Comprehensive Study of Pulmonary Disease: Chapter 24 - Pleural Effusion and Empyema

pleural effusion

the accumulation of fluid in the pleural space

empyema

the accumulation of infected fluid in the pleural space

-lung compression

-atelectasis

-compression of the great veins

name 3 major pathologic/structural changes in pleural effusion

parietal

fluid in the pleural space is primarily produced from which of the pleura?

parietal pleura

which of the pleura has higher hydrostatic pressures?

equal

The oncotic pressures between the visceral and parietal pleural are...

lymphatic vessels

these vessels in the parietal pleura (chest wall) are responsible for fluid reabsorption

True

True or False: Congestive heart failure, cancer, and pneumonia account for the majority of pleural effusion cases

-the origin of the fluid

-the pathophysiology (transudative or exudative)

pleural effusions are classified by...

hydrothorax

pleural effusion with serous fluid

hemothorax

pleural effusion with blood

Chylothorax

pleural effusion with chyle

pyothorax/empyema

pleural effusion with pus

urinothorax

pleural effusion with urine

-Transudative

-Exudative

name the 2 pathophysiological types of pleural effusion

transudative

pleural effusion that develops when fluid from the pulmonary capillaries moves into the pleural space

transudative

which type of pleural effusion would have thin and watery fluid?

no

are the pleural surfaces involved in producing transudate?

exudative

pleural effusion that develops when the pleural surfaces are diseased

exudative

which kind of pleural effusion would have fluid with high protein content and lots of cellular debris?

True

True or False: Exudative pleural effusion is usually caused by inflammation, infection, or malignancy

congestive heart failure

what is the most common cause of transudative pleural effusion?

transudative pleural effusion

Hepatic hydrothorax causes which kind of pleural effusion?

exudative

Tuberculosis, bacterial pneumonias, and fungal disease would cause which kind of pleural effusion?

yes

would you expect atelectasis in pleural effusion?

yes

would you expect chest pain in pleural effusion?

decreased

would chest expansion be increased or decreased in the pleural effusion?

yes

could a patient with pleural effusion be cyanotic?

nonproductive because the fluid is outside of the lung, not in the lung

would the cough in pleural effusion be productive or nonproductive? why?

decreased fremitus (fluid outside the lung, not in the lung)

would there be increased or decreased fremitus in pleural effusion?

dull

describe a percussion note pleural effusion

-diminished

-pleural friction rub

give 2 potential breath sounds in pleural effusion

restrictive

is pleural effusion restrictive or obstructive?

-blunted costophrenic angles

-meniscus sign

name 2 hallmark signs of pleural effusion on a chest radiograph

-thoracentesis

-chest tubes

-antibiotics

name 3 methods of treating pleural effusion

-pneumothorax

-re-expansion pulmonary edema

name 2 things we should be cautious of when performing a thoracentesis

yes

could pleural effusion cause atelectasis?

True

True or False: The best way to resolve a pleural effusion is to direct the treatment at what is causing it

pleurodesis

how would we treat a persistent/reoccurring pleural effusion?