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Flashcards in Pleural Effusion Deck (7)
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1

3 mechanisms of pleural effusion?

- increased drainage of fluid into the space
- increased production of fluid by cells in the space
- decreased drainage of fluid from the space

2

What is intrapleural pressure?

- neg pressure is created in pleural space as thoracic cage enlarges and lungs recoil during normal inspiration
- negative pressure may be lost if fluid collects in pleural space, making the lung unable to expand fully

3

Normal amt of pleural fluid?

- up to 25 ml is normally present, not detectable on conventional radiographs
- pleural effusion: abnorm accum of fluid into pleural space

4

What are the main causes of pleural effusion?

- CHF (venous pressure increased - fluid exceeds hydrostatic pressure)
- liver failure ( decreased albumin = decreased oncotic pressure)
- infection
- atelectasis
- cancer
- trauma

5

What is a hemothorax?

- blood in pleural cavity
- usually b/c of chest injury
- blood vessel ruptures into pleural space or bulging area into aorta (aortic aneurysm) leaks blood into pleural space
- can occur as a result of bleeding from ribs, chest wall, pleura and lung

6

Diff types of pleural fluid?

- transudate: serum w/o protein
- exudate: protein in fluid; infection, inflammation
- empyema: infection - pus accum
- chyle: lymph fluid (milky appearance)
- hemothorax

7

How much fluid needs to be present to be visible on XR? What position can confirm fluid? Other signs on imaging?

- 250 ml to be seen on PA CXR
- Lateral decubitus on affected side will almost always confirm fluid
- fluid will sit in Costophrenic angles or fissures
- pleural fluid becomes traped by pleural adhesions, form unusual colelctions along chest wall or in lung fissures - US or CT is uesful to locate loculated or small effusions
- massive pleural effusion: is usually caused by cancer but has been observed in TB and other diseases
- CT scanning is useful in free or loculated pleural fluid