Atelectasis

Question 1

what is acquired atelectasis

Answer 1

the collapse of a previously inflated lung in children or adults

Question 2

what is neonatal atelectasis

Answer 2

incomplete expansion of the lungs in infants

Question 3

what are the four types of atelectasis?

Answer 3

o Reabsorption atelectasis
o Alveolar collapse atelectasis
o Compressive atelectasis
o Contraction atelectasis

Question 4

in Reabsorption (obstruction) atelectasis, Complete obstruction results in reabsorption of oxygen (gas) in lobe/whole lung while maintaining ______intrapleural pressure (i.e., no gas or fluid in the intrapleural space)

Answer 4

negative

Question 5

in Reabsorption (obstruction) atelectasis, Lung volume decreases and trachea deviates _____ the affected lung if there is a large enough lung volume affected

Answer 5

towards

Question 6

how can you reverse Reabsorption (obstruction) atelectasis?

Answer 6

by removing obstruction and reinflating

Question 7

in a chest x-ray of Reabsorption (obstruction) atelectasis, why is Atelectic lung tissue white?

Answer 7

because of increased tissue density caused by loss of air.

Question 8

in Alveolar collapse atelectasis, what results in collapse?

Answer 8

insufficient surfactant

premature infant

Question 9

Inadequate ventilation of a lung or part of a lung (NOT caused by obstruction) results in what?

Answer 9

absorption of alveolar air and collapse of the alveoli (e.g., after rib fracture)

Question 10

in Alveolar collapse atelectasis, where will the trachea deviate to?

Answer 10

Depending on amount of lung tissue affected either will not cause tracheal deviation the (small atelectasis) or deviate towards the affected lung (large atelectasis)

Question 11

in Compressive atelectasis, The pleural cavity becomes filled with tumor, air (in the case of a tension pneumothorax), or fluid (e.g., blood - hemothorax), causing compression of what?

Answer 11

lung tissue

Question 12

in Compressive atelectasis, Since the pleural space becomes filled, where does the trachea deviate to?

Answer 12

it pushes the mediastinum away, i.e., the trachea deviates away from the affected lung

Question 13

how can you reverse Compressive atelectasis?

Answer 13

removal of compressing mass

Question 14

what type of atelectasis is irreversible?

Answer 14

Contraction atelectasis

Question 15

in Contraction atelectasis, _____ changes of the lung or pleura prevent full expansion of the lung (or actually contract the lung to a smaller volume)

Answer 15

Fibrotic

Question 16

where is the tracheal deviation in Contraction atelectasis

Answer 16

there is none

Slow process, intrapleural space created during contraction will fill with fluid, therefore no tracheal deviation

Question 17

risk factors for Alveolar collapse atelectasis

Answer 17

Anesthesia,

prolonged bed rest (lack of movement) or

shallow breathing (e.g., rib fracture, resulting in poor ventilation),

premature birth (insufficient surfactant)

Question 18

risk factors for Obstruction atelectasis

Answer 18

Obstruction by foreign object (common in children), mucus or tumor

Question 19

risk factors for Contraction atelectasis

Answer 19

Inflammatory lung diseases (fibrosis)

Question 20

risk factors for Compressive atelectasis

Answer 20

Pneumo / hemothorax, pleural effusion (result in lung compression)

Question 21

symptoms seen in atelectasis

Answer 21

shortness of breath, chest pain, cough, low-grade fever

Question 22

complication of atelectasis?

Answer 22

pneumonia

Question 23

how should you evaluate atelectasis?

Answer 23

o History and physical examination (breath sounds, excursion, percussion, ergophony, tracheal deviation)
o CXR, CT
o Oximetry, arterial blood gas, acid-base balance