Chest Injuries Flashcards
(23 cards)
What is a pneumothorax?
A collapsed lung, occurs when air leaks into the space between your lungs and chest wall (pleural space), causing the lung to collapse. This buildup of air puts pressure on the lung, preventing it from expanding as much as it normally does when you take a breath.
A Pneumothorax is also called a punctured lung or atelactasis.
What are the different types of pneumothorax?
- Traumatic pnuemothorax
- Spontaneous pneumothorax
- Tension pneumothorax
- Latrogenic pneumothorax
Spontaneous pneumothorax
A spontaneous pneumothorax is a collapsed lung that happens without an injury. Types include:
* Primary spontaneous pneumothorax: When no underlying health condition or disease causes the collapsed lung. This can happen if abnormal air pockets in your lung (blebs) break apart and release air.
* Secondary spontaneous pneumothorax: Certain lung diseases can lead to a collapsed lung. This can happen when your lung is blocked, causing bulging areas (bullae) that can burst.
Traumatic pneumothorax
Injuries and medical procedures can cause a traumatic pneumothorax. Types include:
* Injury-related pneumothorax: When injury to your chest, like a fractured rib or knife wound, punctures your lung.
* Latrogenic pneumothorax: When your lung is punctured during a medical procedure, like a lung biopsy or a central venous line insertion.
Tension pneumothorax
A life-threatening condition caused by the continuous entrance and entrapment of air into the pleural space, thereby compressing the lungs, heart, blood vessels, and other structures in the chest.
Catamenial pneumothorax
A rare condition that can affect people with endometriosis. Endometrial tissue growing outside of your uterus can form cysts that can bleed into the pleural space, causing your lung to collapse.
Signs and Symptoms of a pneumothorax.
Signs and symptoms of a pneumothorax include:
* Chest pain on one side, especially when taking breaths.
* Cough.
* Fast breathing
* Fast heart rate
* Fatigue
* Shortness of breath (dyspnea).
* Bluish skin, lips or nails (cyanosis).
What causes a pneumothorax?
Medical conditions:
* Asthma
* Pneumonia
* Chronic obstructive pulmonary disease
* Collagen vascular disease.
* Cystic fibrosis
* Emphysema
* Idiopathic pulmonary fibrosis
* Lung cancer
* Lymphangioleiomyomatosis
* Tuberculosis
* Acute respiratory distress syndrome (ARDS)
Injuries:
* Blunt force trauma
* Gunshot wound
* Stab wound
* Blast injuries
* Medical procedures, like a nerve block, lung biopsy, central venouse line placement or mechanical ventilation.
Lifestyle factors:
* Drug use, especially inhaled drugs
* Smoking.
* Flying that involves drastic changes in air pressure
* Scuba or deep-sea diving.
What are the risk factors for this condition?
You might be more at risk for a collapsed lung if you:
* Have a family history of pneumothorax
* Are pregnant
* Have a tall, thin body type, especially if you are a man.
* Have Marfan syndrome
* Have endometriosis
What are the complications of a punctured lung?
Although most collapsed lungs heal without issues, some people have serious complications. These can include:
* Re-expansion pulmonary edema
* Damage or infection caused by the treatment
* Respiratory failure
* Heart failure
How is pneumothorax diagnosed?
Providers usually diagnose a collapsed lung by listening to your lungs and by using imaging:
* Chest X-rays.
* CT scans
* They may also use an arterial blood gas test to measure the levels of oxygen and carbon dioxide in your blood.
How is pneumothorax treated?
Your treatment depends on the cause, size and severity of your pneumothorax. Treatment may include:
* Observation: If your pneumothorax is minor, your provider may watch you for signs of heart or breathing problems.
* Oxygen therapy
* Thoracentesis: Placing a temporary needle between your ribs on the side of the pneumothorax to evacuate the air in your chest.
* Chest tube drainage: If you have a larger pneumothorax, your provider may put a tube in your chest to reduce the air in your pleural space. As the air pressure pressure decreases, your lung re-expands and heals. You may have this tube in place for a couple of days or longer.
* Chemical pleurodesis: To prevent your lung form collapsing again, a provider may perform pleurodesis. Your provider makes a cut (incision) and inserts a tube. Then they use chemicals (such as doxycycline or talcum powder) to attach your lung to your chest cavity eliminating extra space.
What are the most common presenting symptoms in newbors with a primary spontaneous pneumothorax?
tachypnea, cyanosis, and grunting
Pneumothorax is more common in neonates than in any other age group. The incidence of symptomatic neonatal is estimated to be around 1-3 per 1000 live births. Prematurity, low birth weight and asphyxia are the major risk factors, and a majority of newborn infant cases occur during the first 72 hours of life.
Symptoms in SSPs tend to be more severe than in PSPs. True or False?
True. Hypoxemia (decreased blood-oxygen levels) is usually present and may be observed as cyanosis (blue discoloration of the lips and skin). Hypercapnia (accumulation of carbon dioxide in the blood) is sometimes encountered. This may cause confusion and -if very severe- may result in comas.
Percussion of the chest may be perceived as ____ (like a booming drum), and ____ and ____ can both be noticeably decreased.
Percussion of the chest may be perceived as hyperresonant (like a booming drum), and vocal resonance and tactile fremitus can both be noticeably decreased.
What is the most common cause (approximately 70% of cases) of SSPs?
The most common cause of SSPs is chronic obstrucive pulmonary disease (COPD).
Additional causes of spontaneous pneumothorax in children.
In children, additional causes include measles, echinococcosis (hydatid disease), inhalation of a foreign body, and certain congenital malformations (congenital pulmonary airway malformation and congenital lobar emphysema).
In an ____, there is a passage from the external environment into the pleural space through the chest wall.
In an open pneumothorax, there is a passage from the external environment into the pleural space through the chest wall. When air is drawn into the pleural space through this passageway, it is known as a “sucking chest wound”. A closed pneumothorax is when the chest wall remains intact.
Blebs
Lung blebs are small, air-filled sacs or blisters that can form on the surface of the lungs or in the chest cavity, typically between the lung and the chest wall. They are often asymptomatic and may be discovered incidentally during a CT scan. If a bleb ruptures, it can release air into the chest cavity, potentially leading to a collapsed lung, or pneumothorax.
“Safe Triangle”
Purpose: In medicine, particularly for chest tube insertion, the “triangle of safety” is an anatomical area in the armpit considered safe for the procedure.
Boundaries: This region is defined by the lateral edges of the pectoralis muscles in the front and the latissimus dorsi muscle in the back, with a horizontal line from the nipp from the bottom boundary.
Rationale: Using this area helps avoid damaging chest wall muscles and the breast.
Tension Pneumothorax: Signs and Symptoms
Signs and symptoms include:
* Severe shortness of breath
* Sharp chest pain
* Rapid breathing
* Rapid heart rate
* Low blood pressure
* Bulged neck vein (jugular vein distention)
* Possibly tracheal deviation
Setting up chest tube suction.
