Pneumothorax

Question 1

What is a pneumothorax?

Answer 1

Air in pleural space

Question 2

What are the symptoms of a pneumothorax?

Answer 2

Dyspnoea

+/- pleuritic chest pain

Question 3

What are the signs of a pneumothorax on examination?

Answer 3

Affected side

• reduced expansion
• reduced breath sounds
• hyper resonant

Question 4

Where can the air come from?

Answer 4

Lung

• primary
• secondary
• iatrogenic

Through chest wall

• trauma
• iatrogenic

Question 5

What is a primary pneumothorax?

Answer 5

Spontaneous accumulation of air in the pleural space

Question 6

Who commonly gets a primary pneumothorax?

Answer 6

Tall thin young men

Question 7

How does a primary pneumothorax commonly occur?

Answer 7

Small sub-pleural bulla that bursts

Question 8

What is a secondary pneumothorax?

Answer 8

Accumulation of air in the pleural space due to underlying lung disease

Question 9

What can cause a secondary pneumothorax?

Answer 9

COPD
Asthma
Lung cancer
Fractured rib

Question 10

What is a tension pneumothorax?

Answer 10

Pneumothorax where air can enter the pleural cavity but can not leave

Question 11

What are the symptoms of a tension pneumothorax?

Answer 11

Severe dyspnoea
Pleuritic chest pain
Fatigue

Question 12

What are the signs of a tension pneumothorax?

Answer 12

Tachycardia
Hypotension
Raised JVP
Deviated trachea

Question 13

How is a tension pneumothorax managed?

Answer 13

Insert a cannula into 2nd IC in mid clavicular line

Question 14

How is a pneumothorax managed?

Answer 14

Aspiration

Chest drain

Question 15

Where is the chest drain inserted?

Answer 15

Safe triangle = mid axillary line of 5th ICS

Borders

• anterior edge of lat dorsi
• lateral edge of pec major
• line superior to nipple
• apex of axilla

Question 16

What are potential complications of a chest drain?

Answer 16

Scapula winging
Failure of insertion 
Bleeding 
Infection 
Penetration of the lung
Re-expansion pulmonary oedema