Peptic Ulcer Disease (PUD)
ulceration of the esophagus.  PUD is a general term that is used to describe ulcers
 Chronic herniation of the stomach may be associated of the stomach and duodenum.
with gastroesophageal reflux disease (GERD).  This is usually a chronic disease.
 Treatment includes a bland diet, antacids, and  Causes include the use of aspirin, steroids, spicy
medications to reduce reflux. foods, stress, and it can be the result of a bacterial
infection.
Paraesophageal Hiatal Hernia  Complications include the potential for an obstruction,
 This UGI study provides a great example of a perforation, and bleeding.
relatively rare paraesophageal hiatal hernia. In this  Treatment consists of a bland diet, antacids, decrease
case, a portion of the stomach has herniated into the stress, surgery, antibiotics and abstinence from
thorax (a) while the esophagus and lower esophageal smoking, alcohol, and aspirin.
sphincter remain in place (b  Gastric Ulcers These are very rare and may be a
complication of gastric
Gastroesophageal Reflux Disease carcinoma.
 This is often abbreviated as GERD and it is also often  Peptic Ulcers These are located in the duodenum
referred to as heartburn and acid reflux. and are much more common than gastric ulcers.
 This disease is characterized by a backward flow of They are mostly located in the duodenal bulb and are
gastric contents into the esophagus due to an usually not associate
incompetent lower esophageal sphincter (LES).
 GERD is commonly associated with a hiatal hernia. Gastric Carcinoma
 It is acquired by poor eating habits, obesity,  It is generally asymptomatic in the early stages and
pregnancy, NG tubes, alcohol abuse, tobacco, and as has generally metastasized to other areas of the body
a side effect of morphine. by the time it has been diagnosed.
 As a result, it has a poor prognosis.
Achalasia  UGI studies present thick, irregular, and rigid (linitis
 This is the exact opposite of acid reflux. plastica) folds.
 Achalasia is an esophageal motility disorder that  Treatment includes gastrectomy, chemotherapy, and
occurs due to the inability of the lower esophageal radiation therapy.
sphincter (LES) to relax.
Bezoar abdominal wall. This is called an inguinal hernia and it is
 This is a hard mass of entangled material found within estimated that about 5% of the population will develop an
the stomach or intestines that cannot be digested. abdominal wall hernia.
 They are often made of hair and food fibers.
Volvulus
Bowel Obstruction  A volvulus is a loop of intestine that has twisted
 The two broad categories of bowel obstructions are as around itself causing either a partial or complete
follows: adynamic or paralytic ileus and a mechanical obstruction.
bowel obstruction.  They may resolve on their own but some will require
 In either case, the net result is a partial or complete surgical intervention in order to prevent a loss of blood
loss of the normal parastaltic action of the small and/or supply to the affected area and relieve the obstruction.
large intestine thus impeding the normal transit of
chyme. Intussusception
 Signs and symptoms of a bowel obstruction would  Intussusception occurs when a section of bowel is
include the following: constricted by peristalsis causing it to prolapse or
 Abdominal Pain and/or Cramping telescope into itself.
 Abdominal Distention  This condition is primarily confined to infants aged 2 to
 Vomiting and Fecal Vomiting (unpalatable!) 36 months and occurs more frequently in boys than
 Constipation girls at a ratio of 3:1.
 Intussusception is the cause of approximately 1% of
Adynamic or Paralytic Ileus all adult bowel obstructions and commonly affects the
 This type of bowel obstruction is caused by a ileocecal valve.
reduction in the normal peristaltic action of the  It is commonly corrected with a barium enema.
intestines.
 This loss of peristalsis will cause the lumen of both the Adenomatous Polyp
small and large intestines to fill with air and fluid.  A neoplasm that grows into the lumen of the colon is
 Therefore, the radiographic appearance of air in both called a polyp.
the small and large intestines is an indication of this  A pedunculated polyp possess a stalk while a
condition. sessile (barnacle) polyp is attached directly to the
 Some common causes of an adynamic ileus are as bowel wall.
follows:  Most polyps are benign but an adenomatous polyp
 Anesthesia/Some Medications may transform into a malignancy and must be
 Abdominal Surgery removed.
 Illness  This is sometimes referred to as simply an adenoma.
 Colon polyps are generally asymptomatic but some
Mechanical Bowel Obstruction may cause rectal bleeding, pain, diarrhea, and/or
 This is the second category for bowel obstructions. constipation.
 A mechanical obstruction is caused by a motility
disorder that results from some type of structural Adenocarcinoma
abnormality.  An adenocarcinoma is a type of neoplasm that
 Many factors can contribute to a mechanical bowel originates in glandular tissue and can be the cause a
obstruction and some of them are listed below: bowel obstruction.
 Hernia  In the colon, it is also commonly referred to as
 Adhesions colorectal cancer and is thought to arise from
 Volvulus adenomatous polyps.
 Intussusception  The lifetime risk of developing colon cancer in the US
 Neoplasm (Adenoma/Polyp, Adenocarcinoma) is 7% and it is the second most common cause of
 Crohn’s Disease cancer mortality.
 Constipation  Unfortunately, this type of metastatic cancer often
goes unnoticed until it reaches a relatively advanced
Hernia stage.
 This type of obstruction is caused by a weakening of  A colonoscopy is the method of choice for diagnosis.
the abdominal wall that allows a portion of the small  A positive diagnosis is followed by surgical removal
and/or large intestine to protrude through it. and in many instances, chemotherapy.
 A reducibleherniacan be pushed back into the
abdominal cavity while an incarceratedherniacannot Regional Enteritis pr Crohn’s Disease
and could therefore lead to a bowel obstruction.  This is the last example of a disease that may be the
 A common hernia in men is called an inguinal hernia. cause of a mechanical bowel obstruction.
 This condition occurs when the inguinal ring is  Crohn’s disease is characterized by a chronic
compromised thus allowing a portion of the bowel to inflammation of the bowel and has an unknown
rupture through the abdominal wall. etiology.
 In some instances, the bowel will descend into  It is characterized by abdominal cramping, diarrhea,
the scrotum. constipation, weight loss or gain, and vomiting.
Inguinal- A large portion of this patients bowel (arrows) has  Fistulas may form in response the chronic
protruded through an unnatural opening within the inflammation that characterizes this disease.
 There is no known cure for Crohn’s disease.  Transcatheter embolization or an infusion of
vasopression have proven to be effective strategies
Constipation employed to stop the bleeding.
 Constipation is a very common digestive complaint
where the patient experiences hard stool that can be  Alveoli - thin walled sacs surrounded by capillaries
difficult to defecate. that allow for quick exchange of oxygen and carbon
 Straining to defecate can lead to anal fissures and dioxide
hemorrhoids (varicose veins of the rectum).  Bronchi- passage airway in the lower respiratory tract
 Severe cases can lead to a mechanical bowel that conducts air into lungs
obstruction called a fecal impaction.  Respiratory System- series of organs responsible for
 Causes of constipation include lack of dietary fiber, taking in oxygen and expelling carbon dioxide
dehydration, a decrease in peristalsis, stenosis,  Anoxia - complete lack of oxygen
tumors, anxiety, and abdominal surgery.  Diaphragm- sheet of muscle located between thoracic
 Treatment usually consists of an increased intake of and abdominal cavities
fluid and dietary fibers and the use of laxatives. In  Epistaxis- bleeding from the nose that may caused by
some instances, the impaction will require the use of dry air, an injury AKA nosebleed
enemas and/or manual removal.  Aspiration Pneumonia - occur when a foreign
 Constipation is a very common digestive complaint substance such as vomit is inhaled into lungs
where the patient experiences hard stool that can be  Aspiration- inhaling or drawing of foreign substance
difficult to defecate into upper respiratory tract
 Bacterial Pneumonia - caused by streptococcus
Divertuculosis pneumonia
 As mentioned earlier, diverticulum can occur along the  Bradypnea- slow rate of respiration less than 10
entire length of the GI tract. breaths per mim
 In regards to the large intestine, they are commonly  Tachypnea - abnormal rapid rate of respiratory, more
found in the area of the sigmoid colon. than 20 breaths per min
 Diverticulum often have no signs or symptoms and are  Apnea- absence of spontaneous respiration
often a serendipitous discover on a barium study or  Piothorax - collection of pis in pleural cavity
colonoscopy.  Pleuris- inflammation of parietal pleura in the lungs
 Mediastinum- space between lungs where the heart
Diverticulitis lies
 Diverticulitis occurs when a diverticulum become  Aorta- largest artery in the body that sends out
infected and bleeds. oxygenated blood to body
 This is often caused by entrapment of chyme or feces  Four (4) - valves contained in heart
within the diverticulum.  Arteries -carries blood away from the heart
 Veins- carries from towards or back to the heart
Appendicitis  Heart- cone shaped, muscular pump located within
 Appendicitis occurs as a result of entrapment of feces the mediastinum of the thorax resting upon diaphragm
within the appendix and the presence of an  Cholesterol or Plaque- yellow fatty deposit lipids in
appendicolith. artery that is hallmark of atherosclerosis. Also called
 Symptoms include right lower quadrant pain and an “atheroma”
increase the white blood cell count.  Angina pectoris(med term) -severe chest pain that
 A barium enema will demonstrate a spasm of the radiate the neck, jaw and left arm and is often
cecum and a non filling appendix. associated with sensation of chest tightness or
 Mild cases may resolve on their own but more severe suffocation cause by oxygen insufficiency
infections may require the surgical removal of the  CHF - pathological condition of heart which there is
appendix. reduced outflow of blood from the left side of the heart
because the left ventricle myocardium has become
Diverticula of the Appendix weak to pump blood
 Diverticula can form anywhere along the alimentary  Aneurysm- weakness in the wall of an artery resulting
canal. In this instance, the lining of the appendix has in localized widening of the artery.
weakened resulting in the formation of a small  Myocarditis - inflammation of the muscle layer of the
diverticula heart wall
 Myocardial Infarction - cause by partial or complete
GI BLEED occlusion or closing of one or more coronary arteries.
 A GI bleed can occur throughout the GI tract. Delay in treatment could result to death.
 The most common causes of lower GI bleeding are  Hypertension- blood pressure above normal
diverticulitis and angiodysplasia.  Dextrocardia -apex of heart points to the right rasher
 The primary symptom is rectal bleeding with bright than the left side of chest
red blood.  Sitos inversus - all prgans in the body are
 Endoscopy, nuclear medicine scans, and/or special transported to opposide side.
procedure studies (IMA/SMA) can be performed to
diagnose this condition.