Murray & Nadel's Textbook of Respiratory Medicine, 2-Volume Set (Murray and Nadel's Textbook of Respiratory Medicine)

Title Front Matter.pdf Murray & Nadel’s Textbook of Respiratory Medicine Copyright.pdf Copyright Dedication.pdf Dedication Dedication 1.pdf Dedication Contributors.pdf Contributors Preface to the Seventh Edition.pdf Preface to the Seventh Edition 1 Anatomy.pdf 1 - Anatomy Introduction Gross and Subgross Organization Airways Bronchial Circulation Pulmonary Circulation Terminal Respiratory Units Lymphatics Innervation Pleural Space and Pleural Membranes Cellular Anatomy of the Lung Airway Lining Cells Alveolar Lining Cells Mesenchymal Cells Neural Cells Hematopoietic and Lymphoid Cells Pleural Cells Molecular Anatomy of the Lung Comparison of the Lung of Humans and Mice Key Readings Acknowledgments eFIGURE IMAGE GALLERY References 2 Lung Growth and Development.pdf 2 - Lung Growth and Development Stages of Lung Development With Cellular and Molecular Mechanisms Embryonic Stage Pseudoglandular Stage Canalicular Stage Saccular Stage Alveolar Stage Developmental Insights Into Lung Repair and Regrowth Emerging Technologies to Study Lung Development Induced Pluripotent Stem Cell–Derived Lung Cells Lung Organoids CRISPR/Cas9 Genome Editing Single-­Cell Sequencing Representative Developmental Lung Diseases Defects in Trachea/Esophagus Specification and Separation Defects in Branching Morphogenesis Lung Hypoplasia Surfactant Protein Deficiencies Preterm Birth and Bronchopulmonary Dysplasia Childhood Interstitial Lung Diseases Pulmonary Vascular Disease Congenital or Lung Developmental Defects That Manifest Later in Life Key Readings References 3 Alveolar Compartment.pdf 3 - Alveolar Compartment INTRODUCTION Cellular Composition of the Alveolar Epithelium Alveolar Type 1 Cells Functional Roles of the Alveolar Unit Surfactant Composition Surfactant Protein A Surfactant Protein B Surfactant Protein C Surfactant Protein D Surfactant Secretion and Turnover Alveolar Immune Defense and Inflammatory Modulation Alveolar Epithelial Integrity and Barrier Function Alveolar Fluid Clearance and Ion Transport Developmental Ion and Fluid Management Roles of Individual Ion Transporters . The primary pathway for Na+ entry is via apical amiloride-­sensitive ENaC, with basolateral Na+,K+-­ATPase driving Na+ into th... . Apically located amiloride-­insensitive CNG channels provide another Na+ entry pathway in the alveolar epithelium. CNG channel... . Both AT1 and AT2 cells express a number of Cl− transport proteins, including CFTR, the CLC2 and CLC5 channels of the CLC famil... . The activity of the Na+,K+-­ATPase pump provides the driving force for Na+ resorption by maintaining low intracellular levels ... . A number of K+ channels are present on AECs and are important for maintaining membrane potential and the electrochemical gradi... Physiologic Regulation of Ion and Fluid Transport Impaired Fluid Clearance and Resolution of Alveolar Edema Under Pathologic Conditions Alveolar Epithelial Repair Diseases of the Distal Lung Epithelium Key Readings References 4 Airway Biology.pdf 4 - Airway Biology INTRODUCTION OVERVIEW Airway Structure and Cellular Components Upper Airway Structure and Function Lower Airway Structure and Function Microvasculature Airflow Upper Airways Lower Airways Airflow Resistance Airway Lymphatic Vessels Microvascular-­Related Inflammation Extracellular Matrix and Fibroblasts Anatomic Specificity of Extracellular Matrix Smooth Muscle Innervation Afferent Autonomic Control of Airway Smooth Muscle Efferent Autonomic Control of Airway Smooth Muscle Other Neural Controls Airway Epithelium Morphology Cell-­Cell Junctions Airway Barrier Function Tight Junction Proteins Adherens Junction Proteins Cell Populations Upper Airway Epithelial Cells Lower Airway Epithelial Cell Populations and Frequencies Basal Cells Intermediate Cells . Ciliated cells are the most common type of differentiated cells lining the airway lumen of the bronchi and are present in high... Secretory Cells Mucous Cells Pulmonary Neuroendocrine Cells Ionocytes Respiratory Brush (Tuft) Cells Bronchoalveolar Stem Cells Submucosal Glands Progenitor Cells Airway Epithelial Cell Life Span Tissue-­Specific Stem Cells of the Airway Facultative Progenitor Epithelial Cells Airway Epithelial Cell Differentiation Notch Signaling Differentiation Pathways for Secretory and Ciliated Cells Airway Surface Liquid Composition Airway Surface Liquid Layers Water Ions Mucins and Other Macromolecules Periciliary Layer Contribution to Airway Surface Liquid Hydration Mucus Gel Layer Integrated Effects of PCL and Mucus Gels on ASL Hydration Secretion Submucosal Gland Secretion Surface Mucous Cell Secretion Mucus and Mucociliary Interactions Mucociliary Clearance Establishment of Directional Mucociliary Clearance Regulation of Cilia Beat Frequency and Motility Periciliary Layer and Ciliary Beating Purinergic Signals Integrate Mucociliary Functions Mucociliary Transport Cough Clearance of Mucus Mucous Cell Metaplasia and Hyperplasia Baseline Mucin Expression Mucous Cell Metaplasia Mucous Cell Hyperplasia Mechanisms of Mucin Overproduction Mechanisms of Regulated Mucin Secretion Innate Defense Molecules and Microbiota Integration of Barrier Function and Airway Defense Soluble Pattern Recognition Receptor Proteins Resident Immune Cells of the Airway Epithelium Airway Immunoglobulin A Nitric Oxide Airway Microbiota Key Readings eFIGURE IMAGE GALLERY References 5 Lung Mesenchyme.pdf 5 - Lung Mesenchyme INTRODUCTION Dynamic Regulation of the Extracellular Matrix Extracellular Matrix Degradation and Turnover Extracellular Matrix Modification and Cross-­Linking Cell–Extracellular Matrix Interactions via Integrins Growth Factors Within the Lung Mesenchyme The Lung Mesenchyme in Development Branching Morphogenesis Vascularization Alveolarization The Lung Mesenchyme in Aging The Lung Mesenchyme in Disease Obstructive Airway Diseases Lung Fibrosis Other Lung Disorders Current Understanding and Gaps in Knowledge Key Readings References 6 Vascular Biology.pdf 6 - Vascular Biology Overview of Development of the Pulmonary Circulation Physiologic Control of the Pulmonary Circulation Mechanical Factors or Passive Regulation Gravity Lung Volume Shear Stress Active Regulation Hypoxic Pulmonary Vasoconstriction Endothelium-­Derived Vasoactive Agents Neural Control Role of Pulmonary Veins Communication Between Endothelial and Smooth Muscle Cells Myoendothelial Junctions Extracellular Vesicles Nonrespiratory Functions of the Pulmonary Circulation Pericytes, Adventitial Cells, and Other Cells Pulmonary Vascular Endothelium and Control of Endothelial Permeability Bronchial Circulation Key Readings eFigure Image Gallery References 7 Lymphatic Biology.pdf 7 - Lymphatic Biology INTRODUCTION Anatomy of the Pulmonary Lymphatics Pulmonary Lymphatic Markers Role of Lymphatics in the Lung Fluid Uptake and Prevention of Pulmonary Edema Immune Cell Trafficking Local Immunity and Inducible Bronchus-­Associated Lymphoid Tissue Pulmonary Lymphatics in Lung Injury Lymphatic Disorders During Lung Development Asthma Chronic Obstructive Pulmonary Disease Interstitial Lung Disease Lymphangioleiomyomatosis Lung Transplantation Tuberculosis Sarcoidosis Key Readings References 8 Regeneration and Repair.pdf 8 - Regeneration and Repair Factors Mediating Acute Epithelial and Endothelial Cell Injury Histopathology and Mechanisms That Constitute Alveolar Cell Injury Endothelial Damage Epithelial Damage Lung Regeneration and Repair Resolution of Inflammation Resorption of Edema Fluid Endothelial Repair Epithelial Repair Basic Principles in Epithelial Repair: Cell Spreading and Migration, Cell Proliferation, and Junctional Resealing Stem and Progenitor Cells in the Lung Stem/Progenitor Cells Involved in Lung Repair Loss of Regenerative Potential: Depletion of the Facultative Progenitor Cell Pool The Mesenchymal Niche in Epithelial Repair Does Lung Repair Recapitulate Mechanisms of Lung Development Key Readings References 9 Genetics of Lung Disease.pdf 9 - Genetics of Lung Disease INTRODUCTION Human Genetics Characterization of Genetic Variation Linkage Disequilibrium Public Databases Genetic Epidemiology Linkage Studies Association Studies Genome-­Wide Association Studies Genetic Architecture and Rare Variants Gene By Environment Interaction Epigenetics Fine Mapping and Functional Genetics Integrative Genomics and Systems Genetics Application to Pulmonary Diseases Asthma COPD and Lung Function Acute Respiratory Distress Syndrome Lung Cancer Fibrosing Idiopathic Interstitial Pneumonia Pulmonary Hypertension Sarcoidosis Rare Diseases The Path Forward Key Readings eFIGURE IMAGE GALLERY References 10 Ventilation, Blood Flow, and Gas Exchange.pdf 10 - Ventilation, Blood Flow, and Gas Exchange Introduction Ventilation Total And Alveolar Ventilation Total Ventilation Alveolar Ventilation Anatomic Dead Space Physiologic Dead Space INEQUALITY OF VENTILATION Gravitational Influences on Inequality Airway Closure Nongravitational Influences on Inequality Blood Flow Pressures of the Pulmonary Circulation Pressure Inside Blood Vessels Pressures Outside Blood Vessels Pulmonary Vascular Resistance Pressure-­Flow Relations Effect of Lung Volume Other Factors Affecting Pulmonary Vascular Resistance Distribution of Pulmonary Blood Flow Normal Distribution Three-­Zone Model for the Distribution of Blood Flow The Effect of Lung Volume on the Distribution of Blood Flow—Zone 4 Other Factors Affecting the Distribution of Blood Flow Abnormal Patterns of Blood Flow Active Control of the Pulmonary Circulation Hypoxic Pulmonary Vasoconstriction Damage to Pulmonary Capillaries by High Wall Stresses Blood-­Gas Transport Oxygen Carbon Dioxide Gas Exchange Causes of Hypoxemia (See Chapter 44) Hypoventilation Diffusion Limitation . Figure 10.16 shows calculated changes in the Po2 of the blood along the pulmonary capillary as oxygen is taken up under normal... Shunt Ventilation-­Perfusion Relationships Oxygen Sensing Acknowledgment Key Readings eFigure Image Gallery References 11 Respiratory System Mechanics and Energetics.pdf 11 - Respiratory System Mechanics and Energetics Terminology Flow Volume Pressure Compliance, Resistance, and Time Constants Respiratory Mechanics in Static Conditions Elastic Recoil of the Lungs Lung Connective Tissue Alveolar Surface Forces and Surfactant Hysteresis and Stress Adaptation Elastic Recoil of the Chest Wall Chest Wall Compliance Integration of Lung and Chest Wall Mechanics Calculation of Total Respiratory System Compliance from Lung and Chest Wall Compliance Clinical Applications Positive End-­Expiratory Pressure and its Impact on Pleural Pressure Plateau Pressures in Patients Receiving Positive-­Pressure Mechanical Ventilation Stress and Strain The Respiratory System in Dynamic Conditions Resistive Work Due to Gas Flow Through Airways Laminar versus Turbulent Flow Reynolds Number Clinical Effects of Heliox Flow Limitation Other Resistive Work Equation of Motion Intrinsic Peep During Positive-­Pressure Ventilation of Copd Measurement of Static Compliance and Resistance During Mechanical Ventilation Respiratory Mechanics in ARDS PEEP Optimization and Recruitment Maneuvers Stress Index Recruitment Maneuvers in ARDS Ventilating ARDS Using Plateau Pressure, Tidal Volume, and Driving Pressure Driving Pressure Energetics and Work of Breathing Measuring Work of Breathing Done by a Positive-­Pressure Ventilator in a Paralyzed Patient Measuring Work of Breathing in a Spontaneously Breathing Patient Oxygen Cost of Breathing Key Readings eFIGURE IMAGE GALLERY References 12 Acid-Base Balance.pdf 12 - Acid-­Base Balance FUNDAMENTAL CONCEPTS Acid-­Base Chemistry Carbon Dioxide and Bicarbonate pH Versus H+, Conjugate Acids and Bases Arterial and Venous Blood gas Analysis Nomenclature of Acid-­Base Disorders Role of Ventilation: Arterial Pco2 Role of the Kidneys Metabolic Alkalosis Metabolic Acidosis Compensation Respiratory Acidosis Respiratory Alkalosis Metabolic Acidosis Strong Ion Difference Metabolic Alkalosis Metabolic Acidosis Anion gap Concept Causes of Anion gap Acidosis Lactic Acidosis Lactic Acidosis Biochemistry Diabetic Ketoacidosis Starvation Ketoacidosis Uremic Acidosis Toxic Forms of Anion Gap Acidosis ?Salicylates. Large ingestions of salicylates, such as aspirin, cause a mixed disorder with both an anion gap metabolic acidosis... . Methanol, isopropyl ethanol, and ethylene glycol ingestions are frequent causes of anion gap metabolic acidoses. Methanol (rub... Hyperchloremic Acidosis Type 1 Renal Tubular Acidosis Type 2 Renal Tubular Acidosis Type 4 Renal Tubular Acidosis Acidosis of Progressive Renal Failure Gastrointestinal Causes of Hyperchloremic Acidosis Miscellaneous Causes of Hyperchloremic Acidosis Clinical Manifestations Therapy Metabolic Alkalosis General Considerations Chloride-­Responsive Alkalosis Gastrointestinal Losses Diuretics Mechanisms of Hyperkalemia During Metabolic Acidosis Sweat Mechanical Ventilation Chloride-­Resistant Alkalosis Excessive Intake of Alkali Extracellular Fluid Contraction Clinical Manifestations Therapy Respiratory Acidosis General Considerations Causes Clinical Manifestations Therapy Respiratory Alkalosis General Considerations Causes Clinical Manifestations Therapy Key Readings eFIGURE IMAGE GALLERY References 13 Aerosols and Drug Delivery.pdf 13 - Aerosols and Drug Delivery INTRODUCTION Definition and Description of an Aerosol Principles of Deposition Measurements and Applications of Aerosol Particle Size Generation of Therapeutic Aerosols Dry Powder Devices Pressurized Metered-­Dose Inhalers Jet Nebulizers Vibrating Mesh Nebulizers Soft Mist Aerosols Principles of Assessment of Delivery Systems The Inhaled Mass Deposition Strategies to Optimize Deposition of Therapeutic Aerosols Getting Particles Past the Oropharynx Control of Breathing Pattern and Aerosol Deposition Expiration and Problems With Aerosol Deposition Additional Factors Influencing Development of Therapeutic Aerosols Inhaled Proteins Asthma Cystic Fibrosis and Non–Cystic Fibrosis Bronchiectasis Idiopathic Pulmonary Fibrosis Pulmonary Mycobacterial Infections Delivery of Inhaled Medications to Young Children Delivery of Therapeutic Aerosols to the Nasal Mucosa Aerosol Delivery During Mechanical Ventilation Diagnostic Radioaerosols Mucociliary Clearance and Disease Alveolar Clearance Key Readings eFIGURE IMAGE GALLERY References 14 Pleural Physiology and Pathophysiology.pdf 14 - Pleural Physiology and Pathophysiology INTRODUCTION Function Anatomy Pleural Membranes Blood Supply Lymphatics Nerve Supply Pleural Pressure Physiology of the Pleural Space Entry of Normal Pleural Liquid A Systemic Microvascular Source . The protein concentration of normal pleural liquid is low in sheep38 and probably in humans, which im­plies sieving of the pro... . With increases in filtration rates across a semipermeable membrane, proteins are retarded relative to liquid and electrolytes,... The Parietal Pleura Is the Major Source Pleural Membranes Are Leaky Entry From the Interstitium into the Pleural Space The Pleural Space Is Vulnerable to Liquid Entry Exit of Normal Pleural Liquid Lymphatics Are the Major Exit Route Lymphatics Have a Large Reserve Capacity Pathophysiology of the Pleural Space What Is Required to Produce a Pleural Effusion What Diseases Could Account for This Mechanisms of Increased Entry of Liquid Increased Filtration Pressure .An increase in microvascular pressure (i.e., capillary pressure) will increase the filtration across the microvascular barrier.... .A decrease in the osmotic pressure of the blood within microvessels would be expected to increase filtration. The osmotic press... Increased Microvascular Permeability .When the permeability of the microvascular barrier increases due to inflammation, infection, or malignancy, the resistance to t... .As mentioned, the Starling factors discussed above are relevant to all the circulations of the body, systemic and pulmonary, an... Mechanisms of Decreased Exit of Liquid Categories of Pleural Effusions Transudates Exudates Pseudoexudates Indeterminate Effusions Mechanisms by Which Specific Diseases Cause Pleural Effusions Congestive Heart Failure Malignancy Pulmonary Embolism Tuberculosis Pleural Effusion Effects on Lung and Cardiac Function Key Readings References 15 Innate Immunit.pdf 15 - Innate Immunity Introduction Overview of the Components of Lung Innate Immunity Innate Recognition in the Lung Secreted Pattern Recognition Receptors Collectins Complement Pentraxins and Other Secreted Pattern Recognition Receptors Cellular Pattern Recognition Receptors Plasma Membrane and Endosomal Pattern Recognition Receptors . TLRs are expressed on airway and alveolar epithelial cells, macrophages, PMNs, and DCs.46–49 There are 10 TLRs in humans (TLR ... . The first macrophage SR was described by Goldstein and colleagues and Brown and associates71,72 and was shown to bind and inte... . C-­type lectin receptor (CLR) domains are also present in a family of cell surface receptors that plays an important role in t... Cytoplasmic Pattern Recognition Receptors . In humans, NLRs are a family of intracellular PRRs that have evolved to sense PAMPs in the cytoplasm of most cells. Cytoplasmi... . The last group of cytoplasmic PAMP sensors is the RIG-­I–like receptors that have evolved to detect the presence of RNA from R... Summary Effector Mechanisms Epithelium Polymorphonuclear Leukocytes Innate Lymphoid Cells Mononuclear Phagocytes Resident Macrophages Alveolar Macrophages Interstitial Macrophages Monocytes Functions of Recruited Monocytes and Macrophages Resident and Recruited Dendritic Cells System Integration Key Readings References 16 Adaptive Immunity.pdf 16 - Adaptive Immunity INTRODUCTION Components of the Immune System: Overview Immune Recognition B Cells and Antibodies Structure of Immunoglobulin and the B Cell Receptor for Antigen Formation of the B Cell Receptor Repertoire Isotype Switching and Function of the Different Immunoglobulin Classes B Cell Development Immunoglobulin Interactions with Antigen T Cells and Antigen-­Presenting Cells T Cell Receptors T Cell Receptor Structure and T Cell Receptor Repertoire Formation Antigen-­Presenting Cells and the Major Histocompatibility Complex Presentation and T Cell Recognition of Antigens Development and Selection of the TCR Repertoire T Cell Tolerance: Prevention of Self-­Reactivity Generation of an Immune Response T ­Cell Activation and Co-­stimulation Subsets of T Helper Cells CD4+ T Cell–B Cell Collaboration and Regulation of Antibody Production Generation and Regulation of Cell-Mediated Immune Responses Innate Lymphoid Cell Subsets and Function Specific Immune Responses in the Lung Lymphocyte Populations and Trafficking in the Lung Antibody-­Mediated Immune Responses in the Lung Immune Response to Extracellular Pathogens Immune Response to Autoantigens Immune Response in Allergic Disease Cell-­Mediated Immune Responses in the Lung Granulomatous Lung Disease Cytotoxic T Cell Reactions in the Lung Innate Lymphoid Cell Responses in the Lung Key Readings eFigure Image Gallery References 17 Microbiome.pdf 17 - Microbiome INTRODUCTION The Genesis of the Lung Microbiome Field Technologies for Microbiome Studies Sequencing Data Analysis Study Design Approaches for Microbiome Studies of the Respiratory Tract Human Studies Animal Model Studies The Healthy Lung Microbiome Derivation of the Lung Microbiome The Early Life Origins of the Human Lung Microbiome The Lung Microbiome in Disease Obstructive Diseases Asthma Chronic Obstructive Pulmonary Disease Cystic Fibrosis Non–Cystic Fibrosis Bronchiectasis Interstitial Lung Diseases Idiopathic Pulmonary Fibrosis Sarcoidosis Infectious Diseases Pneumonia Nontuberculous Mycobacteria Infection Tuberculosis Human Immunodeficiency Virus Lung Disease Lung Cancer Lung Transplant Acute Respiratory Distress Syndrome Other Lung Diseases Future Directions for Lung Microbiome Research Key Readings eFIGURE IMAGE GALLERY References 18 History and Physical Examination.pdf 18 - History and Physical Examination Communication Skills Clinical Reasoning Clinical History Chief Complaint and Present Illness Major Pulmonary Symptoms Dyspnea . Patients with respiratory, cardiac, hematologic, metabolic, and neuromuscular disorders may all complain of dyspnea, which may... Cough . Most episodes of coughing are short lived, and patients, recognizing this, seldom visit their physicians for this type of coug... Chest Pain . Pleurisy, or acute inflammation of the pleural surfaces, has several distinctive features. Pleuritic pain is usually localized... Family History and Social History Medications and Allergies Occupational History Travel History Past Medical History Questionnaires, Computer-­Assisted and Nursing History Physical Examination Examination of the Chest Inspection Palpation Percussion Auscultation Normal Lung Sounds Adventitious (Abnormal) Lung Sounds Fine and Coarse Crackles (Discontinuous Sounds) Wheezes and Rhonchi (Continuous Sounds) Voice-­Generated Sounds Pleural Friction Rub Extrapulmonary Sounds Interpretation Extrapulmonary Manifestations Clubbing Other Extrapulmonary Associations Acknowledgment Key Readings Anchor 372 eFIGURE IMAGE GALLERY References 19 Microbiologic Diagnosis of Lung Infection.pdf 19 - Microbiologic Diagnosis of Lung Infection INTRODUCTION Preanalytic Principles Principles of Testing Infection Prevention Syndromic Order Sets Specimen Selection, Collection, and Transport Specimen Adequacy Microbiologic Assays Microscopy Culture Antimicrobial Susceptibility Testing Nucleic Acid Tests Antigen Testing Serologic Testing and Interferon-­γ Release Assays Acknowledgment Key Readings References 20 Thoracic Radiology Noninvasive Diagnostic Imaging.pdf 20 - Thoracic Radiology: Noninvasive Diagnostic Imaging INTRODUCTION Chest Radiography: Techniques Radiographic Views and Techniques Routine Examination Expiratory Views Major Factors Affecting Image Quality in Standard Film-­Screen Radiography and Digital Radiography Radiographic Contrast Spatial Resolution Noise American College of Radiology Standards Portable Radiography Digital Radiographic Techniques: Computed Radiography and Direct Radiography Computed Radiography Storage Phosphor Systems Direct Radiography Clinical Efficacy Medical Imaging and Radiation Applications of Conventional Chest Radiography Screening and “Routine” Chest Radiographs Decubitus Views Lordotic Views Oblique Views Fluoroscopy Bronchography Pulmonary Angiography (see Chapter 21) Aortography and Bronchial Angiography (see Chapter 21) Ultrasonography Computed Tomography Physical Principles Image Display Volumetric Imaging via Helical and Multislice Computed Tomography Computed Tomography Scan Protocols Scanning Range Patient Position Multislice Computed Tomography Detector Configuration and Scan Section Thickness Contrast Enhancement Radiation Exposure and Cancer Risk Low-­Level Radiation-­Induced Malignancy: Evidence for and Against Magnetic Resonance Imaging Physical Principles Techniques Detection of Lung Cancer and Assessment of Solitary Pulmonary Nodules Evaluation of Intensive Care Unit Patients Indications in Acute Lung Disease Dyspnea Acute Respiratory Symptoms Indications for Chest Radiography in the ICU Acute Asthma Exacerbation of COPD or Cystic Fibrosis Applications of Cross-­Sectional Imaging Techniques Solitary Pulmonary Nodules (see Chapter 41) Multiple Pulmonary Nodules Lung Cancer Staging Computed Tomography Positron Emission Tomography and Positron Emission Tomography–Computed Tomography Magnetic Resonance Imaging LUNG CANCER SCREENING Hilar and Mediastinal Masses Technical Aspects of Computed Tomography Performed for Lung Cancer Screening Nodule Size Nodule Attenuation Nodule Morphology Nodule Growth Rate Diffuse Lung Disease Increased Lung Opacity . Thickening of the interstitial fiber network of lung by fluid, fibrous tissue, or interstitial infiltration by cells results i... . Nodules can be classified as perilymphatic, random, or centrilobular, according to their distribution within the secondary pul... Consolidation and Ground-1396983920Glass Opacity. Air space consolidation, by definition, is seen when alveolar air is replaced ... Decreased Lung Opacity . Emphysema is accurately diagnosed with HRCT, and HRCT is more sensitive for the detection of emphysema than is routine CT or c... . Lymphangioleiomyomatosis (see images associated with Chapter 97, eFig. 97.2, and Fig. 20.25A–B) and PLCH (see Chapter 95) ofte... Mosaic Perfusion. Decreased lung attenuation not reflecting the presence of cystic lesions or emphysema can sometimes be recogni... Honeycombing Diagnostic Utility Intrathoracic Airway Disease Central Airways Bronchiectasis Small Airway Disease History of the Use of HRCT for DILD: Diagnosis, Assessing Activity and Directing Biopsy . It is well documented that chest radiographs are limited in both their sensitivity and specificity in patients with DILD.203–2... . Even in the presence of definite abnormalities, chest radiographs have limited diagnostic accuracy for patients with DILD.238 ... . In addition to being more sensitive, specific, and accurate than chest radiographs, HRCT may also play a critical role in the ... . Among the many indications for HRCT, an important one is as a potential guide for surgical lung biopsies. Many “diffuse” lung ... Cardiovascular Disease Pulmonary Thromboembolism Evolution of Single-Slice CTPA to Multislice Pleural Disease CARDIOVASCULAR DISEASE AND THORACIC GREAT VESSELS Acquired Cardiovascular Disease Congenital Anomalies of the Thoracic Great Vessels Type of Fluid Pleural Versus Parenchymal Disease Early Detection Recent Advancements and Future Directions Artificial Intelligence, Machine Learning, and Deep Learning Functional Imaging and Quantification: COPD and Fibrotic Lung Disease Dual-­Energy/Spectral Computed Tomography Imaging Key Readings eFIGURE IMAGE GALLERY References 21 Thoracic Radiology Invasive Diagnostic Imaging and Image-Guided Interventions.pdf 21 - Thoracic Radiology: Invasive Diagnostic Imaging and Image-­Guided Interventions INTRODUCTION Transthoracic Needle Biopsy Indications and Contraindications Patient-­Lesion Selection and Preprocedure Clinical and Imaging Evaluation Choice of Imaging Guidance Procedure Postprocedure Patient Management Diagnostic Yield Complications Catheter Drainage of Intrathoracic Collections Parapneumonic Effusions: Empyema Malignant Pleural Effusions Pneumothorax (See Chapter 110) Lung Abscess (See Chapter 50) Bronchial Arteriography Indications and Contraindications Pulmonary Arteriography Indications and Contraindications Thermal Ablation of Localized Lung Cancer and Pulmonary Metastatic Disease Indications and Contraindications Preoperative Computed Tomography–Guided Localization for Video-­Assisted Thoracic Surgery Nodule Resection Indications and Contraindications Key Readings eFIGURE IMAGE GALLERY References 22 Pathology Neoplastic and Non-neoplastic Lung Disease.pdf 22 - Pathology: Neoplastic and Non-­neoplastic Lung Disease INTRODUCTION Types of Lung Tissue Specimens Tissue Processing and Histologic Evaluation Cytology Specimens Evaluation of Neoplastic Lung Lesions Adenocarcinoma Squamous Cell Carcinoma Small Cell Carcinoma Large Cell Neuroendocrine Carcinoma Carcinoid Tumors Other Less Common Tumor Types Pathologic Staging Evaluation of Non-­Neoplastic Lung Disease Is There Acute Lung Injury Diffuse Alveolar Damage Organizing Pneumonia Acute Fibrinous and Organizing Pneumonia Is There Consolidation of Alveolar Spaces Eosinophilic Pneumonia Desquamative Interstitial Pneumonia Pulmonary Alveolar Proteinosis Is There Interstitial Fibrosis Usual Interstitial Pneumonia Nonspecific Interstitial Pneumonia Is There Interstitial Inflammation Cellular Nonspecific Interstitial Pneumonia Versus Lymphocytic Interstitial Pneumonia Hypersensitivity Pneumonitis Are There Nodules or Masses Pulmonary Sarcoidosis Infectious Granulomas Pulmonary Langerhans Cell Histiocytosis What if the Lung Parenchyma Looks Normal Future Outlook Key Readings References 23 Ultrasonography Principles and Basic Thoracic and Vascular Imaging.pdf 23 - Ultrasonography: Principles and Basic Thoracic and Vascular Imaging Physics of Ultrasound Ultrasonography: Principles and Basic Thoracic and Vascular Imaging Transducer Selection Vascular Imaging Thoracic Imaging Abdominal Imaging Ultrasound Modes Two-­Dimensional Mode, or B-­Mode M-­Mode Doppler Imaging Knobology Imaging Planes and Transducer Movement Depth Gain Orientation Measurements Ultrasound Artifacts Acoustic Attenuation and Enhancement Reverberation Mirroring Artifacts and Image Processing Features Thoracic Ultrasound Normal Pleura and Lung Pneumothorax Pleural Effusion and Thoracentesis Pleura and Pleural Biopsy Lung Parenchyma B-­Lines Consolidation Diaphragm Use of Ultrasound in the Clinical Evaluation of Acute Respiratory Failure Vascular Imaging Central Venous Catheter Placement Technique Peripheral Vascular Access Deep Venous Thrombosis Assessment Key Readings eFigure Image Gallery References 24 Ultrasonography Advanced Applications and Procedures.pdf 24 - Ultrasonography: Advanced Applications and Procedures INTRODUCTION Critical Care Echocardiography as a Diagnostic Tool for Intensivists Impact of Critical Care Echocardiography on the Management of Critically ill Patients Critical Care Echocardiography Training, Competency, and Certification Image Acquisition and Interpretation of the Critical Care Echocardiogram Data Quality, Confidence of Interpretation, and Responsibility for Unexpected Findings Preparation for the Critical Care Echocardiogram Probe Manipulation Basic Critical Care Echocardiogram Views Parasternal Long-­Axis View Parasternal Short-­Axis View Apical Four-­Chamber View Subcostal View Interpretation of Ultrasound Images Left Ventricular Function Right Ventricular Function Right Atrial Pressure Pericardial Effusion and Cardia