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6.Pleural Effusions

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Pleural Effusions MBBS.weebly.com Dr. Canmao xie
Contents ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Canmao xie
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Introduction Dr. Canmao xie
Introduction ,[object Object],[object Object],Dr. Canmao xie
[object Object],[object Object],[object Object],Anatomy of the Pleural Space Dr. Canmao xie SC: Systemic capillaries PC: Pulmonary capillaries
[object Object],[object Object],Anatomy of the Pleural Space Dr. Canmao xie SC: Systemic capillaries PC: Pulmonary capillaries
Figure 1. Anatomy of the pleural space SC: Systemic capillaries PC: Pulmonary capillaries Dr. Canmao xie
Figure 2. pleural fluids turnover PF enter the pleural space through parietal & visceral pleurae, And leave pleural space through lymphatics in parietal pleura Dr. Canmao xie
[object Object],[object Object],[object Object],Mechanism of pleural fluids turnover Dr. Canmao xie
Figure. Diagrammatic representation of the pressures involved in the formation and absorption of pleural fluid. Parietal Pleura Visceral Pleura Space Pleura Hydrostatic Pressure + 30 - 5 + 24 35 29 6 0 Net 29 29 + 34 + 5 +34 Oncotic Pressure Dr. Canmao xie
Mechanism of pleural fluids turnover ,[object Object],[object Object],Dr. Canmao xie
Pathophysiology ,[object Object],[object Object],[object Object],[object Object],Dr. Canmao xie
Etiology and Pathogenesis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Canmao xie
Clinical Manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Canmao xie
Physical Examinations ,[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Canmao xie Bronchial breath sounds Diminished breath sounds
Radiographic Appearance ,[object Object],[object Object],[object Object],[object Object],Dr. Canmao xie
A posteroanterior and lateral chest radiograph of pleural effusion blunting of the posterior costophrenic angle Dr. Canmao xie
Approach to the Patient with Pleural Effusion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Canmao xie
Appearance of the Pleural Fluid ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Canmao xie
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Appearance of the Pleural Fluid Dr. Canmao xie
Separating exudates from transudates ,[object Object],[object Object],[object Object],[object Object],Dr. Canmao xie Dr. Light raised the Light’s criteria when he was at age of 32 LDH=lactate dehydrogenase
Dr. Canmao xie
Routine tests on exudative pleural effusions ,[object Object],[object Object],[object Object],Dr. Canmao xie
Cell count and differential ,[object Object],[object Object],[object Object],[object Object],Dr. Canmao xie
Pleural fluid glucose levels ,[object Object],[object Object],Dr. Canmao xie
Pleural fluid LDH level ,[object Object],[object Object],Dr. Canmao xie
Pleural fluid pH ,[object Object],[object Object],[object Object],Dr. Canmao xie
Pleural fluid tests for malignancy ,[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Canmao xie
Malignant effusions Dr. Canmao xie
肺腺癌 患者男性， 65 岁。 因“反复胸痛 5 月，呼吸困难 1 月，加重 1 周” 入院。胸水 CEA 增高。 镜下见：脏、壁层胸膜间粘连带形成，壁层胸膜、膈面见弥漫性结节样新生物，部分表面覆盖白色坏死组织，右上叶后段斜裂缘见白色息肉样肿物，右下叶表面多发灰色斑状浸润。病理示腺癌。
Pleural fluid markers for tuberculosis ,[object Object],[object Object],[object Object],Dr. Canmao xie
Parapneumonic Effusion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Canmao xie
Tuberculous Pleural Effusions ,[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Canmao xie
Tuberculous Pleurisy Dr. Canmao xie
Management of Tuberculous Pleural Effusions ,[object Object],[object Object],[object Object],Dr. Canmao xie
Malignant Pleural Effusions ,[object Object],[object Object],[object Object],[object Object],Dr. Canmao xie
Management of malignant pleural effusion ,[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Canmao xie
Diagnostic Workup of A Pleural Effusion ,[object Object],[object Object],[object Object],Dr. Canmao xie
Thank you for attention! Dr. Canmao xie

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6.Pleural Effusions

  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7. Figure 1. Anatomy of the pleural space SC: Systemic capillaries PC: Pulmonary capillaries Dr. Canmao xie
  • 8. Figure 2. pleural fluids turnover PF enter the pleural space through parietal & visceral pleurae, And leave pleural space through lymphatics in parietal pleura Dr. Canmao xie
  • 9.
  • 10. Figure. Diagrammatic representation of the pressures involved in the formation and absorption of pleural fluid. Parietal Pleura Visceral Pleura Space Pleura Hydrostatic Pressure + 30 - 5 + 24 35 29 6 0 Net 29 29 + 34 + 5 +34 Oncotic Pressure Dr. Canmao xie
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17. A posteroanterior and lateral chest radiograph of pleural effusion blunting of the posterior costophrenic angle Dr. Canmao xie
  • 18.
  • 19.
  • 20.
  • 21.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 30. 肺腺癌 患者男性， 65 岁。 因“反复胸痛 5 月，呼吸困难 1 月，加重 1 周” 入院。胸水 CEA 增高。 镜下见：脏、壁层胸膜间粘连带形成，壁层胸膜、膈面见弥漫性结节样新生物，部分表面覆盖白色坏死组织，右上叶后段斜裂缘见白色息肉样肿物，右下叶表面多发灰色斑状浸润。病理示腺癌。
  • 31.
  • 32.
  • 33.
  • 35.
  • 36.
  • 37.
  • 38.
  • 39. Thank you for attention! Dr. Canmao xie