Session 10- Pneumothorax

Question 1

what is a pneumothorax

Answer 1

air within the pleural cavity

disruption of the pleura therefore air flows from higher pressure to lower pressure which disrupts the balance of the outward recoil of the chest and inward recoil of the lung

Question 2

what is the difference between simple and tension pneumothorax

Answer 2

simple pneumothroaxes - haemodynamic stable patients

tension causes haemodynamic intability and are caused by the one-way flow of air

Question 3

risk factors of pneumothorax

Answer 3

male
young
Fhx
smoking

Question 4

what is the cause of a spontanous pneumothorax

Answer 4

due to disruption subpleural blebs

Question 5

iatrogenic pneumothorax

Answer 5

insertion of central lines/ pacing

Question 6

what causes trauma pneumothorax

Answer 6

severe chest wall injury-> stab wounds or gunshot wound -> allows air to enter the pleural space

rib fracture-> puncture the visceral pleura

Question 7

how does a simple pneumothorax present - signs

Answer 7

reduced chest movement on affected side

hyperesonant or resonant on percussion

reduced or absent auscultaion

reduced vocal/tactile resonance

Question 8

what are the borders of the safe triangle where chest drains are inserted

Answer 8

superior- base of the axilla

inferior- 6th rib/ 5th intercostal space

anterior- lateral edge of pectoralis major

posterior- lateral edge of latissimus dorsi

Question 9

how does a tension pnuemohroax occur

Answer 9

one way valve air moves into pleural space and cant move out

Question 10

symptoms of simple pneumothorax

Answer 10

pleuritic chest pain
sudden onset chest pain
sharp pain
shortness of breath

Question 11

how does a tension pneumothorax present- symptoms

Answer 11

chest pain
-pleuritic sudden and sharp
SOB

Question 12

signs of tension pneumothorax

Answer 12

trachea deviation away from affected side
reduced chest movement on affected side
no sounds on percussion
reduced or absent breath sounds on auscultation

Question 13

where do you insert an emergency needle

Answer 13

2nd intercostal space in mid clavicular line

Question 14

how does a tension pneumothorax affect venous return

Answer 14

compromises it as the IVC becomes bent due to the air in the pleural cavity accumulating and pushing on it

Question 15

how does a tension pneumothrax appear on radiology

Answer 15

absence of lung markings
depression of diaphragm
hyperlucency affected side
mediastinal shift
deviated trachea
ribs more horizontal and over expanded on affected side

Question 16

how do we treat a tension pneumothorax

Answer 16

immediate needle decompression by inserting a large bore needle into the 2nd intercostal space in mid clavicular line