Chapter 27-pleural Diseases Flashcards
Each lung is covered by
Visceral pleura
How does pleural fluid travel between lobes of the lungs
Visceral pleura dips into the fissures
The inner side of the ribs and chest wall are covered by
Parietal pleura
Pleural space is
Located between the parietal and visceral pleura
What is a pleural effusion
An abnormal amount of fluid in the pleural space
When interstitial pressure within the lung or chest wall is increased
Pleural fluid enters the pleural space
A pleural effusion that forms while the pleural space is intact is called a
Transudate
A pleural effusion with high protein in fluid is called a
Exudate
Causes of transudate pleural effusion include
Chf Cirrhosis Nephrotic syndrome Hypoalbuminemia Atelectasis
Causes of exudate pleural effusion
Pneumonia Tb Lung cancer Pe Connective tissue disease
How to detect pleural effusions on cxr
Lateral decubitus x ray
Or have patient sit up during pa or ap xray
Risks to thoracentesis
Intercostal artery laceration
Infection
Pneumothorax
What is pleurodesis
The process of fusing the parietal and visceral pleura together to prevent further pleural effusions
What is a pneumothorax
Air in the pleural space
What are the two causes of pneumothorax
Spontaneous and tramatic
What are causes of traumatic pneumothorax
Gunshot
Stabbing
Blunt trauma-rib fracture that enters lung parenchyma
What causes pneumothorax in neonates
High trans pulmonary pressure after birth
How is neonatal pneumothorax diagnosed
Shifting of heart sounds
Trans illumination of the chest
What are the two types of spontaneous pneumothorax
Primary-no underlying lung disease
Secondary-lung disease is present
What type of patients typically have spontaneous primary pneumothorax
Tall, thin patients in late teens or early 20s
When air in pleural space exceeds atmospheric pressure it is considered a ?
Tension pneumothorax
In tension pneumothorax, medistinal shift will happen in which direction
Away from pneumothorax
What happens physiologically as pressure in the chest rises
Decreased venous return due to pressure on the heart
Cardiac output decreases resulting in hypotension and tachycardia
Intrapulmonary shunting occurs through collapsed lung which worsens hypoxemia
What is the placement for needle decompression of a tension pneumothorax
Second intercostal, midclavicular line.
