Disorders of Lung Inflation - Atelectasis and Pleural Effusion

Question 1

What two disorders are considered lung inflation problems?

Answer 1

Atelectasis and Pleural Effusion

Question 2

What is Atelectasis?

Answer 2

Atelectasis is a structural collapse of a small part of the lung which impedes it from filling with air.

Question 3

How many different types of atelectasis is there? What are they called?

Answer 3

There are three different types of atelectasis:

1. Obstructive/Resorptive atelactasis
2. Compression atelectasis
3. Contration atelectasis

Question 4

Describe Obstructive/Resorptive Atelectasis?

Answer 4

Occurs when there is a local airway obstruction which causes air to become trapped. The trapped air is then absorbed into the capilaries leading to local collapse of the blocked structure.

Question 5

What is an example of something which might block an airway in Obstructive/Resorptive Atelectasis? What will occur if the obstruction is resolved?

Answer 5

Mucus is something which might block an airway. If the obstruction is removed, the collapse will resolve itself.

Question 6

What is Compression Atelectasis? What can cause compression atelectasis?

Answer 6

Compression Atelectasis is a collapse from external pressure of a portion of the lung. A tumor could cause compression atelectasis.

Question 7

What is Contraction Atelectasis?

Answer 7

Contraction atelectasis is caused when scar tissue formation with-in the alveoli contracts leading to lung collapse.

Question 8

What are the manifestations of Atelectasis?

Answer 8

Dyspnea, Tachypnea, Decreased Chest Expansion, Tachycardia

Question 9

Why would someone suffereing from Atelectasis present with dyspnea?

Answer 9

Their lung capacity is decreased.

Question 10

Why would someone suffereing from Atelectasis present with tachypnea?

Answer 10

Tachypnea is a compenary mechanism due to the decreased ventillation capacity of the lungs.

Question 11

How is Atelectasis diagnosed?

Answer 11

Patient presentation, Chest X-ray, CT, Bronchoscopy.

Question 12

How is Atelectasis treated?

Answer 12

Atelectasis is treated by dealing with the cause. Removal of tumors, or mucus plugs. Once the cause is dealt with the area will inflate again.

Question 13

What is Pleural Effusion?

Answer 13

Pleural effusion is fluid accumulation in the pleural space.

Question 14

What is another name for pleural effusion?

Answer 14

Hydrothorax.

Question 15

What is the singular form of pleural?

Answer 15

Pleura

Question 16

What is transcapillary exchange?

Answer 16

Transcapillary exhange is the movement of fluid and substances between blood and interstitial fluid.

Question 17

In pleural effusion, fluid moves from _____ into the ____ _____?

Answer 17

Blood into the Pleural Space.

Question 18

Pleural Effusion is due to ?

Answer 18

Abnormal seepage and/or drainage.

Question 19

In pleural effusion, fluid seepage referes to fluid movment to ____?

Answer 19

Membranes

Question 20

In pleural effusion, fluid drainage referes to fluid ____?

Answer 20

Returning to vasculature.

Question 21

What is exudate?

Answer 21

Inflammation fluid with high protein count.

Question 22

What is transudate?

Answer 22

Transudate is extravascular fluid with low protein count, non-inflammation fluid made up primarily fo macrophages, lymphocytes and mesothelial cells.

Question 23

What is the difference between transudate and exudate fluid in a pleural effusion?

Answer 23

Transudate is fluid pushed through the capillary due to high pressrue within the capillary. Exudate is fluid that leaks around the cells of the capillaries caused by inflammation.

Question 24

What is empyema?

Answer 24

Empyema is purulent thick pus in the pleural space.

Question 25

What is hemothorax?

Answer 25

Hemothorax is a type of pleural effusion in which blood accumulates in the pleural cacity.

Question 26

What is chylothorax?

Answer 26

Chylorthorax is the accumulation of lymph formed in the digestive tract, called chyle, with-in the pleural cavity.

Question 27

What is the etiology of Pleural Effusions?

Answer 27

Usually caused by Congestive Heart Failure. Can also be caused by infection, Cancer, or pulmonaory infarct (Ischemia).

Question 28

What type of cough will an individual with a pleural effusion have? Which disorder will have the opposite cough?

Answer 28

A dry cough. A patient with pulmonary edema will have a wet, productive cough.

Question 29

What is the Pathophysiology of pleural effusions?

Answer 29

Fluid enters the pleural space through parietal capillaries and drains into parietal lymphatics. Fluid entry exceeds drainage resulting in pleural effusion.

Question 30

What cardiac condition is similar to pleural effusions?

Answer 30

Cardiac Tamponade

Question 31

What are the manifestations of pleural effusions?

Answer 31

Manifestations are based on cause and volume of fluid. Dyspnea, Pleuritic Pain, Lung Compression. Manifestations will revolve around inflammation problems, Substantial pain as added fluid layer applies pressure which stretches membrane. Fluid surrounds lungs, making expansion difficult.

Question 32

How is diagnosis of pleural effusion made?

Answer 32

It is not diffucult to diagnose. Easy to spot on x-ray, ultrasound, CT scan.

Question 33

What is treatment for pleural effusion?

Answer 33

Treatment is centered on the cause of the effusion. Thoracentesis (+fluid analysis). Chest-tube.

Question 34

What is the purpose of a chest tube?

Answer 34

The chest tube will remain in place, continuously draining while the underlying cause of the effusion is dealth with.

Question 35

Why does a patient receiving a thoracentesis not receive volume expanders?

Answer 35

The pleural space is very small. During treatment we are not concerned with the small amount of fluid which gets into the pleural space.