what is happening (main body) = patho

Question 1

What is happening within the body?

Answer 1

Air enters the pleural cavity during inspiration but cannot escape through expiration, as the air builds up the involved lung will lose the ability to oxygenate blood or expel C02.

As more air enters the pleural space, the pressure increases and begins to collapse the lung on the injured side. As the injured lung collapses, there is less air that can be exchanged for perfusion in the lung. Once the lung has collapsed, pressure begins to compress the heart, shifting the mediastinum toward the uninjured lung, and rebreathing is the beginning of a rapid deterioration of a patient’s ability to maintain oxygenation.

When the pressure is increasesing it can decrease venous return to the heart, ( try to commponsate by increasing the HR and RR in an attempt to maintain cardiac output ) which can result in shock.

As this continues, the compression of the vena cava reduces cardiac blood flow to the heart and decreasing cardiac output. This leads to difficulty breathing, and tachycardia. A noticeable shift in the trachea will be evident. (late stage )This entire process leads to a life-threatening condition known as a “tension pneumothorax.” The patient in this condition will die if treatment is not provided. (Totora )

Question 2

S+S

Answer 2

Chest Pain, cyanosis, jugular neck vein distention, trachial deviation, asymmetrical chest movement, chest wall contusion, surgical emphyseama, absent breath sounds on affected side,
creps, increase in breathlessness, resp. distress, tachy, hypotensive

Question 3

Massive Haemothorax

Answer 3

The collection of blood in the plural space compresses the lung limiting adequate oxygenation and ventilation.
This injury can cause hypovolaemia and shock.
A massive haemothorax is defined as accumulation of 1500mls blood within the pleural space - Stage 2 or 3 shock (decomonsating)
It is possible for the pt to bleed out into the thoracic cavity.

Question 4

S+S

Answer 4

Hypoxia, agitation, anxiety, SOB, dullness on percussion effected area, hypovolemic shock
NO jugular distension
NO tracheal deveation
Possible bloody sputum