Pleural Effusion Flashcards
Define pleural effusion
- normal amount of fluid?
Fluid in the pleural space
- normal physiological amount of fluid in the pleural space is 10-20mls
When do pleural effusions manifest?
formation of pleural fluid is excessive or when fluid resorption is disturbed
Which type of pleural effusion does the pleura remain intact?
- transudative vs exudative?
Transudative pleural effusion
3 complications of transudative pleural effusions?
CHF (most common)
Liver cirrhosis
Nephrotic syndrome
Exudative pleural effusions have what?
- causes?
High protein content; they’re acidic in nature
- caused by infection/inflammation -> leak = increased permeability
In the realm of pleural effusions, what happens during CHF?
Most common indicator of pleural effusions
There is increased hydrostatic pressure
- Transudative pleural effusion
In the realm of pleural effusions, what happens during liver cirrhosis?
There is reduced ontoctic pressure due to reduced production of albumin
- transudative pleural effusion
In the realm of pleural effusions, what happens during nephrotic syndrome
Reduced oncotic pressure due to increased elimination of proteins
- transudative pleural effusion
3 complications of exudative pleural effusions?
Localized ruptures of blood/lymphatic vessels, lung abscess or esophagus
- Increased permeability
- infections
- Malignant effusions and mesothelioma
What do Empyema, chylothorax and hemothorax have in common?
Different pathologic fluid conditions that separate the parietal form from the visceral pleura.
Clinical manifestations of pleural effusion?
Any condition that compresses the lung and in turn probably the heart. so..
- tachycardia and tachypnea
- hypertension
- pleuritic chest pain
- diminished or absent breath sounds
- pleural rub
(are some examples but not all)
resp and metabolic acidosis are accosiated with which type of pleural effusion?
exudative effusions.
- also resp failure after compensation failure
CxR findings for a pleural effusion?
Blunted costophrenic angle
fluid level on the affected side/meniscus sign
depressed diaphragm
mediantinal shift to unafffected side
atelectasis
minimum range to see a pleural effusion on a CxR?
200-300 ml
- Lateral decubitus (Pt on their side) can be recognized w//50 mls
- other scans (CT, Ultrsound,MRI) require 100 mls or more
What is it called when pleural effusions are drained?
Thoracentesis