Flashcards in Respiratory: Clinical signs of common disease Deck (14):
What diseases would cause reduced chest movements?
Unilateral: lobar collapse, pleural effusion, pneumothorax, pneumonia
Bilateral: stiff lungs due to interstitial lung disease, hyperinflated lungs seen in COPD
What diseases would cause tracheal shift?
Pushed to opposite side: massive pleural effusion or tension pneumothorax
Pulled to same side: central collapse, unilateral fibrosis
What diseases cause hyper-resonant, dull and stony dull percussion?
Hyper-resonant: air so pneumothorax
Dull: solid so a consolidation
Stony dull: liquid so pleural effusion
What diseases would cause bronchial or reduced breath sounds?
Bronchial breathing: consolidation eg lobar pneumonia
Reduced breath sounds: pneumothorax or pleural effusion
What is a consolidation?
Fluid inside the alveoli
What is the function of the pleural space?
- allows movement of the lung and chest wall
- couples the chest wall and lung
- pleural fluid circulation (lubricant)
What is the innervation of the pleura?
Visceral pleura has very little innervation so no pain
Parietal pleura is innervated by the phrenic and intercostal nerves so when it gets irritated there is pain
What is the difference between a transudate and exudate?
Transudate is watery and is formed when there is decreased oncotic pressure or increased venous pressure
Exudate has more protein and is forms when there is inflammation, the vessels become more leaky so fluid and protein leak out.
What are the common primary and secondary pleural malignancies?
Primary: mesothelioma caused by asbestos exposure. Has a poor prognosis
Secondary: metastasis from the lung parenchyma or breast
What is a pneumothorax and how is it casued?
Air in the pleural space
Can occur spontaneously, secondary to an underlying disease such as cancer or COPD, or as a result of medical procedures eg central lines.
How should a pneumothorax be treated?
Small pneumothorax with no shortness of breath - observation, may reinflate on its own.
If there is shortness of breath will need to be administered and the air aspirated and an intercostal drain fitted.
Tension pneumothorax - no xray, need immediate drain
What factors can cause increased pleural fluid formation and absorption?
Increased formation of fluid:
Increased hydrostatic pressure, decreased oncotic pressure, increased permeability of vessels
Increased absorption of fluid: (via lymphatics)
Lymphatic blockage or increased system venous pressure
What is the difference between haemothorax, chylothorax, empyema and simple effusion?
They are all types of pleural effusion but differ on the type of fluid
Heamothorax - blood
Chylothorax - lymph with fats in it
Empyema - pus
Simple effusion - serous fluid