Pleural Disease

Question 1

What does the perietal pleura cover?

Answer 1

Covers the mediastinum, diaphragm and inner surfaces of the thorax.

Question 2

What is the pulmonary surfactant

Answer 2

It lubricates the 2 plural surfaces, allowing the pleura to slide smoothly during respiration

Question 3

What is the purpose of surface tension

Answer 3

Allows the lung surface to stay touching the thoracic wall, creating a seal between the two surfaces

Question 4

What is a pleural effusion

Answer 4

An abnormal collection of fluid in the pleural space. It is a common presentation of many diseases. It does not always need to be drained but large unilateral effusions should be a cause for concern.

Question 5

How to diagnose a pleural effusion

Answer 5

o	History and examination
o	Chest X-Ray
o	Pleural aspirate
o	Biochemistry
o	Cytology
o	Culture
o	Possibly: CT chest, Pleural tap, Pleural biopsy

Question 6

Pleural fluid appearance

Answer 6

o Straw coloured – it is indicative of cardiac failure or hypoalbuminemia
o Bloody – it indicates trauma, malignancy, infection or infarction
o Milky – its indicates empyema or chylothorax
o Foul smelling – Anaerobic empyema
o Food Particles – Oesophageal rupture

Question 7

What does Transudate mean and what can it indicate?

Answer 7

extravascular fluid with low protein content and a low specific gravity
Heart failure, liver cirrhosis, Hypoalbuminemia etc.