Atelectasis and pulmonary edema

What disease?

incomplete expansion of the lungs or collapse of a previously inflated lung

atelectasis

What disease?

foreign body, mucus plugs, or tumors

obstructive atelectasis (resorption atelectasis)

What disease?

fluid or air in pleural cavity

compression atelectasis (non-obstructive atelectasis)

What disease?

pulmonary or pleural fibrosis prevents full lung expansion

contraction atelectasis (non-obstructive atelectasis)

obstruction/resorption atelectasis: gas absorption from the alveoli promotes what two things?

• retraction of the lung

• airless state within those alveoli

With obstruction/resorption atelectasis, there is mediastinal shift ____, diaphragm is ___, and the chest wall _____

mediastinal shift towards atelectasis area, while the diaphragm is elevated, and the chest wall flattens

With compression atelectasis, mediastinum ad/or trachea shift/deviate ____

away from the affected side

What disease?

it follows a reduction of lung volume subsequent to severe parenchymal scarring

contraction atelectasis (cicatrization/cicatricial)

What disease?

fibrosis/scarring with narrowing of bronchial lumen

contraction atelectasis (cicatrization/cicatricial)

What disease?

a special form of atelectasis due to loss of surfactant

respiratory distress syndrome in newborns (RDS)

What do we do to prevent respiratory distress syndrome in newborns?

for a premature labor, give the mother glucocorticoids to increase surfactant synthesis

What disease?

associated with prematurity and maternal diabetes

respiratory distress syndrome in newborns

What disease?

excessive accumulation of fluid in the alveoli

pulmonary edema

What type of pulmonary edema?

increased capillary hydrostatic pressure secondary to elevated pulmonary venous pressure

hemodynamic pulmonary edema

What disease?

associated with hypoalbuminemia

hemodynamic pulmonary edema

What type of pulmonary edema?

loss of oncotic pressure associated with edema

hemodynamic pulmonary edema

What type of pulmonary edema?

changes in capillary permeability as result of direct or indirect insult

microvascular injury associated pulmonary edema

What disease?

patients cough up froth when the edema fluid escapes into the alveoli 

hemodynamic pulmonary edema

With pulmonary edema, where does edema accumulate?

basal regions of the lower lobes

Injury-related alveolar edema is an important feature of a serious and often fatal condition known as ____

acute respiratory distress syndrome (ARDS)

What disease?

acute and rapidly progressive hypoxia with bilateral pulmonary edema due to alveolar injury caused by pulmonary or systemic insults

acute respiratory distress syndrome (ARDS)

What disease?

clinical features: profound dyspnea and tachypnea, respiratory failure, hypoxemia, cyanosis, and respiratory acidosis 

acute respiratory distress syndrome (ARDS)

What disease?

lungs are stiff due to loss of functional surfactant

acute respiratory distress syndrome (ARDS)

What disease?

xray: diffuse bilateral infiltrates (opacities)

acute respiratory distress syndrome (ARDS)

What disease?

diagnosis of exclusion: 

abnormal chest xray, respiratory failure, decreased PaO2/FiO2, and symptoms of respiratory failure

acute respiratory distress syndrome (ARDS)

ARDS pathogenesis: what phase is 1-7 days

exudative (acute) phase

ARDS pathogenesis: what phase is 1-3 weeks

proliferative/organizing phase

ARDS pathogenesis: what phase is after 3 weeks

fibrotic (chronic) phase

What phase of ARDS do we see: the lungs are heavy, form, red, and boggy?

acute exudative phase

What disease?

associated with hypoalbuminemia with loss of oncotic pressure

hemodynamic pulmonary edema

What disease?

injury to alveolar capillary endothelium, leakage of fluids and proteins in the lung interstitium

microvascular injury associated pulmonary edema