Pleural diseases

Question 1

what is eupnea

Answer 1

normal breathing
rate typically 8-16 breaths per minute
tidal volume 400-800mL

Question 2

what is Kussmaul respiration

Answer 2

increased rate with large tidal volumes
no pause between inspiration/expieration

Question 3

what is Cheyne-stokes respiration

Answer 3

irregular rhythm with deep then shallow breathing
apnea which may last 15-60 seconds
alteration to brainstem blood flow

Question 4

what is labored breathing

Answer 4

increase in effort
depending on underlying disorder, may have prolongation of inspiration or expiration

Question 5

what creates plueral effusion

Answer 5

vasculature of the visceral pleura
fluid moved into space 2 to filtration pressure

Question 6

what do intrinsic factors lead to with pleural effusions

Answer 6

decreased abosrption
infiltrative process within the lymphatics
hormonal changes
anatomic abnormality

Question 7

what do extrinsic factors lead to with pleural effusions

Answer 7

decreased absoprtion
normal lymphatic structure but draining is disrupted
respiratory motion that typically helps to move along lymphatic fluid is disrupted
blockage of port of entry
something is pushing on lymphatic flow

Question 8

what is transudative pleual effusion

Answer 8

occurs due to increased hydrostatic pressure or low plasma oncotic pressure
EX. CHF, cirrhosis, nephrotic syndrome, PE, hypoalbuminemia

Question 9

what is exudative pleural effusion

Answer 9

occurs due to inflammation and increased capillary permeability
ex. pneumonia, cancer, TB, viral, PE, autoimmune
(more pus like)

Question 10

what is a pleural effusion

Answer 10

accumulation of fluid within the pleural space

Question 11

What is LDH with transudative and exudative pleural effusion

Answer 11

indicator of inflammation
transudate < or equal to 0.6
Exudate >0.6 (elevated)

Question 12

What is the protein with transudate and exudative pleural effusions

Answer 12

transudate < or equal to 0.5
exudate >0.5

Question 13

What is the presentation of pleural effusion

Answer 13

small ones may be symptomatic
sx will increase based on size and patients underlying hemodynamics
-SOB, pleuritic pain, can progress to decreased ventilation
dullness to percussion
pleural friction rub if inflammatory

Question 14

What is a pneumothorax

Answer 14

air within the pleural space secondary to rupture of visceral pleura or parietal pleura

Question 15

what can cause pneumothorax

Answer 15

spontaneous (primary) - marfans
iatrogenic (secondary)
traumatic (secondary)

Question 16

What is a spontaneous pneumothorax

Answer 16

rupture of an alveoli, typically at an area of bleb formation - Marfans
most common at the apex of the lung

Question 17

what is an iatrogenic pneumothorax

Answer 17

secondary to mechanical ventilation, line placement, lung bx

Question 18

what is an open pneumothorax

Answer 18

damaged chest wall allows air in during inspiration

Question 19

what are causes of open pneumothorax

Answer 19

trauma (blunt/penetrating)
Iatrogenic (transtracheal aspiration, lung biopsy, tube thoracostomy)

Question 20

what is the treatment for open pneumothorax

Answer 20

three-way dressing
chest tube
surgical repair

Question 21

what is a tension pneumothorax

Answer 21

mediastinal shift

Question 22

what is the presentation of penumothorax

Answer 22

decreased breath sounds
SOB of sudden onset
ipsilateral pleuritic pain
increased resonance on percussion
tachycardia (compensation)

Question 23

what is pneumomediasatinum

Answer 23

free air around the mediastinal structures

Question 24

what is pleurisy

Answer 24

aka pluritis
inflammation of the pleura

Question 25

what is pleuritic pain

Answer 25

sharp or stabbing pain with inspiration or cough