36. Pneumothorax Flashcards Preview

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Flashcards in 36. Pneumothorax Deck (19):
1

definition

acumulation of air in pleural space

2

symptoms and signs

1. Unilateral chest pain and dyspnea,
2. unilateral chest expansion,
3. decreased tactile fremitus,
4. hyperresonance,
5. diminished breath sounds,
all on the affected side.

3

types

1. primary spontaneous
2. secondary spontaneous
3. traumatic spontaneous
4. Tension ( can be any of the above)

4

primary spontaneous pneumothorax is due to

rupture of apical blebs or cysts

5

primary spontaneous pneumothorax occurs most often in

tall, thin, young males

6

secondary spontaneous pneumothorax is due to

1. diseased lung (bullae in emphysema, infenctions)
2. mechanical ventilation with use of high pressures ( barotrauma)

7

traumatic pneumothorax is caused by

blunt (rib fracture) or penetrating ( gunshot) trauma

8

tension pneumothorax is caused by

any of the other (traumatic , primary or secondary spontaneous

9

tension pneumothorax is caused by

any of the others ( traumatic , primary or secondary spontaneous)

10

tension pneumothorax pathophysiology

air enters pleural space but cannot exit --> increasing trapped air --> tension pneumothorax

11

tension pneumothorax - trachea

trachea deviates away fron affected lung

12

Tension pneumothorax - management

immediated needle decompression and chest tube placement

13

• Name four types of pneumothorax.


Primary spontaneous, secondary spontaneous, traumatic, and tension

14

• A tall young man has unilateral chest pain, dyspnea, and ruptured apical blebs. Which way is his trachea deviated?

Toward the affected lung (this is a spontaneous pneumothorax)

15

• A tall, thin 15-y/o male has chest pain and dyspnea. There is decreased fremitus and hyperresonance on the left chest. What caused this?

Primary spontaneous pneumothorax occurs in tall, thin, young males as a result of apical bleb or cyst rupture

16

• Name two causes of secondary spontaneous pneumothorax.

Lung disease (e.g., emphysema, infections) and barotrauma from high pressures on use of mechanical ventilation

17

• A patient is on mechanical ventilation. He then complains of unilateral chest pain and dyspnea. What happened?

He likely developed a pneumothorax from the high pressure of mechanical ventilation

18

• A man presents after falling from the top of a roof. He has chest pain, dyspnea, diminished breath sounds, and tactile fremitus. Diagnosis?

This is likely a traumatic pneumothorax from blunt trauma, also seen in penetrating trauma (e.g., gunshot wounds)

19

• A patient is involved in a motor vehicle crash and has a right-sided tension pneumothorax. Which direction is the trachea pointing?

Left (a tension pneumothorax deviates the trachea away from the affected lung)