Respiratory - Class 2 Flashcards
Defined as the presence of blood in the pleural cavity; can result in the collapse of a lobe or an entire lung, leading to impaired ventilation and oxygenation.
Hemothorax
Defined as the presence of air/gas in the pleural cavity; can result in the collapse of a lobe or an entire lung, leading to impaired ventilation and oxygenation.
Pneumothorax
Chest pain: severe and/or stabbing, radiating to the ipsilateral shoulder and increasing with inspiration (pleuritic-type pain), due to hypoxia.
Pneumothorax
Dyspnea, respiratory distress or respiratory arrest.
Pneumothorax
Tachypnea and tachycardia (mediastinum can shift as a result, which can affect hemodynamic stability).
Signs and Symptoms of
Pneumothorax
Traumatic: blunt trauma or penetrating trauma that disrupts the parietal or visceral pleura eg. gunshot, arrow, stabbing, rib fracture, surgery.
Pathologic: rupture of pleural layers or alveoli eg. tumors, abscess, COPD, CF, TB, and air enters the pleural space via distended/damaged/ruptured alveoli.
Iatrogenic: secondary to diagnostic or therapeutic medical intervention.
Idiopathic: no preceding trauma and no underlying lung pathology - not uncommon in tall, thin, athletic adolescents, and smokers.
Causes of Pneumothorax
Dependent on the degree of collapse of the lung, can range from completely asymptomatic to life-threatening respiratory distress.
Signs and Symptoms of Pneumothorax
An inflammation of the pleural membranes
Pleuritis (Pleurisy)
Can be extremely painful, often unilateral with abrupt onset
May be accompanied by reflex splinting of chest muscles
Pleuritis (Pleurisy)
Pain may be referred to shoulder
Pleuritis (Pleurisy)
Pain worsens when the inflamed pleura is stretched on breathing (deep breathing, coughing), so breath tends to be shallow and may be rapid
Pleuritis (Pleurisy)
May be accompanied by reflex splinting of chest muscles
Pleuritis (Pleurisy)
- chest pain with breathing/moving, exacerbated by coughing or sneezing - pain is usually severe, sharp, and knife-like on inspiration
- tachypnea which may lead to tachycardia
- dry cough
- weakness
- headache
- fever
Symptoms of Pleuritis (Pleurisy)
- treatment is directed to the underlying cause and suppressing the inflammation
- pain medications
- laying on the affected side to limit breathing movement may reduce the stretching of the pleura and therefore the pain, when pleuritis is acute
Treatment for Pleura’s (Pleurisy)
Pain Differentiation vs. Pleuritis
often bi-lateral and located around lower ribs, irritated by coughing?
Musculoskeletal
Pain Differentiation vs. Pleuritis
sub-sternal and dull, “tightening”, made worse by coughing but not deep breathing
Bronchial
Pain Differentiation vs. Pleuritis
substernal discomfort, not affected by respiratory movements
Myocardial
a.k.a. Atelectasis
Dysfunctional Lung Expansion
incomplete expansion of part of a lung, or the entire lung.
Atelectasis
May be caused by airway obstruction, lung compression or lung collapse
Atelectasis