The document discusses anatomy and physiology of the pleura. It describes the two layers of pleura - parietal and visceral layers. The parietal layer lines the chest wall and diaphragm. The visceral layer covers the lungs. Between the two layers is a potential space that normally contains a small amount of fluid. The document also discusses intrapleural pressure, intra-alveolar pressure, and transpulmonary pressure. Pleural effusions, pneumothorax, and hemothorax are also summarized.
Pleural effusion may be defined figuratively as the juice, oozing from the leaky lingerie of the lung. However the text book definition is the abnormal accumulation of fluid in the pleural space due to disturbances in the forces that keep the pleural fluid economy in equilibrium...
Pleural effusion may be defined figuratively as the juice, oozing from the leaky lingerie of the lung. However the text book definition is the abnormal accumulation of fluid in the pleural space due to disturbances in the forces that keep the pleural fluid economy in equilibrium...
Apparently a lengthy presentation actually very good for junior physicians as it covers all aspects of assessment, diagnosis and treatment of pleural effusion
Apparently a lengthy presentation actually very good for junior physicians as it covers all aspects of assessment, diagnosis and treatment of pleural effusion
The Chest Wall, Pleura,Diaphragm and Intervention 10 Dr. Muhammad Bin ZulfiqarDr. Muhammad Bin Zulfiqar
This Presentation is basically image collection from chapter 10 of GRAINGER & ALLISON’S DIAGNOSTIC RADIOLOGY.
This is an effort to present the most authentic images.
Anatomy of the Thorax
b. Complaints
c. Inspection
d. Pathological forms of the chest
e. Breathing rate & types
f. Palpation of the chest
g. Percussion of chest
h. Auscultation of chest
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
2. Pleura
A thin serous membrane that envelops each lung and folds back to
make a lining for the chest cavity.
It consists of two connected layers visceral and
parietal layer.
3. Parietal Layer
It lines the thoracic wall (costal pleura), covers the thoracic surface
of the diaphragm (diaphragmatic pleura) and the lateral aspect of
the mediastinum (mediastinal pleura), and extends into the neck
(cervical pleura).
The Parietal pleura is sensitive to pressure, pain, and temperature.
It produces a well localized pain, and is innervated by
the phrenic and intercostal nerves.
The blood supply is derived from the intercostal arteries.
4. Visceral Layer
It completely covers the outer surfaces of the lungs and extends
into the interlobar fissures.
The visceral pleura is not sensitive to pain, temperature or touch. Its
sensory fibers only detect stretch. It also receives autonomic
innervation from the pulmonary plexus.
Arterial supply is via the bronchial circulation (internal thoracic
arteries).
The visceral layer of each pleura becomes continuous with the
parietal layer by the means of the pleural cuff.
The pleural cuff surrounds the structures entering and leaving the
lung at the hilum of each lung.
The pleural cuff hangs down as a loose fold called the pulmonary
ligament.
5.
6. Pleural Fluid
The pleural space is a potential space normally contains 5 to 10
ml of clear fluid.
It lubricates the opposing surfaces of the visceral and parietal
pleurae during respiration.
The formation of the fluid results from hydrostatic and osmotic
pressures between the capillaries of the Parietal pleura.
The pleural fluid is normally absorbed into the capillaries of the
visceral pleura.
Any condition that increases the production of the fluid or
impairs the drainage of the fluid results in the abnormal
accumulation of fluid.
7. Pulmonary Pressures
There are four primary pressures associated with ventilation:
1- Atmospheric Pressure.
2- Intrapleural pressure.
3- Intra-Alveolar Pressure.
4- Transpulmonary pressure.
Atmospheric pressure: At sea level is 760 mm Hg. The lung
pressures are expressed relative to this pressure.
8. Intrapleural Pressure:
At rest its -4 mmHg, it varies during ventilation but it is always less
than intra-alveolar pressure.
Intrapleural pressure is always negative during normal breathing.
The negative intrapleural pressure is due to three main factors:
a. The elasticity of the lungs.
The abundant elastic tissue in the lungs tends to recoil and pulls the
lung inward.
9. b. The elasticity of the thoracic wall.
The elastic thoracic wall tends to pull away from the lung, further
enlarging the pleural cavity and creating this negative pressure.
c. The surface tension of the alveolar fluid.
The surface tension of the alveolar fluid tends to pull each of the
alveoli inward and therefore pulls the entire lung inward.
10. Intra-Alveolar Pressure
Varies with ventilation, during inspiration it is less than
atmospheric pressure, during expiration it is greater than
atmospheric pressure.
At rest it is equal to atmospheric pressure.
When it is equal to atmospheric pressure it is considered to be at
0 mmHg.
Transpulmonary pressure is the difference between the alveolar
pressure and the intrapleural pressure in the lungs.
12. Pleural effusion
-Is the abnormal accumulation of fluid in the pleural space.
-results from increased drainage into the cavity, increased production,
or decreased absorption.
-there are many types of effusion depending on the nature of fluid.
-causes limited expansion of the lungs
18. Signs
1- dullnes on percussion
2- decreased tactile vocal fremitus
3-decreased breath sounds
4- asymmetrical expansion of chest
5- tracheal deviation away from effusion (in severe cases)
19. Diagnosis
1- chest X-ray:
-loss of costophrenic angle
- atleast 250 ml must accumulate to be seen
2- CT scan
3-thoracocentesis
20. Empyema (pyothorax)
- Is the accumulation of pus in the pleural cavity.
- Mostly the cause is pneumonia.
-Most common types of bacteria are:
-streptococcus pneumonia
-Staphylococcus aureus
28. A. Spontaneous Pneumothorax
1. Primary Pneumothorax:
Occurs without any lung disease healthy persons.
Caused by rupture of blebs.
Common in tall, lean, young men.
29. 2. SecondaryPneumothorax:
Occurs as a complication of underlying lung disease.
Most commonly COPD.
May occur with Asthma, ILD, TB etc..
Life threatening.
38. Definition:
• Presence of blood in the pleural space.
• The source of blood may be the chest wall, lung parenchyma,
heart, or great vessels.
• Causes:
Traumatic hemothorax.
Spontaneous hemothorax.
Iatrogenic hemothorax.
39. Pathophysiology:
• The physiologic response to the development
of a hemothorax is manifested in two major
areas:
1. Hemodynamic response
2. Respiratory response
40. Clinical features:
Signs & symptoms:
1- Blunt or penetrating chest trauma.
2- Shock: (Dyspnea, Tachycardia, Tachypnea, Hypotension).
3- Dull to percussion over injured side.
46. Chylothorax
• accumulation of lymph in the pleural space”.
• Usually resulting from leakage from thoracic duct following
trauma or infiltration by carcinoma .
• Triglycerides > 110 mg/dl and the fluid is cloudy.
52. Pleural tumors
Primary
Mesothelioma
Pleural Fibroma
Pleural Fibrosarcoma
Pleural Liposarcoma
Primary Pleural Lymphoma
Pleural Synovial Sarcoma
Secondary
Metastasis
Thymoma with pleural invasion
Invasive chest wall tumors
Ewing Sarcoma of chest wall with pleural
invasion
Pericardial Tumors with pleural invasion
53.
54. • ** Mesothelioma :: is an aggressive primary malignant tumor of the
mesothelium. The overwhelming majority arise from the Pleura ..
• -Given the presence of the mesothelium in different parts of the body, mesothelioma
can arise in various locations :
• 1) peritoneal mesothelioma
• 2) pericardial mesothelioma (heart linning)
• 3) cystic/multicystic mesothelioma
• 4) tunica vaginalis testis mesothelioma
Mesothelioma
55. Epidemiology
• -Mesothelioma is an uncommon entity and accounts for 5-
28% of all malignancies that involve the pleura..
• - There is a strong association with exposure to Asbestos , but
unlike other asbestos-related lung diseases, it doesn't appear
to be dose dependent..
• -There has been no convincing evidence for an association
with smoking..
• -The annual death rate from mesothelioma has decreased in
the last thirty years. Part of this decrease in the reported rate
may be due to better diagnostic techniques..
56. Possible risk factors
1) Personal history of asbestos exposure
2) Living with someone who works with asbestos
3) Radiation
4) Viruses - simian virus 40 (SV40)
5) Chronic inflammation
6) Heavy metals - nickel and beryllium
7) Chemical agents - Diethylstilbestrol.
57. Clinical presentation
• -Typically patients present with dyspnoea and low back non-
pleuritic chest pain.
Other Signs &
Symptoms
• persistent cough
• wight loss in peritoneal mesothelioma
• abdominal edema due to ascites
• obstructed bowel
• anemia
• pyrexia
• difficulty in swallowing
• swelling in neck and face
• difficulty in breathing
• malaise
• hoarseness of voice
• hemoptysis(blood in sputum)
• pneumothorax
58. • **In severe cases :
• Blood clots in the vein
• Jaundice
• Low blood Sugar level
• Severe ascites
• Pulmonary Embolism
• ** Mostly affects people between the ages of 40 – 70
59. Diagnosis
• -Diagnosis is difficult to make as it shows similar symptoms of
other medical conditions
• -A chest x-ray or CT scan is the necessary first step in
identifying mesothelioma, which is followed up with a
bronchoscopy.
• -The diagnosis itself requires a biopsy (Histological diagnosis is
difficult and generous (often surgical) pleural biopsies are
needed) although tumour may invade along the surgical
track following biopsy
• -Mesotheliomas have a predilection for a direct invasion of
adjacent structures (chest wall, diaphragm and Mediastinal
content) but also frequently metastasize to the contralateral
lung and local nodes
60. Prognosis
• -The prognosis is poor for all tumor types with a median
overall survival without treatment of 4-12 months, although
small survival advantages have been reported following the
use of chemotherapy.
• -In favourable patient subgroups up to 45% 5-year survival
may be achievable , however even with aggressive multi-
modality therapy overall 5-year survival remains poor (3-
18%) with a median survival time of approximately 18
months .
61. Treatment
**Treatment includes:
1. Extrapleural pneumonectomy (Surgery)
2. Adjuvant chemotherapy
3. Radiotherapy may be helpful in preventing tumour growth through
previous chest drain or biopsy sites.
63. Definition
Pleurisy :
also known as pleuritis is an inflammation of
the pleura. There are many possible causes of pleurisy but
viral infections spreading from the lungs to pleural cavity are
the most common. The inflamed pleural layers rub against
each other every time the lungs expand to breathe in air. This
can cause sharp pain when breathing, also called
pleuritic chest pain.
64. symptoms:
• Chest pain that worsens when you breathe, cough or sneeze
• Shortness of breath — because you are trying to minimize
breathing in and out
• A cough — only in some cases
• A fever — only in some cases
• pain also might affect your shoulder or back
Causes :
#infection
#autoimmunedisease
#Certain medications such
as(hydralizine,isoniazid)
#Lung tumor near the pleural surface
65. Diagnosis
diagnosis of pleurisy or another pleural condition is based on
a medical history, physical examinations, and diagnostic
tests. The goals are to rule out other sources of the symptoms
and to find the cause of the pleurisy so that the underlying
disorder can be treated.
On examination ;
1- reduce movement of chest on effected side
2- breath sound maybe reduce in effected side
3- pleural rub which is a crackling sound at the end of
inspiration and beginning of expiration localized in small area
of the chest
67. Traetment and mangement:
• Antibiotics for an infection
• Codeine will be prescribed to control a cough that can exacerbate
pain
• Sometimes, if the pleural fluid is infected or the amount is excessive,
the doctor may drain it through a tube inserted in your chest, a
procedure that requires hospitalization.
• paracitamol
68. • is a group of minerals with thin microscopic fibers. Because these
fibers are resistant to heat, fire, and chemicals and do not conduct
electricity, asbestos has been and used widely in the construction,
automotive, and other industries.
• Asbestosis, an inflammatory condition of lungs that can cause
shortness of breath, and eventually scarring of the lungs that makes
it hard to breathe.
Aspestosis
69. Benign pleural plaques
• Common
• Usually symmetrical
• Pain during breathig
• Suspect mesothelioma in the
future.
• With time it become calcify
making them more obvious
on X-ray
70. Mesothelioma
primary malignant tumour of
the pleura,.arise from the
mesothelial cells that line the
pleural cavities.
Clinical manifestation:
1-the ages of 65 – 70 years,
2-chest pain, blood coughing,
3-weght loss,
4-Pain in the lower back or rib
area ,Painful breathing .
5-lumps under skin.
Management: surgical,
chemotherapy and
radiotherapy.
71. Benign pleural effusions
• Early manifestation of
pleural disease
• Usually small and
unilateral
• Resolve spontaneously
• Blood stained exudate
• Must exclude
mesothelioma
• Present with feature of
pleurisy ( pleural pain ,
fever , leukocytosis )
72. Diffuse pleural thickening
• Extensive fibrosis of visceral
pleura with adhesion to
parietal pleura
• if sufficiently extensive it may
restrict chest expansion and
cause breathlessness
• On X-ray show thickening of
the pleura along chest wall
with obliteration of
costophrenic angle
• On CT occasion shrinkage of
the pleura cavity result in
rounded atelectasis which has
appearance of a mass near the
pleura , this may confuse with a
tumour .