Pneumothorax and Pleural Effusion Flashcards
Where can the air in a pneumothorax come from?
- lung trauma or disease
- iatrogenic
- through the chest wall
True or false: primary pneumothorax is most common in old, obese women
FALSE - young, tall, thin men
How does air enter the pleural cavity in primary pneumothorax?
Subpleural bulla (air filled sac) which bursts
Which lung diseases can cause secondary pneumothorax?
- COPD
- asthma
- bronchiectasis
- lung cancer
- pneumonia
- TB
What is a tension pneumothorax?
When air enters pleural cavity but can’t escape because of a flap that closes on expiration which acts as a one-way valve
What are the symptoms and signs of tension pneumothorax?
- breathlessness
- hyper-resonance
- no breath sounds
What is the treatment for tension pneumothorax?
Insert plastic cannula into second intercostal space in mid-clavicular line
Where is a chest drain placed?
5th intercostal space, mid-axillary line
Why is the chest drain removed at the end of expiration?
Lowest intra-pulmonary pressure so lower chance of another pneumothorax
What is pleural effusion?
Dysfunction of production or absorption of pleural fluid
Why is fluid more likely to accumulate in the pleura than in the peritoneal cavity?
More negative pressure in pleura
What is failure of absorption of pleural fluid most commonly due to?
Hypoproteinaemia: liver failure, nephrotic syndrome
What are the differences between transudate and exudate?
- transudate: clear, no protein
- exudate: cloudy, protein
What is overproduction of pleural fluid due to?
Increased capillary permeability due to inflammation: infection, cancer, PE
What are bilateral pleural effusions more likely to be due to?
Transudates as a result of heart failure
