1(E): Pneumothorax Flashcards
Define pneumothorax
Air with the pleural space
What is a primary pneumothorax
Pneumothorax with no underlying lung disease
What is a secondary pneumothorax
Pneumothorax with underlying lung disease
In which gender is primary pneumothorax more common
Male
Which age group is primary pneumothorax more common
20-30 years
Which age-group is secondary pneumothorax more common
60-70 years
What causes primary pneumothorax
- Connective Tissue Disease: Ehlers-Danlos, Marfans
2. Trauma
What causes secondary pneumothorax
Underlying lung disease:
- COPD (emphysema)
- Asthma
- TB
- Pneumonia
- Carcinoma
- CF
What can cause an iatrogenic pneumothorax
- CVC line insertion
- Pleural aspiration
- Biopsy
- Liver Biopsy
- Mechanical ventilation
What is the stereotype for primary pneumothorax
Tall, thin male
What are 3 risk factors for primary pneumothorax
- Tall, thin male
- Smoking (20-times risk)
- FH
Describe symptoms of pneumothorax
Sudden-onset:
- Dyspneoa
- Pleuritic chest pain
What are signs of pneumothorax on auscultation
Reduced breath sounds
What are signs of pneumothorax on percussion
Hyper-resonant to percussion
What is the main feature of a tension pneumothorax
Tracheal deviation
How may the chest appear in a tension pneumothorax
Reduced chest expansion (asymmetrical)
What are symptoms of tension pneumothorax
- Respiratory distress (cyanosis, hyperventilation)
- Haemodynamic compromised
What is a mnemonic to remember features of pneumothorax
P-THORAX
What are features of pneumothorax (P-THORAX)
Pleuritic chest pain Tracheal deviaiton Haemodynamic compromise Onset sudden Reduced breath sounds Absent fremitus X-ray shows collapse
What causes a tension pneumothorax
Air enters pleural space however cannot exit due to tissue forming a one-way valve system meaning air can enter pleural space but cannot leave.
Why does haemodynamic instability occur in tension pneumothorax
Increase pressure causes a mediastinal shift impairing venous return to the heart
What investigations are ordered in pneumothorax
CXR
ABG
Explain presentation of pneumothorax on CXR
- Increase radiolucency on affected side
- On the affected side there is a thin white line - there
are no lung markings peripheral to this - May be evidence of lung collapse
What indications tension pneumothorax on CXR and why shouldn’t this be seen
Mediastinal shift.
CXR should not be ordered in tension pneumothorax
