Podcast
Questions and Answers
Which of the following conditions involves the accumulation of pus in the pleural space?
Which of the following conditions involves the accumulation of pus in the pleural space?
- Empyema (correct)
- Pleural effusion
- Pleuritis
- Pneumothorax
After a traumatic intubation a patient is found to have only their right lung inflating. Where is the most likely placement of the endotracheal tube?
After a traumatic intubation a patient is found to have only their right lung inflating. Where is the most likely placement of the endotracheal tube?
- Trachea above the carina
- Left main-stem bronchus
- Esophagus
- Right main-stem bronchus (correct)
Hyaline Membrane Disease, also known as Respiratory Distress Syndrome (RDS) of the newborn, results primarily from a deficiency in what?
Hyaline Membrane Disease, also known as Respiratory Distress Syndrome (RDS) of the newborn, results primarily from a deficiency in what?
- Alveolar macrophages
- Bronchial ciliated cells
- Pulmonary surfactant (correct)
- Type I pneumocytes
What is the primary physiological consequence of a V/Q mismatch in the lungs?
What is the primary physiological consequence of a V/Q mismatch in the lungs?
A chest X-ray (CXR) relies on what type of energy to create an image?
A chest X-ray (CXR) relies on what type of energy to create an image?
Which diagnostic imaging technique is most suitable for differentiating between pleural thickening and pleural fluid?
Which diagnostic imaging technique is most suitable for differentiating between pleural thickening and pleural fluid?
Which of the following is a primary application of CT-guided lung biopsy?
Which of the following is a primary application of CT-guided lung biopsy?
A physician suspects a pulmonary embolism but the patient has renal insufficiency. Which of the following tests should the physician AVOID?
A physician suspects a pulmonary embolism but the patient has renal insufficiency. Which of the following tests should the physician AVOID?
Which diagnostic test is most useful to assess for B-lines to help narrow down a differential diagnosis in the emergency department?
Which diagnostic test is most useful to assess for B-lines to help narrow down a differential diagnosis in the emergency department?
Following blunt chest trauma, a patient exhibits signs of a pneumothorax. A focused assessment with sonography for trauma (FAST) exam is performed. With the probe perpendicular to the chest, absence of "gliding sign" with presence of "A lines" can indicate pneumothorax. What explains this finding?
Following blunt chest trauma, a patient exhibits signs of a pneumothorax. A focused assessment with sonography for trauma (FAST) exam is performed. With the probe perpendicular to the chest, absence of "gliding sign" with presence of "A lines" can indicate pneumothorax. What explains this finding?
Flashcards
Pleural Space
Pleural Space
The space between the visceral and parietal pleura, normally containing a thin layer of fluid.
Pleuritis
Pleuritis
Inflammation of the pleura.
Pneumothorax
Pneumothorax
Air in the pleural space, leading to lung collapse.
Empyema
Empyema
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Pleural Effusion
Pleural Effusion
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Epiglottitis
Epiglottitis
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CXR (Chest X-ray)
CXR (Chest X-ray)
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Chest CT Scan
Chest CT Scan
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CT Guided Lung Biopsy
CT Guided Lung Biopsy
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V/Q Scan
V/Q Scan
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Study Notes
- Pulmonary Pathophysiology covers anatomy, physiology, clinically significant conditions, and diagnostic tests.
Pleural Space
- The pleural space exists in the lungs.
- Clinically significant conditions related to the pleural space include pleuritis, pneumothorax, and pleural effusion (pus leads to empyema).
Clinically Significant Conditions
- Epiglottitis, foreign body aspiration, right main-stem bronchus intubation, and bronchitis are clinically significant conditions.
Alveoli
- Alveoli are clinically significant.
- Respiratory distress syndrome (RDS) in newborns, also known as Hyaline Membrane Disease, is a clinically significant condition regarding the aveoli
- V/Q mismatch is clinically significant.
- Premature babies lack surfactant.
- Treat the mother with Prednisone prior to birth to help, or administer surfactant to the newborn after birth
- Be careful not to supply too much oxygen when treating newborns.
Basic Physiology
- Oxygen and carbon dioxide are key in basic physiology.
Common Pulmonary Diagnostic Tests
- Common pulmonary diagnostic tests include CXR, chest CT scan, CT guided lung biopsy, chest MRI, bronchoscopy, V/Q scan, CT angiography, pulmonary angiography and PET scan.
CXR
- Anatomical features visible on a CXR include: spinal process, scapula, anterior rib, bronchial bifurcation, vascular hilum, posterior rib, right atrium, liver, trachea, clavicle, aortic knob, left bronchus, hilum, descending aorta, and diaphragm.
- Lobes are separated by fissures.
Chest CT Scan
- A chest CT scan helps evaluate pulmonary nodules and masses and distinguish pleural thickening from pleural fluid.
- It can also evaluate for pericardial fluid or thickening, identify patterns in interstitial lung disease, detect intracavitary processes (fluid or mycetomas), and may detect proximal clots in the pulmonary arteries.
Chest MRI
- A chest MRI gives the same information as a CT scan.
Point of Care Ultrasound (POCUS)
- POCUS is used in the emergency department to answer specific clinical questions, narrow differential diagnoses, and guide treatment.
- B-Lines (comet tails) are suggestive of pulmonary edema if 3 or more are present.
- POCUS can identify the absence of "lung-sliding," which may indicate a pneumothorax or a large pleural effusion.
- Oxygen delivery requires cardiac output, so a global/general assessment of cardiac function can be helpful.
- A quick look at the right ventricle can be helpful; a huge/overriding right ventricle can be suggestive of a pulmonary embolism.
Pulmonary Function Tests (Lung Function Tests)
- Pulmonary function tests include spirometry with and without bronchodilator, DLCO, and ABG on Room Air.
- ABG on Room Air tests pH, paO2, paCO2, HCO3, and sO2.
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Description
Overview of pulmonary pathophysiology covering anatomy, physiology, conditions, and diagnostic tests. Discusses pleural space, clinically significant conditions like epiglottitis and bronchitis, and alveoli-related issues such as respiratory distress syndrome (RDS). Addresses V/Q mismatch and surfactant deficiency in premature babies.
