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THERAPIES AND THERAPEUTIC PROCEDURES

PULMONARY PHARMACOLOGY Pulmonary pharmacology concerns the effects of drugs on the lungs and understanding how drugs used to treat patients with pulmonary diseases work. Much of this pharmacology concerns drugs used to treat obstructive airway diseases, such as asthma and chronic obstructive pulmonary disease (COPD). Two types of drugs are used in the treatment of obstructive airway diseases: Relievers (bronchodilators) give immediate reversal of airway obstruction,…

DISEASES AND PATHOLOGY

Plate 4-1 Open full size image CONGENITAL DEFORMITIES OF THE THORACIC CAGE PECTUS EXCAVATUM Pectus excavatum is also called funnel chest, chonechondrosternon, or trichterbrust. It is a deformity of the anterior chest wall characterized by depression of the lower sternum and adjacent cartilages. The lowest point of the depression is at the junction of the xiphoid process and the body of the sternum. The trait is…

DIAGNOSTIC PROCEDURES

TESTS OF PULMONARY FUNCTION RADIOLOGIC EXAMINATION OF THE LUNGS Chest radiography remains the primary imaging modality for initial evaluation of patients with suspected chest disease and in many cases not only identifies abnormalities but also allows a specific determination of the nature of the disease present. ROUTINE EXAMINATION (see Plates 3-4 to 3-6 ) In most imaging centers, radiographs are no longer recorded on film but…

PHYSIOLOGY

PULMONARY MECHANICS AND GAS EXCHANGE The major function of the lung is to deliver oxygen to and remove carbon dioxide from the blood as it passes through the pulmonary capillary bed. This function is achieved through a series of complex and highly integrated series of processes. The first step in this essential gas exchange process is the contraction of the inspiratory muscles, producing the force (pressure…

ANATOMY AND EMBRYOLOGY

RESPIRATORY SYSTEM The respiratory system is made up of the structures involved in the exchange of oxygen and carbon dioxide between the blood and the atmosphere, so-called external respiration . The exchange of gases between the blood in the capillaries of the systemic circulation and the tissues in which these capillaries are located is referred to as internal respiration . The respiratory system consists of the…

Spine

Cervical Spine Axial 1 Pathologic Process Note on these images that the nasopharynx is often seen on cervical spine imaging. The neuroradiologist should always check for symmetry of the Eustachian tube opening and fossa of Rosenmüller just anterior to the longus capitis muscle to ensure that no nasopharyngeal lesion is present (see Chapter 13 ). Imaging Technique Consideration Spinal imaging can be daunting at first due…

Hypopharynx, Larynx, and Infrahyoid Neck

Hypopharynx, Larynx, and Infrahyoid Neck Axial 1 Diagnostic Consideration Axial 1 on the next page shows both a T2-weighted sequence (upper image) and a T1-weighted image (lower). Note that cerebrospinal fluid (CSF) around the spinal cord is bright on T2-weighted magnetic resonance imaging and dark gray on T1-weighted MRI. Usually the brightest structure on T1-weighted imaging is fat. Note that the fat is somewhat bright on…

Oral Cavity, Pharynx, and Suprahyoid Neck

Oral Cavity, Pharynx, and Suprahyoid Neck Axial 1 Normal Anatomy Note the enhancement of the mucosal surfaces of the aerodigestive tract on the lower magnetic resonance (MR) image in Axial 1 after gadolinium contrast administration. The subcutaneous adipose tissue and the adipose planes between the structures in the neck are visible on both the upper pre-contrast T1-weighted MR image and the lower post-contrast T1-weighted MR image.…

Temporal Bone (Middle Ear, Cochlea, Vestibular System)

Temporal Bone Axial 1 Normal Anatomy The temporal bone initially may seem a daunting area for magnetic resonance imaging because of the apparent structural complexity. To understand the temporal region better, trace the hearing pathway from auricle through external auditory canal, to tympanic membrane attached to small bones (ossicles; malleus, incus, and stapes) in the middle ear cavity, through stapes stirrup on oval window, then vestibule…

Mandible and Muscles of Mastication

Mandible and Muscles of Mastication Axial 1 Normal Anatomy Four paired muscles—temporalis, masseter, medial pterygoid, and lateral pterygoid—are the primary muscles of mastication, responsible for adduction and lateral motion. In the axial MR image on the next page, note the temporalis muscle superficial to the temporal lobe of the brain. These muscles are innervated by the mandibular branch (V 3 ) of the trigeminal nerve, cranial…

Orbits

Orbits Axial 1 Orbits Axial 1 Orbits Axial 2 Orbits Axial 2 Orbits Axial 3 Normal Anatomy The lenses are normally biconvex in shape. If this configuration is replaced by a thin line, the patient likely has had the lens removed because of cataracts and replaced with an artificial lens. Orbits Axial 3 Orbits Axial 4 Orbits Axial 4 Orbits Axial 5 You’re Reading a Preview…

Paranasal Sinuses

Paranasal Sinuses Axial 1 Normal Anatomy The paranasal sinuses are composed of the frontal sinuses, the ethmoid sinuses or ethmoid air cells, the maxillary sinuses or maxillary antra, and the sphenoid sinuses. The names are derived from the bones that form the walls of the sinuses. Paranasal Sinuses Axial 1 Paranasal Sinuses Axial 2 Normal Anatomy The sphenoid sinuses are at the center of the skull…

Sella turcica

Sella Turcica Coronal 1 Technical Note The upper MR image is a coronal T1-weighted pre-contrast sequence and the lower is a coronal T1-weighted post-contrast sequence. Sella Turcica Coronal 1 Sella Turcica Coronal 2 You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Ventricles and Cerebrospinal Fluid Cisterns

Ventricles and CSF Cisterns Axial 1 Normal Anatomy The ventricular system is located deep within the brain and is filled with cerebrospinal fluid (CSF). The normal appearance of CSF on magnetic resonance images is that of water. This axial MR image shows the choroid plexus within the ventricles, where CSF is produced. CSF is also seen outside the brain and within the sulci (subarachnoid space). Pathologic…

Brainstem and Cranial Nerves

Cranial Nerve I Axial 1 Normal Anatomy The olfactory nerve, or cranial nerve (CN) I, is the first of 12 cranial nerves and provides innervation for the sense of smell. CN I can often be seen on axial magnetic resonance imaging of the brain at the level of the temporal lobes. Nerve fibers from the olfactory mucosa in the anterosuperior nasal cavity join with the olfactory…

Limbic System

Limbic System Axial 1 Limbic System Axial 1 Limbic System Axial 2 Normal Anatomy Note how the fornix (Latin, “arch” or “vault”) is more easily seen as a paired structure on the T2-weighted axial magnetic resonance image (upper radiology image), compared with the fornix as seen in the Chapter 3 images focusing on the basal ganglia and thalami. The fornix is a C -shaped bundle of…

Thalamus and Basal Ganglia

Thalamus and Basal Ganglia Axial 1 Normal Anatomy The centrum semiovale, corona radiata, and internal capsules are all continuous white matter tracts. The centrum semiovale is the white matter deep to the gray matter on the surface of the brain and has an ovular shape. On axial imaging, it is generally a term used for white matter superior to the ventricles. The corona radiata (Latin: “sunburst”)…

Brain

Brain Axial 1 Normal Anatomy Named after the French anatomist Paulin Trolard (1842–1910) and also known as the superior anastomotic vein, the vein of Trolard is the largest cortical vein at the convexity (see also Brain Coronal 15 ). The vein of Trolard anastomoses with the middle cerebral vein and the superior sagittal sinus. Note the first cranial nerves, the olfactory nerves, in the olfactory grooves…