Diseases of Pleura Flashcards
intraalveolar greater or less pressure than intrapleural?
intrapleural pressure is always greater
what causes increased fluid entry?
increase microvascular pressure
increase permeability
decrease oncotic (pull) pressure
blockage of lymphatics
protein serum vs. protein in effusion fluid to determine transudate vs. exudate?
Light’s criteria
what else to look for in effusion fluid samples?
pH (anaerobic metabolism) white cells blood LDH glucose micro cytology TB
other investigations for pleural effusion?
bloods
CXR/CT chest
ultrasound
brochoscopy
pleuritic chest pain just pleura?
nope, all organs around it, including muscles
breath sounds in air or fluid are?
reduced
what can mimic a pleural effusion?
raised hemi diaphragm
unilateral effusion cause?
pneumonia primary lung cancers Trauma TB post-PE heart failure but less common
bilateral effusion cause?
heart failure
low-pressure states (low oncotic pressure)
malignancy d
what is a chylothorax?
lymph with chylomicrons effusions into
why do you get air in pleural space?
spontaneous (smoking, FHx, Marfan’s)
trauma
underlying lung disease (COPD, lung bullae)
how to manage air in pleural space?
could resolve spontaneously
-drainage: aspiration, ICC with underwater seal (one way valve)
-pain relief, O2
why O2 speed up resolution of pneumothorax?
concentration gradient to push nitrogen out and O2 into tissues
chest tube has stopped swinging, why?
blocked lumen
kinked tube
Tube slipped into subcut or was never in the right space
Tube tap is in wrong spot.
