Pleural effusion and shifted mediastinum

DEFINITION:
A condition where an abnormal amount of fluid accumulates in inter-pleural space (the potential space between the visceral and parietal membranes). Usually this is serous fluid but can also be blood and rarely other types of fluids.

CAUSES:
In most cases the cause of the fluid accumulation is due to heart failure. Other causes include cirrhosis of the liver, kidney failure and pulmonary embolism.

EXAMINATION:
Physical examination techniques including percussion, tactile vocal fremitus and auscultation may provide positive findings. Observation and palpation of the tracheal may show deviation only if the effusion is large.
Percussion will produce dull sounds, auscultation diminished breath sounds and possible friction rub, decreased vocal resonance and fremitus. There may be increased bronchial breathing and egophony.
Chest X-rays will show effusion especially as it usually accumulates in the bases of the lungs.

 


(Full details and demonstration of procedures are provided with the DVD/videos and associated study material)