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ATELECTASIS

ATELECTASIS. By: Josephine Ekong #688. CONTENTS. Definition. PATHOPHYSIOLOGY. RISK FACTORS. TYPES. Clinical manifestation. PHYSICAL FINDINGS. TREATMENT. PROGNOSIS. DEFINITION. It is defined as partial or complete collapse of a lung.

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ATELECTASIS

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  1. ATELECTASIS By: Josephine Ekong #688

  2. CONTENTS Definition PATHOPHYSIOLOGY RISK FACTORS TYPES Clinical manifestation PHYSICAL FINDINGS TREATMENT PROGNOSIS

  3. DEFINITION • It is defined as partial or complete collapse of a lung. • It is also an incomplete expansion (neonatal atelectasis) or collapse of previously inflated lung providing relatively airless parenchyma.

  4. PATHOPHYSIOLOGY This occurs when there is a blockage of the air passages (bronchus) by mucus or masses or by pressure from outside of the lungs.

  5. RISK FACTORS • Anesthesia • Foreign body in the airway • Lung disease • Mucus plugging of the airway • Pressure caused by mass or fluid • Prolonged bed rest • Shallow breathing (like when people splint secondary to rib fractures)

  6. TYPES Resorption Contraction Compression

  7. Atelectasis

  8. Resorption Atelectasis •Completeobstruction of an airway, whichleads to resorption of oxygen trapped inthe alveoli. • Caused by excessive secretions (mucousplugs) or exudates with in smaller bronchi. • Often found in bronchial asthma, chronicbronchitis, bronchiectasis, postoperative states, and aspiration of foreign bodies. •Mediastinum shifts towards atelectaticlung.

  9. Contraction Atelectasis • Contraction atelectasis: local or generalized fibrotic changes in thelung or pleura prevent full expansion. Contraction atelectasis is irreversible. The other types of atelectasis are Reversible.

  10. Compression Atelectasis • Compression atelectasis: pleural cavity ispartially or completely filled by fluid exudate, tumor, blood, or air. • Tension pneumothorax. •Cardiac failure Pts. develop pleural effusion. • Abnormal elevation of the diaphragminduces basal atelectasis • Mediastinum shifts away from the affectedlung.

  11. CLINICAL FEATURES • Trouble breathing • Pleurisy (chest pain with inspiration) • Cough • Fever • Pneumonia CAN develop in an area of atelectasis.

  12. PHYSICAL FINDINGS • Decreased breath sounds • Dull sound on percussion • Decreased fremitus • Tracheal deviation towards the side of lesion

  13. TREATMENT • The goal is to expand the lung. • If fluid or an air leak (pneumothorax) is causing the trouble, then IT needs to be drained. • Other treatment includes: • Percussion of the chest:- clapping the chest can mobilize mucus plugging and allow for the airways to clear. • Incentive spirometry:- in this breathing exercise, the patient takes a deep breath deeply and slowly then hold the breath long enough to keep the disk raised for at least 3 seconds. Repeat at least once every hour.

  14. Bronchoscopy:- by looking into the lungs and the pulmonary specialist can manually remove any movable blockage from the airway. • Postural drainage:- by changing positions, mucus and plugging can be relieved and thus improve the collapse of the airways. • PEP (positive expiratory pressure)device can open up clogged airways.

  15. PROGNOSIS • In an adult, a small area of atelectasis is not life threatening or even serious. The rest of the lung can make up for this area in terms of oxygenation and CO2 exchange. • Large areas of atelectasis can be serious. Specially if the patient has other illness or lung problems. Small children are particularly at risk of complications.

  16. REFERENCES • Dr. RotimiM.D, Windsor Unisch of Medicine, faculty of Medical Pathology, Jan – April 2014 • RosenbloomSA, Ravin CE, Putman CE, et al. Peripheral middle lobe syndrome. Radiology. 1983;149:17-21. [Medline]. • Priftis KN, Mermiri D, Papadopoulou A, Anthracopoulos MB, Vaos G, Nicolaidou P. The role of timely intervention in middle lobe syndrome in children. Chest. Oct 2005;128(4):2504-10. [Medline]. • O’Donnell AE. Bronchiectasis, atelectasis, cysts, and localized lung disorders. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 90.

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