Pneumothorax

Question 1

Pneumothorax

Answer 1

Air in the pleural space (from outside or from the lungs)

Question 2

Causes of pneumothorax

Answer 2

1. Spontaneous (young thin men) due to rupture of sub-pleural bullae.
2. Trauma.
3. Iatrogenic.

Question 3

What causes lung collapse?

Answer 3

Pneumothorax abolishes the transmural pressure gradient.

Question 4

Signs of pneumothorax

Answer 4

Dyspnoea & pleuritic chest pain.

Question 5

Signs of pneumothorax

Answer 5

Hyper-resonant percussion note, decreased/absent breath sounds, reduced expansion.

Question 6

Signs of tension pneumothorax

Answer 6

Tracheal deviation

Question 7

Investigations

Answer 7

CXR & ABGs

Question 8

Treatment of pneumothorax due to trauma or mechanical ventilation

Answer 8

Requires chest drain

Question 9

Treatment of pneumothorax

Answer 9

<2cm => observe + O2.
>2cm => Percutaneous aspiration.

2nd line: chest drain, 4/5th intercostal space, midaxillary line.

Question 10

Tension Pneumothorax

Answer 10

Leak of air from lung into thoracic space creates a high pressure within the thoracic cavity, pushing the mediastinum away.

Question 11

How does tension pneumothorax reduce cardiac output

Answer 11

Pressure rises so high that it prevents venous return though SVC.

Question 12

Treatment for Tension Pneumothorax

Answer 12

High floe O2, needle decompression with large bore needle in anterior 2nd intercostal space a mid clavicular line => then chest drain.