lulu's life

Laplace's Law: P=T/2R
In COPD
diaphragm is flat and tension force is decrease, so they can' t have a good passive pressure 
during expiration

paradoxymoal movement: 
during the  inspiration phase-->ribcage lift up (may ues the accessary m.)--> 
increase the thoractic cavity
-->abdomen is plugg in 

Pulsus paradoxus
during the inspiration phase--> the intrapericardial and RA pressure↓--> the blood reture↑-->RV volumn↑--> and septal shift to left, also the Plum. vascular compliance↑--> the Pulm. venous return↓-->the LA volumn↓
-->LV volumn ↓--> SBP ↓
but normaly decreased range is below 10 mmHg

Dz: constritive pericaritis(40%), pericardial effusion

1. Pleurae: Visceral & Parietial layer--Serous Plueral Fluid (Capillary layer)
2. Pleural blood supply: bronchial a. and pulmonary vein  

Transudate
Increase hydrostatic pressure---heart failure(40%)
‧Heart failure-->pulmonary hypertension-->mean capillary pressure↑
    -->the pleural fluid can't  be absorbed well--> pleural effusion
‧usually bilateral 80%, if unilateral, the Rt. side pleural effusion is the most.
decrease oncotic pressure-- liver cirrhosis, Nephortic syndrome


Effusion
Parapneumonic effusion
Defintion:  accumlation of  exudative pleural space and associated ipsilateral pulmonary infection 

Classification
-->Uncomplicated: are not infected and usually not need the chest drainage
-->Complicated: are usually associated with plueral infection, and require tube thoracostomy and sometimes decortication of their resolution.
-->empyema: a pus accumlation in the pleural space