Pneumothorax Flashcards
occurs when the parietal or visceral pleura is breached and the pleural space is exposed to positive atmospheric pressure
Pneumothorax
is required to maintain lung inflation
Negative pressure
Types of Pneumothorax
Simole, traumatic and tension pneumothorax
occurs when air enters the pleural space through a breach of either the parietal or visceral pleura.
simple, or spontaneous, pneumothorax
Most commonly, this occurs as air enters the pleural space through the
rupture of a bleb or a bronchopleural fistula
A spontaneous pneumothorax may occur in an apparently healthy person in the absence of trauma due to…. On the surface of the lung, allowing air from the airways to enter the pleural cavity
rupture of an air-filled bleb, or blister
It may be associated with
diffuse interstitial lung disease and severe emphysema
occurs when air escapes from a laceration in the lung itself and enters the pleural space or from a wound in the chest wall
Traumatic pneumothorax
TP may result from
blunt trauma
penetrating chest or abdominal trauma
diaphragmatic tears
may occur during invasive thoracic procedures (i.e., thoracentesis, transbronchial lung biopsy, and insertion of a subclavian line) in which the pleura is inadvertently punctured
Traumatic pneumothorax
A traumatic pneumothorax resulting from major injury to the chest is often accompanied
Hemothorax
collection of blood in the pleural space resulting from torn intercostal vessels, lacerations of the great vessels, or lacerations of the lungs
Hemothorax
both blood and air in the chest cavity is also common after major trauma
Hemopneumothorax
can be classified as a traumatic pneumothorax as a result of the entry into the pleural space and the accumulation of air and fluid in the pleural space.
Chest surgery
is one form of traumatic pneumothorax. It occurs when a
wound in the chest wall is large enough to allow air to pass freely in and out of the thoracic cavity with each attempted respiration
Open pneumothorax
Because the rush of air through the wound in the chest wall produces a sucking sound, such injuries are termed
sucking chest wounds
such patients, not only does the lung collapse, but the structures of the mediastinum (heart and great vessels) also shift toward the uninjured side with each inspiration and in the opposite direction with expiration
Mediastinal flutter or swing and produce circulatory problems
occurs when air is drawn into the pleural space from a lacerated lung or through a small opening or wound in the chest wall. It may be a complication of other types of pneumothor
Tension pneumothorax
occurs where air enters the pleural space but cannot escape
one-way valve or ball valve mechanism
is increased within the affected pleural space. This causes the lung to collapse and the heart, the great vessels, and the trachea to shift toward the unaffected side of the chest (mediastinal shift
Tension (positive pressure)
In extreme casesnof Tension pneumothorax, the pulse may be undetectable—this is known as
pulseless electrical activity
Clinical manifestations
Pleuritic pain
Dyspnea
Tachypnea
Decreased chest expansion
Decreased or absent of breath sounds
Anxious
Air hunger use of accessory muscle
Central cyanosis
Severe Hypoxemia
Hyperresonance
Medical mgt
Small test tube (fr 28)
large-diameter chest tube (32 Fr or greater)
autotransfusion
pressure dressing
Antibiotics
thoracentesis
Chest tube drainage
Thoracotomy
Supplemental oxygen
large-bore needle (14 gauge)
used to re-expand the involved lung and to remove excess air, fluid, and blood, and may be used in patients who have had a thoracotomy
Chest tubes and a closed drainage system
