Pneumothorax Flashcards
1
Q
Definition
A
Presence of air in the pleural cavity
2
Q
Causes
A
- Rupture preumatoceles
- Rupture tuberculous cavity
- Rupture lung abscess.
- Rupture surface alveoli in air trapping
- Vigorous resuscitation
- Chest wall trauma
3
Q
Clinical picture
Symptoms
A
-Asymptomatic (in small pneumothorax) 🌼 discovered accidentally -Symptomatic: 🌼 Respiratory distress (⬆️⬆️ with tension pneumothorax). 🌼 Symptoms of the cause
4
Q
Chest examination
A
🌷
- Inspection → Unilateral decreased movement & unilateral bulge.
- Palpation → Decreased TVF & trachea shifted to opposite side.
- Percussion → Hyper resonance.
- Auscultation → Marked diminished breath sounds.
→ Coin test
🌷 Evidence of tension.
• Mediastinal shift
• Circulatory compromise
• Hearing a “hiss” of rapid exit of air under tension with the insertion of the thoracostomy tube
5
Q
Investigations
A
- Chest X-ray/CT → jet black opacity ± mediastinal shift to the opposite side
- CT chest: may identify underlying pathology such as blebs
- For the cause
6
Q
Treatment
A
1- Small pneumothorax: usually resolve within 1 week.
2- Symptomatic:
- Closed drainage with underwater seal.
- Tube is inserted in the 2 nd space mid clavicular line.
3- Treat the underlying cause.