Cardiothoracic ratio
A simple measurement made on a PA chest radiograph to evaluate the heart size is the C/T ratio, with a value greater than 50% indicating cardiomegaly
Atherosclerosis
One form of arteriosclerosis; major cause of vascular disease of the extremities in which fatty deposits called plaques develop in the intima and produce progressive narrowing and often complete occlusion of large and medium-size arteries
Under 140/90, for every decade add 10 to systolic pressure
Normal BP Values
Infective endocarditis
Refers to the formation of nodules or vegetations on heart valves by deposits of bacteria or fungi
Myocardial infarction
Occlusion of a coronary artery deprives an area of myocardium of its blood supply and leads to the death of muscle cells
Fusiform aneurysm
Bulging of the entire circumference of the vessel wall
Saccular aneurysm
Involves only one side of the arterial wall
Complications of rheumatic fever
Vegetations - Deposits of blood platelets and fibrin from blood flowing over the valve produce small nodules along the margin of the valve cusps
Stenosis - The thickened valves may stick together, so that the valvular opening remains permanently narrowed
Aortic dissection
Occur in patients with arterial hypertension; some are a result of trauma, whereas others are attributable to a congenital defect, such as Marfan's syndrome
Tetralogy of Fallot
Most common cause of cyanotic congenital heart disease
Pericardial effusion
Refers to the accumulation of fluid within the pericardial space surrounding the heart
Left-to-right shunts
Permit mixing of blood in the systemic and pulmonary circulations; because blood is preferentially shunted from the high-pressure systemic circulation to the relatively low-pressure pulmonary circulation, the lungs become overloaded with blood
Coarctation of the aorta
Refers to a narrowing, or constriction, of the aorta that most commonly occurs just beyond the branching of the blood vessels to the head and arms
Coronary artery disease
Causes oxygen deprivation of the myocardium and ischemic heart disease; in most patients, narrowing of the lumen of one or more of the coronary arteries is attributable to the deposition of fatty material on the inner arterial wall
Traumatic rupture of the aorta
Potentially fatal complication of closed-chest trauma (rapid deceleration, blast, compression); aortic tear occurs just distal to the left subclavian artery at the site of the ductus arteriosus
CHF
Causes include an intrinsic cardiac abnormality, hypertension, and any obstructive process that abnormally increases the peripheral resistance to blood flow
CHF
PA Chest - C/T ratio >50%
Left sided: cardiac enlargement, pulmonary edema, and pulmonary effusion
Right sided: widened mediastinum and elevated right hemidiaphragm
Echocardiography - measuring left ventricular performance, ejection fraction, and filling
Pulmonary edema
PA Chest - vascular markings not sharp; severe edema produces a butterfly pattern
Atrial septal defect
Enlargement of right ventricle, right atrium, pulmonary outflow tract
Patent ductus arteriosis
Enlargement of the left atrium, left ventricle, and the central pulmonary arteries, along with a diffuse increase in pulmonary vascularity; the increased blood flow through the aorta proximal to the shunt produces a prominent aortic knob in contrast to th
Goiter
An enlargement of the thyroid gland that does not result from an inflammatory or neoplastic process and is not initially associated with hyperthyroidism or myxedema; although once endemic in areas where there was insufficient iodine in the diet, this situ
Exophtalmos
Outward protrusion of the eyeball caused by edema in the tissue behind the eyes; unilateral or bilateral ________ as a result of Graves' disease can be demonstrated by CT as thickening of the extraocular muscles
Neuroblastoma
A tumor of adrenal medullary origin, is the second most common malignancy in children. About 10% of these tumors arise outside the adrenal gland, primarily in sympathetic ganglia in the neck, chest, abdomen, or pelvis. The tumor is highly malignant and te
Hyperpituitarism
Results from an excess of growth hormone produced by a tumor or generalized hyperplasia of the anterior lobe of the pituitary gland
Diabetes mellitus
Common endocrine disorder in which either beta cells in the islets of Langerhans of the pancreas fail to secrete insulin or target cells throughout the body fail to respond to this hormone; a lack of insulin prevents glucose from entering the cells, thus
Cretinism
Hyperthyroidism can result from any structural or functional abnormality that leads to an insufficient synthesis of thyroid hormone. Hypothyroidism dating from birth
Pheochromocytoma
A tumor that most commonly arises in the adrenal medulla and produces an excess of vasopressor substances (epinephrine and norepinephrine), which can cause an uncommon but curable form of hypertension
Cushing's syndrome
The excess production of glucocorticoid hormones in this condition may be attributable to generalized bilateral hyperplasia of the adrenal cortex, or it may be a result of a functioning adrenal or even nonadrenal tumor
Hypopituitarism in children
Typically leads to a type of dwarfism in which the delayed appearance of epiphyseal centers causes the failure of bones to grow normally in length or width. This results in a person who is small in stature and sexually immature, although well proportioned
Carcinomas of the lung breast, kidney, ovary, and GI tract, and melanomas
Primary malignancies that metastasize to the adrenals
Epinephrine
The adrenal medulla secretes this (adrenaline) and norepinephrine. These fight-or-flight hormones are secreted in stress situations when additional energy and strength are needed.
Norepinephrine
...
Oxytocin
The posterior lobe of the pituitary gland (neurohypophysis) produces two hormones which includes ___________. This causes contraction of smooth muscle, especially in the uterus, an thus strengthens contractions during labor and helps prevent hemorrhage af
Vasopressin (ADH)
The posterior lobe of the pituitary gland (neurohypophysis) produces two hormones which includes _________. This increases the rate of reabsorption of water and electrolytes by the renal tubules, thus decreasing the output of urine and protecting the indi
MRI and CT
Best modality for imaging thyroid
Thyroid carcinoma
On radioactive iodine scans, this usually appears as a solitary cold nodule that corresponds to a palpable mass ; the finding of a nodule that is functioning (hot) essentially excludes a diagnosis of thyroid carcinoma
Papillary carcinoma
Most common type of thyroid carcinoma; has peaks of incidence in adolescence and young adulthood and again in later life, during the third to fifth decades; the tumor is usually slow growing and cystic, and it typically spreads to regional lymph nodes, wh
Acromegaly
Generalized overgrowth of all the body tissues is the underlying abnormality in acromegaly. Although the long bones can no longer grow because the epiphyses are closed, the bones of the hands, feet, and face enlarge, and there is excessive growth of soft
Hypoglycemic shock
Patient feels lightheaded and faint, trembles, and begins to perspire; sugar must be given to manage it, usually in the form of orange juice or candy
Gigantism
The development of hyperpituitarism before enchondral bone growth has ceased results
Acromegaly
The development of hyperpituitarism beginning after bone growth has stopped
CHF
Refers to the inability of the heart to propel blood at a rate and volume sufficient to provide an adequate supply to the tissues
CHF
Intrinsic cardiac abnormalities include insufficient or defective cardiac filling and impaired contractions for emptying
Atherosclerosis
In the abdomen, this disease primarily involves the aorta and the common iliac arteries, often sparing the external iliac vessels
Atherosclerosis
In the lower extremities, this narrowing most commonly affects the superficial femoral artery just above the knee; plaque formation and luminal narrowing often involve the coronary and cerebral arteries, thus decreasing the blood flow to the heart muscle
Rheumatic fever
An autoimmune disease that results from a reaction of the patient's antibodies against antigens from a previous streptococcal infection; Symptoms (fever, inflamed and painful joints, rash) typically develop several weeks after the streptococcal infection
Infective endocarditis
Unlike the smaller nodules in rheumatic fever, the vegetations of this disease are filled with bacteria and tend to break apart easily (they are friable) to enter the bloodstream and form septic emboli that travel to the brian, kidney, lung, or other vita
Infective endocarditis
Emboli lodging in the skin may cause rupture of small blood vessels and characteristic tiny hemorrhagic red spots (petechiae)
Tetralogy of Fallot
Consists of four abnormalities: (1) high ventricular septal defect, (2) pulmonary stenosis, (3) overriding of the aortic orifice above the ventricular defect, and (4) right ventricular hypertrophy
Tetralogy of Fallot
Pulmonary stenosis causes an elevation of pressure in the right ventricle and hypertrophy of that chamber. Because of the narrow opening of the pulmonary valve, an inadequate amount of blood reaches the lungs to be oxygenated
Coarctation of the aorta
Blood supply and pressure to the upper extremities are higher than normal. As a result, there is decreased blood flow through the constricted area to the abdomen and legs.
Coarctation of the aorta
Classically the patient has normal blood pressure in the arms, but very low blood pressure in the legs
Coarctation of the aorta
Most frequent cause of hypertension in children; the relative obstruction of aortic blood flow leads to the progressive development of collateral circulation - the enlargement of normally tiny vessels in an attempt to compensate for the inadequate blood s
Coronary artery disease
Factors predisposing to the development of this disease include hypertension, obesity, smoking, a high-cholesterol diet, and lack of exercise
Left-to-right shunts
Atrial septal defect, which permits free communication between the two atria as a result of either lack of closure f the foramen ovale after birth or its improper closure during gestation. Because the left atrial pressure is usually higher than the pressu
Left-to-right shunts
The ductus arteriosus is a vessel that extends from the bifurcation of the pulmonary artery to join the aorta just distal to the left subclavian artery. It serves to shunt blood from the pulmonary artery into they systemic circulation during intrauterine
Epinephrine
Stimulates heart activity, raises blood pressure, and increases the level of blood glucose. By constricting some blood vessels and dilating others, this shunts blood to active muscles where oxygen and nutrients are urgently needed
Cushing's syndrome
Can also be the result of the exogenous administration of cortisone. Excess secretion of glucocorticoid hormones mobilizes lipids and increases their level in the blood. This increase produces a characteristic obesity that is confined to the trunk of the
Pheochromocytoma
About 10% of these are extraadrenal in origin. About 10% of patients with this have bilateral tumors, and a similar percentage of these are malignant
Acromegaly
The associated hypertrophy of the soft tissues produces the characteristic square, spade-shaped hand of this condition
Cause of cretinism
Hyperthyroidism dating from birth results in multiple developmental abnormalities; children with this condition typically have a short stature; coarse features with a protruding tongue, a broad, flattened nose, and widely set eyes; sparse hair; dry skin;