lulu's life

P.S 注意看優~~ 上面有寫給lulu, 還有畫一個小小的愛心，因為那天是520，很特別的日子優


昨天去聽原音會
看到七年級的小安學姊
穿著小黃雨衣 打赤腳 很開心的跳舞

頓時間 我真的覺得我老了
我的心 好像被現在現實的生活所吸乾

我好像對眼前見到的這一切 失去了熱血

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
 

After watching the "Grey's anatomy" yesterday, some inspirations were in my heart

everyone wanna dreams come true when they wake up in the morning
but we know that it 's not easy to happen to us
you must have some faith to believe yourself