Chapter 23 Phatho

Question 1

1. What is a Pneumothorax?

Answer 1

A pneumothorax exists when gas (sometimes called free air) accumulates in the pleural space

Question 2

2. What happens when gas enter into the Visceral and parietal pleural?

Answer 2

The visceral and partietal pleura Separates

Question 3

3. A pnuemothorax is a _________ disorder.

Answer 3

restrictive

Question 4

4. The major pathologic or structural changes associated with a pneumothorax are as follows:

Answer 4

• Lung collapse
• Atelectasis
• Chest wall expansion (in tension pneumothorax)
• Compression of the great veins and decreased cardiac venous return.

Question 5

5. Major pathologic and structural changes:

- Gas enters pleural space through where?

Answer 5

1. Perforation of visceral pleura
2. Perforation of chest wall
3. Emphysema in pleural space (gas forming bacteria)

Question 6

6. Gas accumulation normally is

Answer 6

in the apex and works down:

Question 7

7. A pneumothorax may be classified as

Answer 7

either closed or open according to the way gas gains entrance to the pleural space.

Question 8

8. Closed pneumothorax.

Answer 8

Gas in the pleural space is not in direct contact with the atmosphere.

Question 9

9. Open pneumothorax.

Answer 9

a condition in which the pleural space is in direct contact with the atmosphere such that gas can move freely in and out

Question 10

10. What is Tension pnuemothorax?

Answer 10

• A pneumothorax in which the intrapleural pressure exeeds the intraalveolar pressure.
• Most potentially dangerous.
• Quickly impairs cardiac function by squeezing the heart and major vessels.

Question 11

11. What is Hemothorax?

Answer 11

• Blood accumulation in the pleural space.

- Normally settle in the bases.

Question 12

12. Some forms of a pnuemothorax:
    1.
    2.
    3.

Answer 12

1. Traumatic
2. Spontaneous
3. Iatrogenic

Question 13

13. What form of a pnuemothorax is the most serious of all?

Answer 13

Tension pneumothorax

Question 14

14. The pleural space is in direct contact with the 14. atmosphere, and gas can move into and out of the pleural cavity. This is known as a ________ _______ _________ and classified as an _______ pnuemothorax.

Answer 14

• Sucking chest wound

- Open pneumothorax

Question 15

15. A piercing chest wound also may result in a __________ or _______ pneumothorax through a one-way valve like action of the ruptured parietal pleura, gas enters the pleural space during inspiration but cannot leave on expiration because the parietal pleura acts as a check valve.

Answer 15

Closed or tension pneumothorax

Question 16

16. Sometimes caused by the rupture of a small bleb or bullae. Occurs in tall, thin, persons aged 15 -35 y/o. It may result from the high negative intrathoracic pressure and mechanical stresses that take place in the upper zone of the upright lung.

Answer 16

Spontaneous

Question 17

17. A spontaneous pneumothorax is classified as both a ________ and ________ pneumothorax.

Answer 17

Closed and Open

Question 18

18. Sometimes occurs during specific diagnostic or therapeutic procedures, biopsy, thoracentesis, nerve block, MV. It is always a hazard during PPV- particulary when high tidal volumes or high system pressures are used.

Answer 18

Iatrogenic

Question 19

19. Vital signs:
1.
2.
3.
4.
5.

Answer 19

1. Increased RR, HR, BP
2. Hypoxemia
3. Cyanosis
4. Decreased lung compliance
5. Increased Ventilatory rate relationship

Question 20

20. Chest Assessment findings:
1.
2.
3.
4.
5.

Answer 20

1. Hyperresonant percussion note
2. Diminished BS
3. Tracheal shift away from affected side
4. Displaced heart sounds
5. Increased thoracic volume on the affected side

Question 21

CXR Findings;
1.
2.
3.
4.
5.

Answer 21

1. Increased translucency
2. Mediastinal shift to unaffected side
3. Depressed diaphragm
4. Lung collapse
5. Atelectasis

Question 22

22. Typically a size _______ to ________ French gauge thoracostomy tube is used for adults.

Answer 22

28 to #36

Question 23

23. When suction is used the negative pressure shouldn’t exceed _______ to __________.

Answer 23

-12 to -5 cmH2O

Question 24

24. After the lung has reexapanded and bubbling form the chest tube has ceased, the tube is clamped and left in placed without suction for _____________.

Answer 24

24-48 hours

Question 25

25. What are some Respiratory Care treatment protocols?
    1.
    2.
    3.

Answer 25

1. O2 therapy
2. Lung expansion therapy
3. MV with PEEP

Question 26

26. What are some drugs used in pleurodesis?
    1.
    2.
    3.

Answer 26

1. Talc
2. Tetracycline
3. Bleomycin sulfate

Question 27

27. A chemical or medication is injected into the chest cavity, which causes an intense inflammatory reaction over the outer surface of the lung and inside of the chest cavity. This is performed to cause the surface of the lung to adhere to the chest cavity, thus preventing or reducing recurrent fluid accumulation or pnuemothorax.

Answer 27

Pleurodesis