Chest Drain

Question 0

Contents in the Thoracic cavity - Mediastinum

apart from R L lungs

Answer 0

heart
aorta and great vessels
Esophagus
Trachea
thyus

Question 1

Thoracic cavity is defined by 4 structure.

Answer 1

Sternum - anterior
Thoracic vertebrae - posterior
Ribs - lateral
Diaphragm - inferior

Question 2

Mechanisms of inspiration - inc nerve innervation of diaphragm

Answer 2

Brain signals the phrenic nerve
phrenic nerve stimulates the diaphragm to contract
Diaphragm moves down making the thoracic cavity larger
volume increases, the pressure inside decreases
air moves from the atmosphere to the lungs
Pressure within the lungs is called intrapulmonary pressure

Question 3

Pneumothorax

Answer 3

Air filled in the pleural space between parietal and visceral pleura.
Normal intralPLEURAL pressure is -8cmH2O.
Normal intraPulmonary pressure is -4cm H2O.
When intraPleural pressure exceeds its normal pressure by having air in the space, normal intraPulmonary pressure disappears and lung collapses.

Question 4

Hemothorax

Answer 4

Blood in the PLEURAL SPACE

Question 5

Pleural Effusion

Answer 5

Transudate or Exudate in the pleural space

Question 6

Tension pneumothorax

Answer 6

Closed pneumothorax (chest wall is intact unlike the puncture from knife stab) occurs when air gets into the pleural space from the lung or airway and no way to leave.
When the pleural pressure receive positive pressure ventilation, mediastinum shifts and causes cardiovacular collapse. 
The vena cava and right side of heart can't accept venous return

No venous return => No cardiac output

Question 7

conditions require chest drain

Answer 7

Pneumothorax (closed, open) , if closed tension pneumothorax can develop.
Haemothorax
Pleural effusion - fluid suc as exudate and transudate

Question 8

Goals for chest drain

Answer 8

1. remove fluid and air from pleural space
2. prevent drained air and fluid from RETURNING to the pleural space
3. Restore NEGATIVE pressure in the pleural space to re-expand the lung

Question 9

what incision and tube is made and place?

Answer 9

thoracostomy

Thoracic catheter

Question 11

Role of thoracic catheter

Answer 11

allows airs and drains to flow out of chest
It is connected to a drainage device which contains a one-way valve to prevent air and fluid returning to the pleural space