Air

The Common Vein copyright 2007

 

Air is a mixture of gases consisting of 20.94% oxygen, 78.03% nitrogen, .99% argon and other rare gases, and 0.04% carbon dioxide. The term “air” is also used to mean any respiratory gas, regardless of chemical makeup.

Principles

Normal Air in the Body

Upper Airways

48728b01.800 skull face facial bones air frontal sinus ethmoid sinus maxillary sinuses auditory canals eustachian tubes mastoid air cells nasopharynx oropharynx nasal passages sphenoid sinuses anatomy normal CTscan 3D volume rendering CTscan Davidoff MD

Air in Diagnosis

Infection

Active Tuberculosis Calcification and Air – Power of CT

49812c01 50 yr F Korean fevers weight loss night sweats cough chest lung apex pleura fx calcified granulomas parenchyma pleural granulomas calcification cavitating nodules dx active tuberculosis active TB acute infection chronic infection infectious isolation Davidoff MD 49812c02

Septic Emboli and Cavitation

The CXR and CT scan is from a 76 year patient who had a complicated history of septicemia and bacterial endocarditis of the mitral valve associated with a septic arthritis and an infected ICD wire. She has a PMH of MI, ischemic cardiomyopathyEF of 20%, PTCA of LAD, RCA stent, chronic renal failure and COPD. Her wcc was 33 thousand Staphylocosccus was isolated from her sputum. The CXR shows multiple large cavitating lesions with 3 large lesions in the right upper lobe (a,b,c), one in the right lower lobe (a), and one large lesion alongside the heart in the lingula. (b,d) These findings are consistent with septic emboli with cavitation.

lung infection cavitation septic emboli SBE BE bacterial endocarditis pleural effusions CXR chest X-ray CTscan Courtesy Ashley DAvidoff MD copyright 2009 all rights reserved 33015c01.8s

Air in a Brain Abscess – T1 T2 FLAIR GRE

71604.c02b 40 year old female with headache brain maxillary sinus frontal lobe fx air fluid level parafalcine falx cerebri a= T1 weighted b= T2 weighted c = FLAIR d= GRE dx left maxillary sinusitis with brain abscess air fluid level thickened mucosa of maxillary sinus MRI Davidoff MD 71604.c02 71604.c03 71604.c04 71604.c02b

Breast Prosthesis Abscess

22983 breast skin prosthesis fx air dx abscess CTscan C-

Loculated Air in Empyema – Air = infection in this Instance

71441c01 lung pleura air air bubbles forces gravity fibrin complex loculated thickened pleura pleural thickening fluid accumulation trapped air dx empyema CTscan Davidoff MD

Pectoralis and Clavicular Clostridial Infection

15754 bone clavicle sternum muscle pectoralis major sternoclavicular joint clavicular fx air fx swollen fx induration air bubbles dx clostridium welchii dx wet gangrene infection CTscan Davidoff MD 15754 15755 15758 15759 15759c01

Clostridial Infection

15759c01 bone clavicle sternum muscle pectoralis major sternoclavicular joint clavicular fx air fx swollen fx induration air bubbles dx clostridium welchii dx wet gangrene infection CTscan Davidoff MD 15754 15755 15758 15759 15759c01

Methane or Nitrogen in a Cholesterol Stone

70269c02 gallbladder air methane nitrogen gas cholesterol stone isodense with bile fat subtle change CTscan

Cholelthiasis Mercedes Benz Sign

72715 gallbladder stones Mercedes Benz sign air in gallstones cholelithiasis CTscan Courtesy Ashley Davidoff MD

Air after a Smoke and a Kiss

27727c.8St This 25 year old man complained of chest pain after smoking marijuana with his girlfriend. The CTscan shows pneumomediastinum.The patient admitted to exchanging marijuana with his girlfriend through kissing. chest mediastinum air trauma marijuana Courtesy Ashley Davidoff MD copyright 2009 all rights reserved trachea CHEST PAIN AFTER A SMOKE AND A KISS

Air in a Tampon

37 year old female with tampon overlaid in green in image b.

endometrial cycle normal uterus USscan Courtesy Ashley Davidoff MD Copyright 2009 all rights reserved

83626bc01.8

Obstructed Uterus with Pyometria

46 year old female with obstructed uterus and fluid filled endometrial cavity with pockets of air caused by cervical carcinoma complicated by pyometria.

CT cervix uterus carcinoma cancer obstruction enlargement size air CTscan Courtesy Ashley Davidoff MD Copyright 2009 all rights reserved 83682c04.8s