Pleural diseases Flashcards
what is eupnea
normal breathing
rate typically 8-16 breaths per minute
tidal volume 400-800mL
what is Kussmaul respiration
increased rate with large tidal volumes
no pause between inspiration/expieration
what is Cheyne-stokes respiration
irregular rhythm with deep then shallow breathing
apnea which may last 15-60 seconds
alteration to brainstem blood flow
what is labored breathing
increase in effort
depending on underlying disorder, may have prolongation of inspiration or expiration
what creates plueral effusion
vasculature of the visceral pleura
fluid moved into space 2 to filtration pressure
what do intrinsic factors lead to with pleural effusions
decreased abosrption
infiltrative process within the lymphatics
hormonal changes
anatomic abnormality
what do extrinsic factors lead to with pleural effusions
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
what is transudative pleual effusion
occurs due to increased hydrostatic pressure or low plasma oncotic pressure
EX. CHF, cirrhosis, nephrotic syndrome, PE, hypoalbuminemia
what is exudative pleural effusion
occurs due to inflammation and increased capillary permeability
ex. pneumonia, cancer, TB, viral, PE, autoimmune
(more pus like)
what is a pleural effusion
accumulation of fluid within the pleural space
What is LDH with transudative and exudative pleural effusion
indicator of inflammation
transudate < or equal to 0.6
Exudate >0.6 (elevated)
What is the protein with transudate and exudative pleural effusions
transudate < or equal to 0.5
exudate >0.5
What is the presentation of pleural effusion
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
What is a pneumothorax
air within the pleural space secondary to rupture of visceral pleura or parietal pleura
what can cause pneumothorax
spontaneous (primary) - marfans
iatrogenic (secondary)
traumatic (secondary)
What is a spontaneous pneumothorax
rupture of an alveoli, typically at an area of bleb formation - Marfans
most common at the apex of the lung
what is an iatrogenic pneumothorax
secondary to mechanical ventilation, line placement, lung bx
what is an open pneumothorax
damaged chest wall allows air in during inspiration
what are causes of open pneumothorax
trauma (blunt/penetrating)
Iatrogenic (transtracheal aspiration, lung biopsy, tube thoracostomy)
what is the treatment for open pneumothorax
three-way dressing
chest tube
surgical repair
what is a tension pneumothorax
mediastinal shift
what is the presentation of penumothorax
decreased breath sounds
SOB of sudden onset
ipsilateral pleuritic pain
increased resonance on percussion
tachycardia (compensation)
what is pneumomediasatinum
free air around the mediastinal structures
what is pleurisy
aka pluritis
inflammation of the pleura
what is pleuritic pain
sharp or stabbing pain with inspiration or cough
