A patient who had a stroke is lying supine in bed when he vomits and aspirates. He is most likely to develop a lung abscess in the:
1) posterior segments of the upper lobes.
2) lingular segments.
3) superior segments of the lower lobes.
4) all segments of both lower lobes.
A)4
B)1, 3
C)2, 3
D)1, 2, 4

Question

Quizplus · Accepted Answer

When a patient aspirates, the initial location where the aspirated material settles is determined by the patient's position at the time of aspiration. In this case, the patient is lying supine, so the aspirated material is more likely to settle in the posterior segments of the upper lobes and superior segments of the lower lobes. These segments have a more upright orientation when the patient is supine. Therefore, choices 1 and 3 are the best options. Choice 4 is incorrect because lung abscesses typically occur in specific locations, rather than affecting all segments of both lower lobes. Choice 2 is incorrect because the lingula is less likely to be affected by aspiration due to its location in the left lung.

A Patient Who Had a Stroke Is Lying Supine in Bed