RESPIRATORY - disruptions in the pleural lining

Question 1

what does disruptions of the pleural lining lead to?

Answer 1

changes the ability of the lungs to inflate, they basically deflate

Question 2

how can pleural lining disruption be categorized?

Answer 2

• pleural effusion
• hemothorax
• pneumothorax
• tension pneumothorax

Question 3

what is the pathophysiology of pleural lining disruption?

Answer 3

something causes disruption of visceral or parietal pleura –> disruption of pleural space
–> change in pressure
–> lungs to collapse
–> restricts ability to expand, ventilate, perfuse & diffuse gasses
–> hypoxia

Question 4

what are the classifications of pleural lining disruptions?

Answer 4

• open or closed
• primary, secondary, or traumatic
• stable or unstable

Question 5

what are the different types of disruptions?

Answer 5

• pneumothorax: air enters pleural space
• hemothorax: blood enters pleural space
• pleural effusion: fluid enters pleural space
• tension pneumothorax: air enters pleural space but CANT LEAVE –> shifting & compressing organs

or COMBO of all the above

Question 6

what are the risk factors of disruption?

Answer 6

• traumatic injury
• lung (visceral pleura) damage from smoking
• genetic conditions: marfan syndrome
• barotrauma from mech ventilation: trauma from pressure
• chronic lung disease
• tall cisgender maes: spontaneous pneumothorax

Question 7

what are the pleural lining disruption manifestations?

Answer 7

• neuro: confusion & altered LOC
• CV: angina, hypotension, tachycardia, muffled heart sounds 9esp with tension pneumothorax)!
• resp: dyspnea, tachypnea, diminished or absent breath sounds! tracheal deviation for tension pneumothorax!

Question 8

what diagnostics would we use for pleural lining distruption?

Answer 8

• chest x -ray: BLACK = FREE SPACE = COLLAPSED LUNG
• CT
• thoracentesis

Question 9

how would we treat pleural lining disruptions?

Answer 9

• focused on removing fluid or air from space
• pharmacological management is focused on secondary issues

Question 10

what are the complications of pleural lining disruptions?

Answer 10

hypoxia –> respiratory collapse –> cardiovascular collapse –> cardiac arrest –> death

some can have small collapses and will resolve on its own