C.O.P.D. - EMPHYSEMA Stretching and overdistention of the alveoli Loss of intralveolar septa, pulmonary elasticity and alveolar capillary surface Loss of pulmonary compliance + partial obstruction No effective inhalation
These lungs appear essentially normal, but are normal-appearing because they are the hyperinflated lungs of a patient who died with status asthmaticus.
This cast of the bronchial tree is formed of inspissated mucus and was coughed up by a patient during an asthmatic attack. The outpouring of mucus from hypertrophied bronchial submucosal glands, the bronchoconstriction, and dehydration all contribute to the formation of mucus plugs that can block airways in asthmatic patients.
From preexisting infections in the lung,ribs or subphrenic space
Lung collapse of affected side
Dull pain and persistent tenderness
limited chest movements
The pleural surface at the lower left demonstrates areas of yellow-tan purulent exudate. Pneumonia may be complicated by a pleuritis. Initially, there may just be an effusion into the pleural space. There may also be a fibrinous pleuritis. However, bacterial infections of lung can spread to the pleura to produce a purulent pleuritis. A collection of pus in the pleural space is known as empyema.
Loss of pulmonary tissue from occlusion of pulmonary artery by an embolus
Long bone fracture; obstetric patients
Aspiration of foreign body
Cough, wheeze, hemoptysis, dyspnea
This is a rare finding that may complicate a term pregnancy at delivery. Seen here in a pulmonary artery branch is an amniotic fluid embolus that has layers of fetal squames. Amniotic fluid embolization can have the same outcome
This is a squamous cell carcinoma of the lung that is arising centrally in the lung (as most squamous cell carcinomas do). It is obstructing the right main bronchus. The neoplasm is very firm and has a pale white to tan cut surface.
This is a lobar pneumonia in which consolidation of the entire left upper lobe has occurred. This pattern is much less common than the bronchopneumonia pattern. In part, this is due to the fact that most lobar pneumonias are due to Streptococcus pneumoniae (pneumococcus)
Regardless of the etiology for restrictive lung diseases, many eventually lead to extensive fibrosis . The gross appearance, as seen here in a patient with organizing diffuse alveolar damage, is known as "honeycomb" lung because of the appearance of the irregular air spaces between bands of dense fibrous connective tissue.
Here is the gross appearance of a lung with tuberculosis. Scattered tan granulomas are present, mostly in the upper lung fields. Some of the larger granulomas have central caseation. Granulomatous disease of the lung grossly appears as irregularly sized rounded nodules that are firm and tan. Larger nodules may have central necrosis known as caseation--a process of necrosis that includes elements of both liquefactive and coagulative necrosis).
On closer inspection, the granulomas have areas of caseous necrosis. This is very extensive granulomatous disease. This pattern of multiple caseating granulomas primarily in the upper lobes is most characteristic of secondary (reactivation) tuberculosis. However, fungal granulomas (histoplasmosis, cryptococcosis, coccidioidomycosis) can mimic this pattern as well.
The Ghon complex is seen here at closer range. Primary tuberculosis is the pattern seen with initial infection with tuberculosis in children. Reactivation, or secondary tuberculosis, is more typically seen in adults.
The nurse enters the room of a client who has a chest tube attached to a water-seal drainage system & noticed the chest tube is dislodged from the chest. The most appropriate nursing intervention is to:
Notify the physician
Insert a new chest tube
Cover the insertion site with petroleum gauze
Instruct client to breathe deeply until help arrives