Complex Respiratory: Pulmonary Effusions & Pleural Space Issues

Vocabulary practice flashcards covering complex respiratory concepts, pleural effusions, empyema, pneumothorax types, thoracentesis, and chest tube management principles from NUR 265 Exam 2 lecture materials.

Ventilation ($V$)

The movement of air, primarily oxygen ($O_2$) and carbon dioxide ($CO_2$), into and out of the lungs; represents the amount of air that reaches the respiratory tract.

Perfusion ($Q$)

The flow of blood through pulmonary capillaries, facilitating oxygen ($O_2$) and carbon dioxide ($CO_2$) exchange at the cellular level.

$V/Q$ Ratio

The amount of air reaching the alveoli divided by the volume of blood flowing through pulmonary capillaries; under normal functioning, $4\,\text{liters}$ of air and $5\,\text{liters}$ of blood pass through per minute, yielding an expected ratio of $0.8$.

$V/Q$ Mismatch

An abnormal pulmonary state occurring when the ratio of ventilation ($V$) to perfusion ($Q$) is higher or lower than the normal value of $0.8$.

Pleural Effusion

An abnormal accumulation of fluid of any consistency within the pleural space between the lungs and the chest wall.

Transudative Pleural Effusion

A collection of fluid in the pleural space that is low in protein and LDH, caused by increased hydrostatic pressure or decreased plasma oncotic pressure (associated with conditions such as CHF, cirrhosis, nephrotic syndrome, PE, and hypoalbuminemia).

Exudative Pleural Effusion

A collection of fluid in the pleural space that is high in protein and LDH, caused by inflammation and increased capillary permeability (associated with conditions such as pneumonia, cancer, TB, viral infection, PE, and autoimmune disorders).

Parapneumonic Effusion

A subtype of exudative pleural effusion that develops when inflammatory fluid gathers in the pleural space secondary to an adjacent pneumonia.

Empyema

The accumulation of thick, purulent infected fluid (pus) in the pleural cavity; most frequently associated with bacterial pneumonia, but can also develop after thoracic surgery or trauma.

Thoracentesis

A procedure involving needle aspiration of fluid from the pleural space to achieve symptomatic relief and obtain specimens for diagnostic testing of causative factors.

Pneumothorax

The abnormal presence of air in the pleural space resulting from chest injury or pathology, which alters thoracic pressures and decreases surface area available for gas exchange.

Subcutaneous Emphysema

A clinical manifestation of pneumothorax where air leaks into the subcutaneous tissues under the skin, producing swelling and a characteristic crackling sensation on palpation.

Open Pneumothorax

A penetrating chest injury (such as from a gunshot, knife, or impalement) causing an abnormal movement of air through an open chest wound into the pleural space with respiration; also called a sucking chest wound.

Spontaneous Pneumothorax

A pneumothorax occurring without obvious external trauma, often linked to underlying lung disease, smoking-related damage, or environmental air pressure changes (e.g., scuba diving, flying, or mountain climbing).

Tension Pneumothorax

A life-threatening closed pleural condition where air enters the pleural space on inhalation through a one-way mechanism but cannot escape, causing severe pressure elevation, lung collapse, and displacement of mediastinal structures.

Tracheal Deviation

A late, critical physical sign of tension pneumothorax characterized by shifting of the trachea toward the unaffected side as a result of rising intrathoracic pressure.

Hemothorax

The accumulation of blood within the pleural space between the chest wall and the lungs, typically resulting from blunt or penetrating chest trauma.

Chest Tube

A catheter inserted into the pleural space to evacuate air, blood, or fluid, facilitate lung re-expansion, and restore normal negative intrathoracic pressure.

Water Seal Chamber

The chamber of a chest drainage unit that holds sterile water to create a one-way valve, allowing air and fluid to exit the pleural space while preventing air from re-entering.

Tidaling

The normal rhythmic rise and fall of fluid in the water seal chamber matching the patient's breathing cycle (rising with inspiration and falling with expiration in spontaneously breathing patients), confirming system patency.

Continuous Bubbling (Water Seal Chamber)

An abnormal finding in the water seal chamber of a chest tube drainage unit that indicates an active air leak in the patient or along the tubing connections.

Suction Control Chamber

The compartment of a wet-seal chest drain where the height of sterile water regulates and limits the negative suction pressure applied to the pleural space.

Three-Sided Occlusive Dressing

An emergency dressing composed of petroleum gauze and sterile gauze taped on only three sides, placed immediately over an accidental chest tube dislodgement site to form a flutter valve that vents air and prevents tension pneumothorax.