Pneumothorax Flashcards
What is the normal relationship between the intrapleural pressure and alveolar pressure?
alveolar pressure is greater than the intrapleural pressure, intrapleural pressure is less than atmospheric pressure
Atmospheric pressure>alveolar pressure>intrapleural pressure
How to measure size of a pneumothorax?
from the lung edge to the thoracic waal at the level of the hilum
Patient is not breathless and has pneumothorax 0.9 cm. What is their management?
admitted for observation (<1cm=observation)
Patient is asymptomatic but has pneumothorax 1.8 cm. What is their management?
Aspiration with 16 gauge canula (1-2cm)
Patient breathless and pneumothorax measures 2.5cm, what is their management?
intercostal drain (>2cm)
Landmarks for the triangle of safety when inserting a chest drain?
ant: lateral edge of pec major
Lateral: lateral edge of latissimus dorsi
Inf: fifth intercostal space
Sup: base of axilla
Name the five types of pneumothorax
- Primary spontaneous pneumothorax
- Secondary spontaneous pneumothorax
- Traumatic
- Tension pneumothorax
- Iatrogenic pneumothorax
Provide two examples of iatrogenic causes of pneumothoraces
thoracentesis, during cpr resulting in rib fracture, mechanical ventilation due to barotrauma, central line insertion
What is the indication for large bore cannula insertion into 2nd intercsotal space mid-clavicular line?
tension pneumothorax
Name three clinical findings on resp exam for tension pneumothorax
reduced expansion
hyperresonance (percussion)
decreased breath sounds
no vocal resonance
Name two groups of patients who are at increased risk of developing spontaneous pneumothorax
men (tall and slender) smokers marfan's syndrome FH pneumothorax underlying resp disease e.g. asthma, CF, COPD
Name two factors that need to be taken into account when considering treatment of SP?
severity of symptoms
size of pneumo-
Name two physical signs of tension pneumothorax
tracheal deviations
cardiovascular instability
tachypnoea, hypoxia
When inserting a chest drain, you wish to avoid the costal blood vessels. Where are these located and how can they be avoided?
location- costal grooves on the inferior surface of the ribs
How to avoid- insert the chest drain directly above the rib
Define pneumothorax
accumulation of air in the pleural space secondary to lung collapse
