Pleural Space Flashcards
Parietal pleura
continuous and covers the inner surface of the thorax
What are the names of the pleura?
Costal
Diaphragmatic
Mediastinal
Visceral pleura
covers the lung
Pleural space
Space between the lung lobes and the body wall and individual lung lobes
Interlobar Fissures
The divisions between the lobes
“Fissure Line”
Pleural fluid accumulates in the interlobar fissures
Pleural effusion
fluid in the pleural space
Pneumothorax
gas in the pleural space
What are the most common pleural effusions?
Congestive Heart Failure
Malignancy
Trauma
Chylothorax
What kind of fluid do you find with Congestive Heart Failure?
Modified Transudate
What kind of fluid do you find with Pyothorax?
Exudate
What kind of fluid do you find with Malignancy?
Modified Transudate
What kind of fluid do you find with Pneumonia?
Modified Transudate
Exudate
What kind of fluid do you find with Trauma?
Modified Transudate
What kind of fluid do you find with Coagulation defect?
Modified Transudate
What kind of fluid do you find with Hypoproteinemia?
Transudate
What kind of fluid do you find with Mediastinitis?
Modified Transudate
Exudate
What kind of fluid do you find with Chylothorax?
Modified transudate
What kind of fluid do you find with Diaphragmatic Hernia?
Modified Transudate
What are the radiographic signs of Pleural Effusion?
Soft Tissue Opacity
Retraction of pleural surface of lung away from pleural surface of thoracic wall, with interposed soft tissue opacity
Increased soft tissue with scalloped margins
decreased cardiac silhouette visualization
obscured diaphragmatic outline
What is the minimum amount of fluid needed to detect wide fissures?
100mL
What causes Asymmetric fluid?
Complete Mediastinum
Fenestrations closed by exudate: Pyothorax
What does chronic fluid lead to?
Fibrosis
What are some Pleural Fluid “Fakeouts”
Normal thin fissures
Costal Cartilages
Chondrodystrophic morphology
What are the causes of Pneumothorax?
Tear in lung involving visceral pleura Hole in thoracic wall extension of pneumomediastinum Iatrogenic Rupture of lung lesion
Tension Pneumothorax
Tension due to lung laceration where air leaks out upon inspiration but cannot return
What is seen on radiographs for pneumothorax
Retraction of pleural surface of lung away from pleural surface with Interposed radiolucency on lateral radiographs
Dorsal displacement of the heart away from the sternum
Contralateral midline shift
Flat Diaphragm
Caudal displacement of diaphragm
Tenting of diaphragm
2 important things to look for in tension pneumothorax?
Flattening of the diaphragm
Tenting of the diaphragm
What are some pneumothorax fakeouts?
Hypovolemia causing cardiac “elevation”
Thoracic wall conformation causing cardiac “elevation”
Skin fold creating peripheral radiolucency
