Pulmonary Pleural Disease Flashcards
Pleural effusion
the accumulation of excess pleural fluid and can be caused by:
- increased pulmonary capillary hydrostatic pressure, increased pulmonary capillary vascular permeability, decreased plasma osmotic pressure, increased negative pressure in the pleural space, lymphatic obstruction
pleural effusion can be caused by ______ or __—– processes
inflammatory or non inflammatory
Inflammatory causes of pleural effusion
the inflammatory process (pleuritic) results in transudate/ exudate being produced and the accumulation of the non-purulent transudate–> exudate (effusion) in the pleural space, with various amounts of fibrin formation.
Transudate and exudate are both fluids collecting in body compartments, however transudate is usually __________ while exudate has a high ________
transudate: usually clear and relatively free of cells and proteins; exudate has a high content of cell, cellular debris and proteins
may be ___, ___, or ____ transudate /exudate and may be associated with sharp, stabbing pain worsening with deep respiration (“_____” pain) and a _______
serous, serofibrinous, or fibrinous ; pleuritic pain and a pulmonary friction rub
Pleural effusion is generally associated with _____ diseases, especially when they affect the _____ aspects of the lungs
infectious; peripheral (close to the pleural membrane)
such as: tuberculosis, pneumonia, lung infarcts, lung abscess and bronchiectasis
Inflammatory Effusion: Empyema occurs when
the effusion contains purulent fluid indicating infection in the fluid (containing large numbers of WBC)
- usually unilateral
Empyema usually results from ___ or ____ seeding of the pleural space. seeding usually occurs by ______ of organisms from pulmonary infection, but may also occur via the lymphatic or hematogenous routes or through the diaphragm
bacterial or fungal; contiguous spread;
Empyema is characterized by ______ in the pleural space composed of ______
yellow-green, creamy pus in the pleural space; exudate with masses of neutrophils mixed with other leukocytes
In Empyema, fibrin forms dense, tough _____ that frequently form the walls of ___ and attach the visceral to the parietal pleura (causing ___ with respiration and _____ pulmonary expansion)
fibrous adhesions; loculations; pain; restrictive
Hemorrhagic Inflammatory Effusion (serosanguinous) is manifested by __
blood (sanguineous) mixed with inflammatory exudate
Hemorrhagic Effusion is also associated with _____. Must be differentiated from _____
hemorrhagic disorders, infections, and cancers; hemothorax (bleeding into the pleural cavity, not from inflammatory response)
Hydrothorax is the collection of __________
non-inflammatory, straw colored serous transudate fluid within the pleural cavities
Hydrothorax can be ____ or ___lateral. most common cause is _____ and may be associated with generalized ____. It usually results in ____
unilateral or bilateral; left heart failure; edema; atelectasis.
Hemothorax occurs with ______ into the pleural cavity. Usually results in _____
bleeding; atelectasis
Chylothorax is accumulation of milky (fat-rich) ______ in the pleural cavity.
lymphatic fluid
Chylothorax is caused by thoracic duct ____ or ___ or ____ of major lymphatic ducts (malignant conditions). Usually results in _____
trauma; obstruction or rupture; results in atelectasis
Pneumothorax is introduction of ______ into the pleural space which usually results in ___
gas (usually air); atelectasis
Spontaneous pneumothorax may occur with _____ allowing gas to enter into the pleural cavity. Associated with ___
rupture of the lung; emphysema, asthma, tuberculosis, abscess, neoplasm
Spontaneous idiopathic pneumothorax probably due to rupture of _________. Generally occurs in relatively _____
small, peripheral, usually apical sub pleural blebs; tall, thin young people
Traumatic pneumothorax usually caused by _____ injury to the chest wall or lung
perforating
Tension pneumothorax: if the point of air entry acts as a _____-
one way, flap valve, permitting air entrance during inspiration but not permitting air escape during expiration, (it will act as a pump that progressively increases intrapleural pressure)
In tension pneumothorax- it compresses the mediastium and the contralateral ling, may cause ______
tracheal deviation away form affected side, also hyper expanded chest that moves little with respiration, and an increased percussion not over affected side
In pneumothorax, ____ of air from the pleural space air will occur slowly in spontaneous and traumatic pneumothorax, provided that the gas source becomes sealed (defect in lung or chest wall)
resorption
small pneumothoraces can be treated with ___ and ____. Large pneumothoraces require ____
time and observation; chest tube insertion
Pleural Tumors: ____ tumors are most common, most frequently arise from lung, breast, or ovary. Most metazoic cancers result in ______
metastatic; serous or serosanguinous pleural effusion that often contains neoplastic cells
