What is pulmonary sequestration? Pulmonary sequestration is a rare abnormality that develops before we are born. In this condition, a portion of the lung is separated off from the rest of the lung. The lung tissue has no direct contact with the tracheobronchial tree and gets the blood supply from the systemic vessels. The term sequestration means that it is not connected to the remaining lung or “ It's by itself”. It creates an issue with the airway and compressing the lungs (if the mass is huge). In 1946, Pryce first dubbed the condition “pulmonary sequestration,” which can be divided into two types. It is a rare lung development condition, which only accounts for .15% to 6.4% of all pulmonary abnormalities. Pulmonary sequestration can …show more content…
be defined as intralobular, extralobular and mix pulmonary sequestration. Intralobular sequestration (ILS) is located in the posterior basilar of the lower lobe. Intralobar is surrounded by normal lung tissue. It accounts for 75 percent of all sequestrations and is usually diagnosed in early childhood. Extralobar is separated from normal lung tissue by its own visceral pleura. It can be located in the mediastinum, pleura or pericardium spaces, and the diaphragmatic tissue. It accounts for 25 percent. Only 10-15% of extralobular sequestrations are located in the abdomen. It affects females and males in equal numbers. Statistics shows that 83.84% of pulmonary sequestration is intralobular is shared lung tissue. Extralobar sequestration is accounted for 16.03%, which is wrapped by their own tissue. Mixed sequestration is rare, only accounting for 0.13%, which contains intralobular and extralobular sequestrations together. Pulmonary sequestration appears to result from abnormal budding. The tissue in this accessory lung bud that migrates with the developing lung, but does not communicate with it. It receives its blood supply from vessels that connect to the aorta or one of its side branches. The arterial supply is derived in most cases from the thoracic aorta (75%) or the abdominal aorta (20%). In some cases (15%), two different arteries supply the blood. If the accessory lung bud develops early in embryonic development, intralobular pulmonary sequestration is present. If the accessory lung bud develops later, extralobular pulmonary sequestration is present. Some typical symptoms are seen in infants with ESL including a cough, feeding difficulties and congestive heart failure.
Present on the 1st six months of life with dyspnea and cyanosis. However, ESL is accidentally misdiagnosed as lung cancer, pulmonary cysts or mediastinal tumors. A total of 713 cases of pulmonary sequestration was reported misdiagnosis, which 36.19% by the pulmonary cyst and 21.04% was misdiagnosed by lung cancer. In some cases, a patient has a reoccurring diagnosis of pneumonia. Intralobular pulmonary sequestration is characterized by recurrent infections, hemoptysis, or pleural effusion. A chronic cough and sputum production is common. More than half of the patients will show signs by the age of …show more content…
twenty. Their aren't any know ways to prevent pulmonary sequestration. During an ultrasound usually, there is a small mass with an odd shape. Pulmonary sequestration happens before birth. Physicians use a Doppler to view the fetus. Due to the risk of infection and bleeding, intralobular pulmonary sequestrations are usually removed, either by segmentectomy (removal of part of the lung) or lobectomy (removal of the full lobe). Treatment of extralobular pulmonary sequestration involves surgical removal via mini-thoracotomy for patients that are experiencing symptoms. During a thoracotomy, the surgeon makes an incision through the chest wall and into the pleural space. Video-assisted thoracoscopy surgery is the better alternative for pulmonary sequestration because of the minimal surgical trauma, post operated pain and a short duration of being in the hospital. During the surgery, the patient is position right lateral. A diagnosis can be shown on x-ray showing as a mass or air-fluid filling. The best way to obtain a proper viewing is through CT scan. A new technique has emerged. Arterial embolization as a treatment of arterial bleeding's has rapidly become the treatment of the first choice for a wide range of indications. After reviewing a case study, the patient (3-year-old female) complained of chest pain, fever, and abdominal chest pain for about three days.
Chest X-ray showed increased translucent mass and a small pleural effusion on the left lower lobe. Even looking at the x-ray, the left lower lobe was complete opacity and the mass was easily seen. After being admitted, she was diagnosed with pneumonia and pulmonary emphysema. Later on during the day, she was experiencing dyspnea, high temperatures, and striking pain. She was taken to the operating room for thoracoscopy, washout, and drainage of a presumed emphysema. A segment of necrotic lung inferior to the left lower lobe was identified adjacent to the left diaphragm. After the surgery, she had no further symptoms. Histology showed conformation of extralobe pulmonary sequestration. This is the first report case of pulmonary sequestration mimicking emphysema. A review of the literature found three cases of pulmonary sequestration with torsion in children, all presenting with pain. Ages between 11 and 13, showed a rapid growth in this rare
condition. Their was a case involving a woman who was pregnant. Was getting a gender screening test done. The baby had a very large fetal chest mass. This particular mass had a feeding supply from the aorta. (largest blood vessel). The mass doesn't grow fast but in this case, the mass was growing rapidly. Compressing the lungs and moving the heart to the left side of the chest. Every week the women would go in and the mass would become larger. The women was determined to do anything to save her child. The physician decided to do a therapy called Needle-based. Where an ultrasound and a needle were used. The needle was placed through the mom's skin (through the abdominal muscle, right through the uterus and into the child's chest).
The risk factors that Jessica presented with are a history that is positive for smoking, bronchitis and living in a large urban area with decreased air quality. The symptoms that suggest a pulmonary disorder include a productive cough with discolored sputum, elevated respiratory rate, use of the accessory respiratory muscles during quite breathing, exertional dyspnea, tachycardia and pedal edema. The discolored sputum is indicative of a respiratory infection. The changes in respiratory rate, use of respiratory muscles and exertional dyspnea indicate a pulmonary disorder since there is an increased amount of work required for normal breathing. Tachycardia may arise due to the lack of oxygenated blood available to the tissue stimulating an increase in heart rate. The pedal edema most probably results from decreased systemic blood flow.
R.S.’s clinical findings as a consequence of his chronic bronchitis are likely to include: being overweight, experiencing shortness of breath on exertion, producing excessive amount of sputum, having a chronic productive cough, as well as edema and hypervolemia just to name a few. (Copstead & Banasik, 548) Some of these signs and symptoms would be different if R.S. had emphysematous COPD. In emphysema (or “pink puffers”), there is weight loss, the cough is absent or negligible, and edema is not present. While central cyanosis and jugular vein distention are present in late chronic bronchitis, these pathologic manifestations are absent in emphysema. . (Copstead & Banasik, 549)
Bronchospasm is an abnormal contraction of the smooth muscle of the bronchi, narrowing and obstructing the respiratory airway, resulting in coughs, wheezing or difficulty in breathing. The chief cause of this condition is asthma, although it may also be caused by respiratory infection, chronic lung disease or an allergic reaction to chemicals. The mucosa lining of the trachea may become irritated and inflamed, which secretes mucus, causing it to be caught in the bronchi and triggers coughing.
Pulmonary stenosis (PS) - Pulmonary Stenosis causes an obstruction of blood flow from the right ventricle into the pulmonary arteries. This obstruction causes the right ventricle to have more difficulty pumping the oxygen-poor blood received from the vena cava to the lungs in order to pick up the oxygen needed. Therefore causing a decrease in exchange of oxygen in the lungs, as well as a decrease of blood volume to the lungs.
Mrs. Jones, An elderly woman, presented severely short of breath. She required two rest periods in order to ambulate across the room, but refused the use of a wheel chair. She was alert and oriented, but was unable to speak in full sentences. Her skin was pale and dry. Her vital signs were as follows: Temperature 97.3°F, pulse 83, respirations 27, blood pressure 142/86, O2 saturation was 84% on room air. Auscultation of the lungs revealed crackles in the lower lobes and expiratory wheezing. Use of accessory muscles was present. She was put on 2 liters of oxygen via nasal canal. With the oxygen, her O2 saturation increased to 90%. With exertion her O2 saturation dropped to the 80's. Mrs. Jones began coughing and she produced large amounts of milky sputum.
A pneumothorax is defined as “the presence of air or gas in the plural cavity which can impair oxygenation and/or ventilation” (Daley, 2014). The development of a pneumothorax to a tension pneumothorax can be caused from positive pressure ventilation.
The simple act of breathing is often taken for granted. As an automated function sustaining life, most of us do not have to think about the act of breathing. However, for many others, respiratory diseases make this simple act thought consuming. Emphysema is one such disease taking away the ease, but instead inflicting labored breathing and a hope for a cure.
Person, A. & Mintz, M., (2006), Anatomy and Physiology of the Respiratory Tract, Disorders of the Respiratory Tract, pp. 11-17, New Jersey: Human Press Inc.
The larynx prevents food and liquids from traveling down the air path ways which could result in choking. From the larynx, Bronchi trachea splits into two bronchi each leading to a lung, each lung is divided into lobes. The right lung has three lobes and the left has two lobes. The right lung is slightly larger than the left lung. The two lungs are mainly made of up connective tissue, which gives them their soft and spongy texture. The bronchi branch are smaller and are called bronchioles which are divided many more times in the lungs. The lungs is made up of connective tissue, blood, lymphatic tissue, air pathways and alveoli are at the end of the branches inside of the lungs. The alveoli sends oxygen and removes carbon dioxide. This is a basic view of how the respiratory system functions and if the respiratory system doesn’t do its job then this could lead to infectious diseases of the respiratory
My case study encompasses pulmonary embolism and a saddle pulmonary embolism. The patient I chose was a female who had just given birth with no complications during labor, but developed a pulmonary embolism that later on was confirmed to be a saddle pulmonary embolism. Not known to me before this clinical study pulmonary embolism is a leading cause of death among pregnant women in the developed world. A pulmonary embolism is a sudden blockage in a lung artery. The blockage is usually by a blood clot that travels to the lung from the vein in the leg. A clot that forms in one part of the body and travels in the bloodstream to another part of the body is called and embolus (NAT13). Pulmonary embolism is a serious condition that can damage your lung due to lack of blood flow to your lung tissue, which can lead to pulmonary hypertension. Pulmonary hypertension is increased pressures in the pulmonary artery. PE can also cause low oxygen levels in your blood and damage other organs in your body because of a lack of oxygen. If a blood clot is very large it can cause death. A pulmonary embolism can also be called a venous thromboembolism.
Parker, Steve. "Chronic Pulmonary Diseases." The Human Body Book. New ed. New York: DK Pub., 2007.
Nursing Diagnosis I for Patient R.M. is ineffective airway clearance related to retained secretions. This is evidenced by a weak unproductive cough and by both objective and subjective data. Objective data includes diagnosis of pneumonia, functional decline, and dyspnea. Subjective data include the patient’s complaints of feeling short of breath, even with assistance with basic ADLs. This is a crucial nursing diagnosis as pneumonia is a serious condition that is the eighth leading cause of death in the United States and the number one cause of death from infectious diseases (Lemon, & Burke, 2011). It is vital to keep the airway clear of the mucus that may be produced from the inflammatory response of pneumonia. This care plan is increasingly important because of R.M.'s state of functional decline; he is unable to perform ADL and to elicit a strong cough by himself due to his slouched posture. Respiratory infections and in this case, pneumonia, will further impair the airway (Lemon, & Burke, 2011). Because of the combination of pneumonia and R.M's other diagnoses of lifelong asthma, it is imperative that the nursing care plan of ineffective airway clearance be carried out. The first goal of this care plan was to have the patient breathe deeply and cough to remove secretions. It is important that the nurse help the patient deep breathe in an upright position; this is the best position for chest expansion, which promotes expansion and ventilation of all lung fields (Sparks and Taylor, 2011). It is also important the nurse teach the patient an easily performed cough technique and help mobilize the patient with ADL's. This helps the patient learn to cough and clear their airways without fatigue (Sparks a...
...o Pneumonia, it causes respiratory failure. The treatment for this would most likely be ventilator breathing for the patient with supplemental oxygen. (Boothby, L. A. (2004)
of the air spaces and drops the air pressure in the lungs so that air
The roles of the circulatory and respiratory system both carry important responsibilities and are essential in their jobs to the human body. The circulatory system is one, if not the, most important system in the human body. The circulatory system is made up of the heart, blood, and blood vessels. Within the blood vessels, there are three types: arteries, veins, and capillaries. The heart is an organ made up of cardiac muscle that has a role similar to a pump. When the muscles in the heart contract, it pumps fresh blood away from the heart, through a main artery called the aorta, and to the organs and cells of the body. Nutrients and oxygen then enter the cells through diffusion of the tissues. The respiratory system transports oxygen to the circulatory system. When transporting oxygen to the circulatory system, this will in turn transport oxygen to the rest of the cells in the body. Aside from transporting oxygen to the body, the respiratory system also plays a role in the removal of carbon dioxide and other contaminants in the body. These two systems effectively and efficiently work together in order to supply the body with oxygen and remove carbon dioxide and any other