14 Pleural Disease - Boards and Beyond

Pneumothorax

  • hole in lung

  • rupture of lung tissue
  • usually secondary to lung disease (damaged lung tissue)

  • pleuritic: deep breath stretch pleura, pain

  • create gradient to allow N2 reabsorption from pleural space into capillary

  • with inhale, air enter space. With exhale, flap shut and doesn't let air out
  • spontaneous PTX: shrinking of the affected side, trachea shift towards side
  • tension PTX: shift away

Pleural Effusion

  • meniscus up top
  • loss of black lung fields and loss of costophrenic angles

Transudative

  • capillary membrane intact, keeps protein in

Exudative

  • leaky, plasma and protein leak out
  • feared cause: malignancy. Tumors can cause capillaries to become leaky

Lymphatic

  • thoracic duct drain lymphoid. If it's obstructed or can't drain, then effusion
  • open heart surgery

Others

Mesothelioma