L5: Pleural Diseases Flashcards
(123 cards)
1
Q
Def of Pleura
A
Mesothelial lining of each hemithorax
2
Q
Embryonic Origin of Pleura
A
Derived from embryonic coelomic lining
3
Q
Parts of Pleura
A
4
Q
Divisions of Pleura
A
5
Q
Divisions of Pleura
- Site
A
6
Q
Divisions of Pleura
- Appearence
A
7
Q
Divisions of Pleura
- Blood Supply
A
8
Q
Divisions of Pleura
- Venous Drainage
A
9
Q
Divisions of Pleura
- Nerve Supply
A
10
Q
Divisions of Pleura
- Lymphatics
A
11
Q
Both layers meet at the ….. of the lung and separated by a potential space which contain very small amount of fluid
A
- root
12
Q
Def of Pleural Cavity
A
Potential space between visceral & parietal pleura
13
Q
Contents of Pleural Cavity
A
Contains a capillary layer of serous fluid produced by mesothelium
14
Q
Functions of Pleural Cavity
A
- Reduces friction between lung and thoracic wall during respiration.
- Creates surface tension that provides cohesion between lung & thoracic wall
15
Q
Amount of Pleural Fluid
A
Small volume of fluid is normally present (about 10-20ml).
16
Q
Function of Pleural Fluid
A
- It acts as dubricant that facilitates the lung movement and to transmit the force generated by the respiratory muscles to the lungs
17
Q
Diseases of The Pleura
A
- Dry pleurisy.
- Pneumothorax.
- Pleural effusion.
- Pleural tumors
18
Q
Causes of Dry Pleurisy
A
19
Q
Def of Dry Pleurisy
A
It is an inflammation of both layers of the pleura without effusion.
20
Q
Causes of Dry Pleurisy
- Infections
A
21
Q
Causes of Dry Pleurisy
- Collagen Lung Diseases
A
- Systemic lupus erythematosus (SLE).
- Rheumatoid disease.
22
Q
Causes of Dry Pleurisy
- Pulmonary Infarction
A
….
23
Q
Causes of Dry Pleurisy
- Tumors
A
Chest wall or the lung.
24
Q
Causes of Dry Pleurisy
- Chest Trauma
A
Fracture ribs.
25
Causes of **Dry Pleurisy**
- Uremia
...
26
Causes of **Dry Pleurisy**
- FMF
...
27
Causes of **Dry Pleurisy**
- Idiopathic
...
28
CP of **Dry Pleurisy**
29
CP of **Dry Pleurisy**
- Pleural Pain
30
Pleural Pain in **Dry Pleurisy**
- Etiology
- Site
- Characters
- Inc With
- Dec With
- Reference
31
CP of **Dry Pleurisy**
- Dyspnea
...
32
CP of **Dry Pleurisy**
- Dry Cough
....
33
CP of **Dry Pleurisy**
- Symptoms of the underlying condition
suppuration in bronchiectasis.
34
CP of **Dry Pleurisy**
- Signs
**Pleural rub:** Due to friction of the inflamed two layers of the pleura.
35
TTT of **Dry Pleurisy**
36
Def of **Pleural Effusion**
- Accumulation of any fluid in the pleural space in an amount more than that of normal (10-20ml))
37
Types of **Pleural Effusion**
- Transudative & Exudative
38
Pathophysiology of **Transudative Pleural Effusion**
39
Causes of **Transudative Pleural Effusion**
40
Causes of **Transudative Pleural Effusion**
- Hydrostatic
- Congestive cardiac failure.
- Constrictive pericarditis.
- Pericardial effusion.
41
Causes of **Transudative Pleural Effusion**
- oncotic
- Cirrhosis.
- Nephrotic syndrome.
- Malnutrition.
42
Causes of **Transudative Pleural Effusion**
- Transmission from Peritoneum
- Any cause of ascites.
- Peritoneal dialysis.
43
Causes of **Transudative Pleural Effusion**
- Capillary permiability
- Small pulmonary emboli.
- Myxoedema
44
Pathophysiology of **Exudative Pleural Effusion**
Results from disease of the pleural surface.
45
Causes of **Exudative Pleural Effusion**
46
Causes of **Exudative Pleural Effusion**
- Infection
- Pneumonia, Abscess.
- Tuberculosis, Fungal infection
- Subphrenic abscess.
- Hepatic amoebiasis.
47
Causes of **Exudative Pleural Effusion**
- Neoplasm
- Pleural metastasis
- Lymphoma
- Primary pleural tumors: Mesothelioma & Pleural sarcoma (Very rare)
48
Causes of **Exudative Pleural Effusion**
- P. embolism & Infarction
....
49
Causes of **Exudative Pleural Effusion**
- Immune
- Post-myocardial infarction / cardiotomy syndrome.
- Rheumatoid disease
50
Causes of **Exudative Pleural Effusion**
- Abdominal
- Pancreatitis, Uremia.
- Other causes of peritoneal exudate
51
Causes of **Exudative Pleural Effusion**
- Other Causes
- A Drug reactions.
- Esophageal rupture.
52
CP of **Pleural Effusion**
53
CP of **Pleural Effusion**
- Symptoms
54
Symptoms of **Pleural Effusion**
- none
- Small pleural effusion.
- Slowly accumulated large pleural effusion.
55
Symptoms of **Exudative Pleural Effusion**
- pleural Pain
- In inflammatory causes.
- Starts with the condition
- Relieved with fluid accumulation.
56
Symptoms of **Exudative Pleural Effusion**
- Dyspnea
- Pleurisy.
- Large pleural effusion.
57
Symptoms of **Exudative Pleural Effusion**
- Recurrent Dry Cough
....
58
Signs of **Exudative Pleural Effusion**
59
Signs of **Exudative Pleural Effusion**
- Inspection
60
Signs of **Exudative Pleural Effusion**
- Palpation
61
Signs of **Exudative Pleural Effusion**
- Percusion
Stony dullness over the affected area
62
Signs of **Exudative Pleural Effusion**
- Auscultation
63
Signs of **Exudative Pleural Effusion**
- Signs of the Cause
....
64
A pleural effusion is not detected clinically until more than ...... of fluid accumulate
500ml
65
INVx for **Pleural Effusion**
- Rads
- Labs
- Pleural Bx
- Thoracoscopy
66
INVx for **Pleural Effusion**
- Rads
67
Rads in **Pleural Effusion**
- Plain X-Ray
68
Plain X-Ray in **Pleural Effusion**
- Free pleural fluid in small amount
- Homogenous opacity obliterates the costophrenic angle
(blunting of costophernic angle on P/A film needs at least 300 ml of effusion).
69
Plain X-Ray in **Pleural Effusion**
- Larger Effusion
70
Plain X-Ray in **Pleural Effusion**
- Massive Pleural Effusion
71
Plain X-Ray in **Pleural Effusion**
- Encysted Effuson
72
Plain X-Ray in **Pleural Effusion**
- Mediastinal Effusion
Broad mediastinum
73
Plain X-Ray in **Pleural Effusion**
- Fissural Effusion
74
Plain X-Ray in **Pleural Effusion**
- Subpulmonary Effusion
75
Rads in **Pleural Effusion**
- US
76
Plain X-Ray in **Pleural Effusion**
- CT
77
INVx for **Pleural Effusion**
- Diagnostic Aspiration
78
INVx for **Pleural Effusion**
- Biochemical Analysis
79
Differentiate between exudative and transudative pleural effusion
80
Differentiate between exudative and transudative pleural effusion
- Pleural fluid protein/serum protein
- Pleural fluid protein
- Pleural fluid LDH/serum LDH
- Absolute LDH value
- Specific gravity
81
INVx for **Pleural Effusion**
- pH of Pleural Fluid
82
INVx for **Pleural Effusion**
- Glucose in Pleural Fluid
83
INVx for **Pleural Effusion**
- Lipids in Pleural Fluid
84
INVx for **Pleural Effusion**
- Amaylase in Pleural Fluid
85
INVx for **Pleural Effusion**
- Bacteriological Examination
86
INVx for **Pleural Effusion**
- Cytological Examination
For malignant cells, lymphocytes, neutrophils, esinophils and other cells.
87
INVx for **Pleural Effusion**
- Pleural Biopsy
For histopathological examination of the pleura.
88
INVx for **Pleural Effusion**
- Thoracoscopy
For undiagnosed cases.
89
TTT of **Pleural Effusion**
90
TTT of **Pleural Effusion**
- TTT of Cause
- Anti-TB for TB
- Antibiotics and postural drainage for lung abscess with effusion, etc.
91
TTT of **Pleural Effusion**
- Pleural Aspiration
To relieve dyspnea.
92
TTT of **Pleural Effusion**
- Intercostal Tube Drainage
- Hemothorax.
- Empyema.
- Chylothorax.
- Hydropneumothorax.
93
TTT of **Pleural Effusion**
- Pleuridesis
**in cases of**
- Recurrent pleural effusion. e.g. malignant.
- Cases with recurrent pneumothorax.
94
TTT of **Pleural Effusion**
- Anti-Biotics
to treat infections.
95
TTT of **Pleural Effusion**
- Anti-TB
In cases of TB pleural effusion.
96
TTT of **Pleural Effusion**
- Chemotherapy
For malignant pleural effusion.
97
TTT of **Pleural Effusion**
- Analgesics
To relieve pain.
97
Def of **Pneumothorax**
Presence of air in the pleural space.
98
Types of **Pneumothorax**
99
Types of **Pneumothorax**
- Spontaneous
100
Types of **Spontaneous Pneumothorax**
- 1ry
In young slender patient with apparently healthy lung.
101
Types of **Spontaneous Pneumothorax**
- 2ry
102
Types of **Pneumothorax**
- Traumatic
103
Types of **Traumatic Pneumothorax**
- Iatrogenic
104
Types of **Traumatic Pneumothorax**
- Traumatic
105
CP of **Pneumothorax**
106
CP of **Pneumothorax**
- symptoms
107
CP of **Pneumothorax**
- General Signs
108
CP of **Pneumothorax**
- Local Chest Ex
109
Small pneumothorax may not be detected clinically
...
110
INVx for **Pneumothorax**
111
INVx for **Pneumothorax**
- Chest X-Ray
112
TTT of **Pneumothorax**
113
TTT of **Pneumothorax**
- Conservative
114
TTT of **Pneumothorax**
- Active
By insertion of intercostal tube (ICT).
115
Indicatios of Intercostal Tube Drainage in **Pneumothorax**
116
Types of **Pleural Tumors**
117
Behaviour of **Pleural Tumors**
118
Source of **Pleural Tumors**
119
Cause of **Pleural Tumors**
120
CP of **Pleural Tumors**
121
Chest X-Ray in **Pleural Tumors**
122
TTT of **Pleural Tumors**
