Pneumothorax and Pleural Effusion Flashcards
What is pneumothorax?
The presence of air in the pleural space
What age and gender does primary spontaneous pneumothorax most commonly occur in?
Young tall thin males (usually caused by rupture of pleural bleb/bulla)
What does a secondary pneumothorax usually occur secondary to?
Underlying lung disease eg asthma, COPD or Trauma eg rib fracture or High pressure ventilation
What is a tension pneumothorax?
Pneumothorax causing mediastinal shift an cardiovascular collapse - occurs when air enters the pleural space but cannot escape because of a flap that closes on expiration (like a one way valve) - this is why there is mediastinal shift
What are some signs of tension pneumothorax?
Reduced breath sounds, hyperresonance, hypotension, tracheal deviation
Why is hypotension seen in a tension pneumothorax?
Compromised venous return to heart as IVC is compressed
How is a tension pneumothorax treated?
Insertion of a plastic cannula into the second intercostal space in the mid clavicular line
Where is a chest drain placed for pneumothorax?
5th intercostal space mid axillary line
True or False:
A chest drain should be removed during inspiration
False
Should be removed at the end of expiration
(this is because there is an increase in negative pressure in the pleural space during inspiration which would suck air back in)
Why is fluid more likely to accumulate in the pleural cavity than the peritoneal cavity?
Due to the negative pressure in pleura
How is pleural fluid secreted and drained?
Secreted by parietal pleura, drained by lymphatics
What is a pleural effusion?
Build up of fluid in the pleural space
What is the difference between a transudate and an exudate?
Transudate - low protein
Exudate - high protein
What are the common causes of a transudate pleural effusion?
Congestive heart failure
Liver failure (cirrhosis)
Nephrotic syndrome
How come congestive heart failure can lead to a transudate pleural effusion?
Increased pleural capillary hydrostatic pressure (increased pressure in venous end of capillary, harder for fluid to move back in, failure in absorption)
