EXAM #2: DISEASES OF THE PLEURA Flashcards
What defines the pleural space?
- Visceral pleura of the lungs
- Parietal pleura of the rib cage, diaphragm, and mediastinum
*Note that the pleura is lined with “mesothelial cells” that secrete fluid into the pleural space, keeping it lubricated
How much fluid is moved through the pleural space per day?
5-10 L
If you’re considering thoracentesis, what type of x-ray should you do? Why?
Lateral decubitus CXR
*Fluid will shift on a lateral decubitus x-ray, indicating that it is thin enough to be drained
Describe the symptoms associated with a pleural effusion.
1) Cough
2) Dyspnea
3) Nonspecific discomfort
4) Occasional pleuritic chest pain
What are the signs of a pleural effusion?
1) Hypoxia
2) Tachypnea
3) Dullness to percussion
4) Decreased breath sounds
5) Bronchial breathing
6) Mediastinal shift
If a pleural effusion has a putrid odor, what does this indicate?
Anaerobic lung infection
What is the difference between transudate and exudate s/p thoracentesis for a pleural effusion (Generally)?
Exudate is protein rich
What is the most common etiology of transudate on thoracentesis?
CHF (LV failure)
What are the most common etiologies of exudate on thoracentesis?
1) Infection
2) Tumor
What defines an empyema? What is the appropriate management for an empyema?
This is a collecting of pus in the pleural cavity, typically with a pH less than 7.2
- 7.2 is DIAGNOSTIC
- Requires a CHEST TUBE
What is the major indication for chemical pleurodesis?
Recurrent pleural effusions (which initially responded to simple thoracentesis)
What are the symptoms associated with a pneumothorax?
1) Dyspnea
2) Chest pain
3) Cough
When is “nothing” the proper treatment for a pneumothorax?
5-10% collapse
What is a common iatrogenic cause of pneumothroax for a patient in the ICU?
Barotrauma from mechanical ventilation
What is a malignant tumor of the pleural space?
Mesothelioma
*Note that this is a malignant neoplasm of the mesothelial cells that line the pleural cavity
