Pneumothorax Flashcards
What is a pneumothorax?
Excess air accumulation in pleural space causing ipsilateral collapse
what does a typical Px look like?
Tall thin males with connective tissue disorders (marfans, ED) +/- smokers
some kind of trauma
It can be 1^ (examples?) or 2^ to ?
1^ - spontaneous, no underlying cause
2^ - to trauma/pathology
Pathology of pneumonia
Pleural space normally a vacuum (no air)
Breach in pleura (trauma/CT disorder) eg. sub pleural bullae burst = abnormal connection between pleural space + airways
Sx?
SOB, One sided sharp pleuritic chest pain, low breathing sounds
HYPER RESONANT PERCUSSION IPSILATERALLY (increased air)
Dx
1st and GS?
what would be seen?
chest x ray
excess air appears black, tracheal deviation to other side
which is more sensitive for small pneumothorax?
CT is more sensitive imaging, for small pneumothorax
Tx?
small?
large?
small = self healing
large =
needle decompression (suck out air with syringe)
Chest drain (one way air removal, air can only leave, more longer term Tx)
Surgical (if recurrent) = pleuroidosis
What is a tension pneumothorax?
Medical emergency
Air can flow into pleural space but CAN’T LEAVE therefore intrapleural pressure increases with every breath
Can even press on heart and cause cardiac Sx
If its obvious, what can you avoid and go straight to?
avoid chest x ray + straight to Tx
Tx for tension pneumothorax?
Insert large bore cannula into 2nd intercostal space at midclavicular line
Needle decompress 1st then chest drain
Simple vs Tension pneumothorax
Medical emergency - Tracheal deviation?
Pathology?
Simple:
Non medical emergency, little tracheal deviation
Air can flow in + out of valve between alveoli + pleura therefore doesn’t/unlikely to worsen with every breath
Tension:
Medical emergency with contralateral tracheal deviation
One way valve (air only pleural space not out) therefore worsens with each breath
