CABS: Pleural Diseases Flashcards
What is the barometric pressure
760 mmHg (0 mmHg)
What is the alveolar pressure
760 mmHg (0 mmHg)
What is the intrapleural pressure
750 mmHg (-4 - -10 mmHg)
always negative
Pleural effusion is
a accumulation of fluid in the space between the visceral and parietal pleura
Normal amount of fluid in between the pleura
10cc
Pleural fluid helps assist with
lubrication, infection prevention, maintain negative pressure
Effusions form when fluid cannot _____ or is ______
drain or is created in excess
Pleural effusions are m/c associated with
CHF, pneumonia and cancer
Transudative Pleural effusion
too much fluid
normal plasma filtrate just too much of it
low LDH, proteins
occurs due to increased hydrostatic pressure or low plasma oncotic pressure
Exudative Pleural effusion
Bad - pus filled fluid, contains more WBW, plasma proteins
elevated LDL, protein
occurs due inflammation and increased capillary permeability
Hemothorax is a
effusion but with blood
traumatic, rupture
Chylothorax is a
milky fluid with fat droplets and lymph fluid
Empyema is
pus
accumulation of infection
Pleural effusion presentation
small ones can be asymptomatic
sxs will increase based on size and pts underlying hemodynamics: SOB, Pleuritic pain, dullness to percussion, pleural friction rub
Pneumothorax is
air within the pleural space secondary to rupture of the visceral pleura or parietal pleura
Pneumothorax m/c caused by
spontaneous (primary), iatrogenic (secondary), traumatic (secondary)
In a pneumo a break in pleura will cause
pressure to equilibrate, will disrupt the negative pressure within the pleural space and cause lung to recoil
Idiopathic example in a pneumo
marfans (pts tall/thin)
Iatrogenic example in a pneumo
mechanical vent
line placement
lung bx
traumatic example in a pneumo
penetrating chest wound
rib fracture that punctures lung parenchyma
Open pneumo is
damaged chest wall allows air in during inspiration
Treatment for open pneumo
three-way dressing (three sides taped down, one side open)
chest tube
surgical repair
tension pneumo is
air in the pleural space increasing and unable to escape, can compress on the structures (mediastinal shift)
Pneumomediastinum is
free air around the mediastinal structures
Pleurisy (aka pleuritis) is
inflammation of the pleura
Presentation of pleuritis
pleuritic pain
sharp or stabbing pain with inspiration or cough
may feel SOB secondary to the discomfort
pleural friction rub
ARDS will always be
bilateral
How do you image a pneumo
Xray - upright
Treatment of a small pneumo
O2
observation
