Pneumothorax Case ILOs

Question 1

What are the primary muscles involved in ventilation?

Answer 1

The diaphragm and external intercostal muscles are the main muscles for inspiration, while abdominal and internal intercostal muscles assist in forced expiration.

Question 2

How does thoracic volume change during inspiration?

Answer 2

Thoracic volume increases during inspiration as the diaphragm contracts and the rib cage expands, allowing the lungs to fill with air.

Question 3

What are normal lung volumes in a healthy adult?

Answer 3

Normal lung volumes include Tidal Volume (TV) ~500 mL, Inspiratory Reserve Volume (IRV) ~3000 mL, Expiratory Reserve Volume (ERV) ~1200 mL, and Residual Volume (RV) ~1200 mL.

Question 4

What are the lung capacities in a healthy adult?

Answer 4

Lung capacities include Vital Capacity (VC) ~4800 mL, Total Lung Capacity (TLC) ~6000 mL, Inspiratory Capacity (IC) ~3500 mL, and Functional Residual Capacity (FRC) ~2400 mL.

Question 5

How is intrapleural pressure related to lung expansion?

Answer 5

Intrapleural pressure is negative (below atmospheric pressure), helping to keep the lungs expanded against the chest wall.

Question 6

What happens to intrathoracic pressure during inspiration?

Answer 6

During inspiration, intrathoracic pressure decreases, allowing air to flow into the lungs.

Question 7

What happens to intrathoracic pressure during expiration?

Answer 7

During expiration, intrathoracic pressure increases, causing air to flow out of the lungs as the diaphragm relaxes.

Question 8

How does intrapleural pressure change during respiration?

Answer 8

Intrapleural pressure becomes more negative during inspiration and less negative during expiration, maintaining lung inflation.

Question 9

What is the effect of stress or trauma on the sympathetic nervous system?

Answer 9

Stress or trauma activates the sympathetic nervous system, triggering the “fight or flight” response with increased heart rate, blood pressure, and respiratory rate.

Question 10

How does the body respond to hypoxia?

Answer 10

In response to hypoxia, chemoreceptors in the carotid and aortic bodies increase respiratory rate and depth to enhance oxygen delivery to tissues.

Question 11

How is respiration controlled in the brain?

Answer 11

Respiration is controlled by the medulla oblongata and pons, which regulate the rate and depth of breathing based on blood gas levels.

Question 12

What is shock?

Answer 12

Shock is a life-threatening condition characterized by inadequate tissue perfusion leading to cellular and organ dysfunction.

Question 13

How is shock classified?

Answer 13

Shock is classified into four types: hypovolemic, cardiogenic, distributive (including septic, neurogenic, and anaphylactic shock), and obstructive.

Question 14

What vascular structures are visible on a chest radiograph?

Answer 14

Vascular structures include the pulmonary vasculature, aortic arch, ascending and descending aorta, and the hilar vessels.

Question 15

What cardiac structures are visible on a chest radiograph?

Answer 15

Cardiac structures visible on a chest radiograph include the heart silhouette, aorta, pulmonary arteries, and superior vena cava.

Question 16

What is a pneumothorax?

Answer 16

A pneumothorax is the presence of air in the pleural cavity, leading to partial or complete lung collapse.

Question 17

What are the types of pneumothorax?

Answer 17

Types of pneumothorax include spontaneous, traumatic, tension pneumothorax, and iatrogenic (caused by medical intervention).

Question 18

What is the physiological effect of a pneumothorax?

Answer 18

A pneumothorax disrupts the negative intrapleural pressure, causing lung collapse and impaired ventilation.

Question 19

How is a pneumothorax diagnosed?

Answer 19

A pneumothorax is diagnosed using chest radiographs, CT scans, and physical examination (e.g., absent breath sounds, hyper-resonance on percussion).

Question 20

How is a pneumothorax treated?

Answer 20

Depends on severity:
No SOB and less than 2cm = no treatment needed, chest x-ray in 2-4 weeks

SOB or more than 2cm = aspiration / if aspiration fails twice then chest drain

Bilateral .. = chest drain

Question 21

What is the primary assessment approach in trauma patients?

Answer 21

Airway, Breathing, Circulation, Disability (neurological status), and Exposure to identify life-threatening conditions.

Question 22

What is the role of the trauma team leader in a hospital setting?

Answer 22

The trauma team leader coordinates the team, makes clinical decisions, and ensures appropriate interventions are performed rapidly.

Question 23

What is the psychophysiological stress model?

Answer 23

The psychophysiological stress model explains how psychological stressors trigger physiological responses, such as increased cortisol and adrenaline release, affecting health.

Question 24

How does stress contribute to illness?

Answer 24

Chronic stress can lead to illnesses like hypertension, heart disease, depression, and immune system suppression, increasing susceptibility to infections.

Question 25

What are the components of cognitive behavioral therapy (CBT)?

Answer 25

CBT involves cognitive restructuring (changing negative thought patterns), behavioral activation, and exposure therapy to address maladaptive behaviors and thoughts.

Question 26

How does geographical location affect health outcomes?

Answer 26

Health outcomes can vary based on geographical location due to differences in access to healthcare, socioeconomic status, and environmental factors like pollution.

Question 27

What are the signs of tension pneumothorax?

Answer 27

Signs of tension pneumothorax include severe respiratory distress, tracheal deviation, jugular vein distension, and absent breath sounds on the affected side.

Question 28

What is the immediate treatment for tension pneumothorax?

Answer 28

Immediate treatment for tension pneumothorax is needle decompression, followed by chest tube insertion to evacuate the air from the pleural space.

Question 29

What is the difference between a simple and a tension pneumothorax?

Answer 29

A simple pneumothorax involves air in the pleural space without major pressure changes, while a tension pneumothorax leads to increased intrathoracic pressure and life-threatening cardiovascular collapse.

Question 30

What is the role of the diaphragm in changing intrathoracic pressure?

Answer 30

The diaphragm contracts during inspiration, increasing thoracic volume and decreasing intrathoracic pressure to allow air into the lungs.

Question 31

What role does intrapleural pressure play in lung function?

Answer 31

Intrapleural pressure remains negative relative to alveolar pressure, preventing lung collapse and ensuring effective lung inflation during inspiration.

Question 32

What are the primary symptoms of hypoxia?

Answer 32

Symptoms of hypoxia include shortness of breath, cyanosis, confusion, increased heart rate, and in severe cases, loss of consciousness.

Question 33

How do chemoreceptors regulate breathing in hypoxia?

Answer 33

Peripheral chemoreceptors in the carotid and aortic bodies sense low oxygen levels and signal the respiratory centers in the brain to increase the rate and depth of breathing.

Question 34

What are some physiological changes triggered by chronic stress?

Answer 34

Chronic stress can lead to increased cortisol levels, hypertension, weakened immune response, and digestive issues.

Question 35

How does CBT address stress and mental health?

Answer 35

CBT helps individuals identify and modify negative thought patterns and behaviors, thereby reducing stress and improving mental health outcomes.

Question 36

What is the role of the pons in respiration?

Answer 36

The pons contains the pneumotaxic and apneustic centers, which regulate the rhythm and depth of breathing by influencing the medullary respiratory centers.

Question 37

Why does a tension pneumothorax cause hypotension?

Answer 37

The rising pressure in the pleural space compresses the vena cava (especially the superior vena cava) and other major veins, reducing venous return to the heart. When less blood flows back into the heart, the amount of blood pumped out (cardiac output) is reduced, leading to hypotension. The compression of the vena cava limits the volume of blood filling the right atrium (preload), leading to reduced stroke volume. As less blood enters the heart during each beat, the amount pumped into systemic circulation drops, further lowering blood pressure. The pressure from the air in the pleural space pushes the mediastinum (which houses the heart and great vessels) toward the opposite side. This shift further impairs the heart's ability to function properly and pump blood effectively. The high pressure in the thoracic cavity opposes the ability of the heart to expand and contract properly. This leads to reduced cardiac output, which is a major contributor to the drop in blood pressure.