Pleural Effusion and Empyema

A set of vocabulary flashcards covering key terms and concepts from the pleural effusion and empyema lecture notes.

Pleural effusion

Excess accumulation of fluid in the pleural space between the visceral and parietal pleura, which can compress the lungs.

Visceral pleura

Membrane that covers the lungs.

Parietal pleura

Membrane lining the chest wall, diaphragm, and mediastinum.

Atelectasis

Collapse or incomplete expansion of lung tissue, often associated with pleural effusion.

Transudate

Thin, watery pleural fluid produced by hydrostatic/oncotic pressure differences; few cells and little protein; pleural surfaces are not involved.

Exudate

Pleural fluid produced by diseased pleural surfaces; higher protein content and cellular debris.

Transudative pleural effusion

Effusion where the fluid is a transudate, usually due to systemic conditions (e.g., CHF, hepatic hydrothorax, nephrotic syndrome).

Exudative pleural effusion

Effusion due to diseased pleural surfaces; high protein content; often from infection, malignancy, or inflammation.

Congestive heart failure

Most common cause of transudative effusions; left-sided failure more likely; increased hydrostatic pressure.

Hepatic hydrothorax

Pleural effusion from ascites passing through diaphragmatic defects into the pleural space, typically with liver cirrhosis.

Peritoneal dialysis

Transudative effusions related to dialysis; fluid movement between peritoneal and pleural spaces.

Nephrotic syndrome

Hypoalbuminemia causing decreased plasma oncotic pressure and bilateral pleural effusions.

Pulmonary embolism

PE or infarction can cause pleural effusions due to inflammation and increased capillary permeability.

Malignant pleural effusion

Effusion caused by cancer; commonly associated with breast cancer and other malignancies.

Malignant mesothelioma

Pleural cancer often linked to asbestos exposure, leading to effusions.

Bacterial pneumonia with effusion

Pneumonia associated with pleural effusion; may resolve or require drainage; untreated can lead to empyema.

Tuberculosis

TB infection that can extend to the pleural space causing effusion.

Fungal disease

Pleural effusion associated with histoplasmosis, coccidioidomycosis, or blastomycosis.

Chylothorax

Presence of chyle in the pleural space, usually due to trauma to the neck or thorax.

Chyle

Milky lymphatic fluid from fat absorption in the intestine, transported by the thoracic duct.

Thoracic duct

Main lymphatic duct carrying chyle from the abdomen to the left subclavian vein; can be disrupted in trauma.

Hemothorax

Blood in the pleural space; typically from trauma; pleural fluid hematocrit ≥50% may indicate blood.

Empyema

Pus in the pleural space due to infection or inflammation.

Pleurodesis

Procedure that causes adhesion of the pleural surfaces to obliterate the pleural space and prevent recurrent effusion or pneumothorax.

Thoracentesis

Procedure to remove pleural fluid with a needle under local anesthesia for diagnostic or therapeutic purposes.

Thoracostomy

Chest tube insertion; typically 4th or 5th intercostal space at the midaxillary line; 28–36 French tube for adults.

Blunting of the costophrenic angle

Radiographic sign of pleural effusion on chest X-ray.

Meniscus sign

Curved meniscus of pleural fluid seen on upright chest radiographs.

Subpulmonic effusion

Pleural effusion that collects beneath the lung, visible on lateral decubitus views.

Pneumothorax

Air in the pleural space; can accompany effusions and complicate imaging.

Tracheal shift

Movement of the trachea away from the affected side in large effusions or tension states.

Dull percussion note

Physical exam finding associated with pleural effusion due to liquid in the pleural space.