番茄花园-PLEURAL EFFUSIONS.pptVIP

PLEURAL EFFUSIONS Anatomy of pleural membraneand pleural space 1234 Pleural membrane consists of parietal pleura and visceral pleura A space situated between parietal and visceral pleura is called pleural space It is normally filled with 5 - 10 milliter of serous fluid Parietal pleura Receiving its blood supply from the systemic circulation and containing sensory nerve ending Visceral pleura Receiving its blood supply from the low pressure pulmonary circulation and containing no sensory nerve fibers Mechanism of formation-resorptionof pleural fluid Parietal Visceral pleura pleura The mechanisms that lead to accumulation  of pleural fluid l. Increased hydrostatic pressure in microvascular circulation (congestive heart failure) 2. Decreased oncotic pressure in microvascular circulation (severe hypoalbuminemia ) 3. Increased permeability of the microvascular circulation (pneumonia) 4. Impaired lymphatic drainage from the pleural space (malignant effusion) 5. Movement of fluid from peritoneal space ( ascites ) Two kinds of pleural effusions Transudates and exudates Transudate Exudate Cause non-inflammatory flammatory,tumor Apperance light yellow yellow, purulent Specific gravity 1.018 1.018 Coagulability unable able Revalta test negative positive Protein content 30g/L 30g/L ΘP. To serum Pre 0.5 0.5 LDH 200 I U/ L 200 I U / L Θ P. To s