Chapter 8: Recognizing a Pleural Effusion Flashcards
What are Pleural Effusions?
They are fluid that has collected between the visceral and parietal pleura; the fluid can be transudate or exudate
How many mL are required to blunt the posterior costophrenic sulcus?
75 mL
How many mL are required to blunt the lateral costophrenic sulcus?
200 to 300 mL
How many Liters of fluid will cause opacification of the entire hemithorax?
2L
What is a subpulmonic effusion?
most pleural effusions start as this; collection of fluid in the pleural space between the hemidiaphragm and the base of the lung
What does a subpulmonic effusion form as the amount of fluid increases?
a meniscus shape
What can very large pleural effusions cause?
They will act like a large mass and shift the mobile mediastinum structures AWAY from the side of the effusion
What is a loculate pleural effusion?
A pleural effusion that occurs with pleural adhesions and the fluid assumes an unusual appearance or occurs in atypical places
What is a pseudotumor?
a type of effusion that occurs in the fissures of the lung and is mot frequently secondary to congestive heart failure; it will clear when the underlying failure is treated
Where are laminar effusions best recognized?
at the lung base just above the costophrenic angles
Why do laminar effusions occur?
CHF or lymphangitic spread of malignancy
What does a hydropneumothorax consist of?
air and increased fluid in pleural space
How is a hydropneumothorax recognized?
on an upright chest, it will appear straight, air-fluid interface; there will be no meniscus shape
What are some causes of excess formation of fluid that cause a Pleural Effusion?
CHF
Hypoproteinemia
Parapneumonic effusions
Hypersensitivity reactions
What are some causes of decreased resorption of fluid that cause a Pleural effusion?
lymphangitic blockade due to tumor
Elevated central venous pressure
Decreased intrapleural pressure
What are some causes of transport from peritoneal cavity of fluid in pleural effusions?
Ascites
What is Dressler Syndrome also known as?
Postpericardiotomy/postmyocardial infarction syndrome
When does Dressler Syndrome occur?
2-3 weeks after a transmural MI and is associated with chest pain and fever
What does Dressler Syndrome Produce?
a left pleural effusion
pericardial effusion
patchy airspace disease at the left lung base
How would you recognize a right-sided Pleural effusion on a frontal CXR?
the highest point of the apparent hemidiaphragm is displaced more laterally; most difficult to recognize becuase of the liver
How would you recognize a right or left sided Plerual effusion on a lateral CXR?
posteriorly, the apparent hemidiaphragm has a curved arc then it becomes flat and drops sharply to the anterior chest wall
How would you recognize a left sided pleural effusion on a frontal CXR?
There is a greater than 1cm distance betweent the stomach bubble and the apparent left hemidiaphragm; the highest point is displaced laterally
