RESPIRATORY DISORDER (Medical surgical) for exit exam preparation скачать в хорошем качестве

RESPIRATORY DISORDER (Medical surgical) for exit exam preparation

Restrictive lung diseases like pneumothorax, pleural effusion, and atelectasis involve conditions that limit the lungs' ability to fully expand. Below is a detailed description based on the clinical breakdown of these conditions. 1. Pleural Effusion A pleural effusion is an abnormal accumulation of fluid in the pleural space (the area between the parietal and visceral pleura). Pathophysiology: Transudative Effusions: Caused by systemic factors like Congestive Heart Failure (CHF), which increases hydrostatic pressure, or Cirrhosis/Nephrotic Syndrome, which decreases oncotic pressure (low albumin) . These fluids are typically low in protein and LDH . Exudative Effusions: Caused by local lung injury or inflammation (e.g., pneumonia, malignancy, or tuberculosis) . These fluids are rich in protein and LDH due to increased capillary permeability . Physical Exam Findings: Dullness to percussion over the fluid . Decreased breath sounds and decreased tactile fremitus  Complications: Large effusions can cause compression atelectasis, leading to VQ mismatch and hypoxemia. 2. Pneumothorax A pneumothorax occurs when air enters the pleural cavity, causing the lung to collapse . Types: Primary Spontaneous: Seen in tall, thin, young males due to the rupture of sub-pleural apical blebs . Secondary Spontaneous: Occurs in patients with underlying lung diseases like COPD (emphysema) or asthma. Traumatic: Caused by external injury or medical procedures (e.g., central line placement or thoracentesis). Tension Pneumothorax (Medical Emergency): A one-way valve effect allows air to enter but not exit the pleural space . This creates a "Mass Effect," shifting the mediastinum, deviating the trachea, and compressing the heart, which leads to hypotension and jugular venous distension (JVD) . Physical Exam Findings: Hyper-resonance (tympany) to percussion and absent breath sounds. 3. Atelectasis Atelectasis is the collapse of the alveoli, preventing gas exchange in that part of the lung . Mechanism in Restrictive Disease: In both pleural effusion and pneumothorax, the increased pressure in the pleural space squeezes the lung tissue, leading to compression atelectasis . Clinical Impact: It results in a low VQ mismatch (perfusion is normal, but ventilation is reduced), which leads to hypoxemia (low blood oxygen) and compensatory tachypnea (rapid breathing) Diagnosis and Treatment Diagnosis: Primarily through Chest X-ray or CT scans. Pleural effusions often show a "meniscus sign" . For effusions, Light’s Criteria is used to distinguish between transudate and exudate Treatment: Pleural Effusion: Thoracentesis (tapping the fluid) or chest tubes for empyema (infected fluid) Pneumothorax: Small ones may be observed; larger ones or those causing respiratory distress require a chest tube  Tension Pneumothorax: Immediate needle decompression followed by a chest tube #Pneumothorax #Pulmonology #MedEd Telegram.. https://t.me/+0mRrcWAFyoRlOTZk