Pneumothorax

Question 1

A pneumothorax is excess ___ accumulation in the _____ space, causing i______ collapse

Answer 1

air
pleural
ipsilateral

Question 2

What is a typical patient who present with a pneumothorax?

Answer 2

Tall thin male with connective tissue disorder, may smoke, had some kind of trauma

Question 3

Why do individuals with a connective tissue disorder be more likely to have a pneumothorax?

Answer 3

Abnormal connective tissue components like collagen and elastin result in weakened lung tissue, more prone to tearing or rupturing. More likely to have bullae on lung surface.

Question 4

Pneumothorax may be primary (spontaneous with no underlying cause) or secondary to _____ or pathology

Answer 4

trauma

Question 5

True or false: the pleural space normally has a small volume of air in

Answer 5

False
Normally a vacuum with no air

Question 6

A pneumothorax occurs when there is a breach in the pleura eg subpleural bullae burst causing an abnormal connection between the pleural space and airways called a….

Answer 6

Bronchopleural fistula (causing a pneumothorax)

Question 7

What are symptoms of a pneumothorax?

Answer 7

SOB
One sided sharp pleuritic chest pain
Decreased breathing sounds
Hyperresonant percussion ipsilaterally due to air

Question 8

Is a simple pneumothorax a medical emergency?

Answer 8

No
Air can flow in and out of a valve between the alveoli and pleura so unlikely to worsen with every breath

Question 9

Is a tension pneumothorax an emergency?

Answer 9

Yes
One way valve so air is only going into the pleural space and not out so it worsens with each breath

Question 10

What is the tracheal deviation like in a simple and tension pneumothorax

Answer 10

Both conditions show contralateral tracheal deviation
Simple, only little
Tension will be greater deviation

Question 11

What is the gold standard and first line method for diagnosing a pneumothorax?

Answer 11

Chest XR:
Shows excess fluid in black
Contralateral tracheal deviation

Question 12

CT is more s____ imaging so good for small pneumothoraxes

Answer 12

sensitive

Question 13

How is a small pneumothorax treated?

Answer 13

Self healing

Question 14

How is a large pneumothorax treated?

Answer 14

Needle decompression (suck air out with syringe)
Chest drain (one way air removal)

Question 15

What is done for recurrent pneumothorax?

Answer 15

Pleurodosis

Question 16

In a tension pneumothorax, air flows into pleural space but can’t leave so there is increased i________ pressure with every breath

Answer 16

intrapleural

Question 17

What can happen with an increased intrapleural pressure from a tension pneumothorax?

Answer 17

Can press on heart and cause cardiac symptoms

Question 18

For a tension pneumothorax, where is the large bore cannula inserted into?

Answer 18

2nd intercostal space at midclavicular line

Question 19

Is a chest drain of needle decompression performed first?

Answer 19

Needle decompression