T4 L14: Pleural and chest wall disease

Question 1

Which ribs does the scalene muscle attach to?

Answer 1

Rib 1 and 2

Question 2

What is Kyphoscoliosis?

Answer 2

An abnormal curve of the spine in the coronal and sagittal planes

Question 3

What are mesothelial cells?

Answer 3

Cells that cover the pleura of the lungs

Question 4

What is contained within the intrapleural space?

Answer 4

Lymphocytes, macrophages, and mesothelial cells

Question 5

What is the pH within the intrapleural space of the lungs?

Answer 5

pH 7.6

Question 6

What is a pleural effusion?

Answer 6

Fluid inside the pleural space

Question 7

What is a pneumothorax?

Answer 7

Air inside the pleural space which creates a positive pressure. It creates a one way valve so more air can come in but none can leave which builds up the pressure

Question 8

What is Marfan’s syndrome?

Answer 8

A disorder of the body’s connective tissues

Question 9

Who is at risk of a primary spontaneous pneumothroax?

Answer 9

Healthy young tall males, smokers

Question 10

What is pleuodesis?

Answer 10

Sticking the visceral and parietal pleura together. Used to treat recurrent collapsed lungs

Question 11

What can cause altered permeability of the pleural membranes leading to a pleural effusion?

Answer 11

Inflammation, infection, or cancer

Question 12

What can cause reduced oncotic pressure leading to a pleural effusion?

Answer 12

Low albumin caused by renal disease or liver cirrhosis

Question 13

What can cause increased capillary hydrostatic pressure leading to a pleural effusion?

Answer 13

Heart failure

Question 14

What can cause decreased lymphatic drainage or blockage leading to a pleural effuion?

Answer 14

Malignancy or trauma

Question 15

What can cause increased peritoneal fluid leading to a pleural effusion?

Answer 15

Liver cirrhosis or peritoneal dialysis

Question 16

What are the most common causes of pleural effusion?

Answer 16

Heart failure, pneumonia, and malignancy

Question 17

What is empyema?

Answer 17

Collection of pus in the pleural space that can thicken the pleural surface and prevent expansion of the lungs

Question 18

What are the risk factors for pleural infection?

Answer 18

Diabetes, immunosuppression, alcohol, poor oral hygiene, trauma, recent hospitalisation

Question 19

Why would you go over the rib when ding a pleural procedure?

Answer 19

Because the neural bundle sits under a rib so going over prevents damage. An ultrasound would also be used during the procedure

Question 20

What is the life expectancy for a malignant pleural effusion?

Answer 20

6 months max

Question 21

When would a pleural effusion be bilateral?

Answer 21

When it’s caused by heart failure

Question 22

When would a pleural effusion be unilateral?

Answer 22

When it’s caused by malignancy

Question 23

What us used for pleurodesis?

Answer 23

Talcum powder slurry that sticks the pleura together

Question 24

What is a heamothorax?

Answer 24

Blood in the pleural space