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53 Cards in this Set
- Front
- Back
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What is the width of the pleural space? What two things does the VISCERAL pleura cover? What two things does the PARIETAL pleura cover? |
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What are the three layers of pleural surface? Describe each (mesothelial cells, MC junction, microvilli) in visceral and parietal (tight, loose 'bumpy stretch, dense, sparse, loose 'leaky') |
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Pleural fluid: Color, smell, contents, mostly what type of cell, protein?, purpose? |
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What is the starling equation? What does it depend on? |
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What direction does fluid move? Which has the higher hydrostatic pressure? |
Parietal = high HP 100 ml/hr fluid formation (promotes movement of fluid into pleural space through mesothelial junctions. Viceral = low hydrostatic pressure (300 ml/hr fluid absorption) |
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What particles are removed by lymphatics? Which pleura has lymphatic drainage? Describe the pathway. |
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What do changes in hydrostatic-tissue forces or in oncotic pressure gradient across the pleural space lead to in the parietal and visceral pleura?
What are pleural effusions divided into? |
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What is the quantity of effusion proportional to in congestive heart failure?
Is the oncotic pressure gradient affected? What is greater than colloid oncotic? What is the shift seen in visceral pleura? What are some common characteristics? |
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What are some causes of decreased oncotic pressure? Is hydrostatic pressure affected? |
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What is a cause of decreased intrapleural pressure? Where is most common? Is oncotic pressure affected? What is greater than the oncotic pressure gradient? What is the change in fluid formation? |
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What are some causes of increased permeability? What type of effusion? What is increased in PI space? What happens to oncotic pressure gradient? Are hydrostatic pressures affected? How does fluid change on both sides? |
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What are some physical signs of pleural effusion? |
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What is the major cause of pleural effusion? Other causes? |
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Top to etiologies for NONCARDIAC effusions? |
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For malignant effusions, what are the top two types of cancer? |
Proximity to pleura! |
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What two major forces control the arrangement of free fluid in the pleural space? Where does it go? Where does it spill as it increases? CXR? |
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What are some conditions if you don't see other radiographic abnormalities? |
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What are some possible conditions if you DO see other radiographic abnormalities? |
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Bilateral effusion with cardiomegaly. What i the condition? |
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Bilateral effusion w/o cardiomegaly. What are some possible conditions? |
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What is shown here? Describe and condition. |
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What is shown here? |
Pleural effusions |
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What is indicated by the arrows |
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When is a thoracentisis indicated? |
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How do you distinguish transudate from exudate? |
MOST IMPORTANT -> narrows down differential Should be pleural fluid LDH not serum LDH! |
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KNOW THE COMMON CAUSES! |
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What are white cell counts in each of the pleural fluids? What are some causes of each? |
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What is a definitive diagnosis for each? |
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What do neutrophils indicate (inflammation)? What do lymphocytes indicate (inflammation)? Other types of cells? |
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What does a red blood cell count of >100,00/mL indicate?
What are signs of a traumatic thoracentisis? |
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What are some causes of low pleural fluid glucose? |
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What are some causes of pleural fluid acidosis (pH <7.30, normal = 7.60)? What are the two mechanisms? |
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What are some causes of pleural fluid amylase > 1? |
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Draw the algorithm for the approach to pleural effusions. |
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Look over |
Pay attention to AFB. |
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If the pleural pressure is less than the atmospheric pressure, what is the result?
If pleura is breached, what is the result? |
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What are the four types of pneumothorax? Causes of each? |
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What do most primary spontaneous pneumothorax patients have? Mechanisms of this? Clinical presentation: Age, sex, any pain or signs, recurrence? |
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Causes of secondary spontaneous? Specific infection types? |
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What causes a tension pneumothorax? Most patients are on what? Mechanism. |
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What is does CXR show on tension pneumothorax? |
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Clinically what will the patient exhibit? What is the treatment? |
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Woman with CHF. What is most likely cause of pleural effusion? |
Increased hydrostatic pressure. |
