Pneumothorax

Question 1

Normal pressure within the pleural space?

Answer 1

Subatomospheric

Question 2

Causes of pneumothorax?

Answer 2

Blunt/penetrating trauma, primary spontaneous, secondary spontaneous, iatrogenic

Question 3

What causes a primary spontaneous pneumothorax?

Answer 3

Apical blebs, atmospheric pressure changes, tall/thin individuals

Question 4

What causes secondary pneumothorax?

Answer 4

Emphysema, CF, granulomatous disease, necrotizing pneumonia, pulm fibrosis, eosinophilic lung disease, sarcoidosis, endometriosis

Question 5

What causes iatrogenic pneumothorax?

Answer 5

Positive pressure mechanical ventilation, central line insertion, thoracentesis

Question 6

Symptoms of pneumothorax?

Answer 6

Acute shortness of breath, chest pain (often sharp), anxiety

Question 7

Physical findings of pneumothorax?

Answer 7

decreased breath sounds on 1 side, +/- tachycardia, +/- low sat, bradycardia, +/- cyanosis, decreased tactile fremitus, subcutaneous emphysema, hyper resonance to percussion

Question 8

Physical findings for tension pneumothorax?

Answer 8

Deviated trachae, JVD

Question 9

Treatment for simple pneumothorax?

Answer 9

very small- O2, observe
Small- needle aspiration, flutter valve tube
M to L- thoracostomy tube with suction and water seal

Question 10

Treatment for tension pneumothorax?

Answer 10

Need to chest in 2nd ICS, thoracostomy tube with suction and water seal

Question 11

What test can you order for simple pneumothorax?

Answer 11

CXR, CT, US