L5: Pneumothorax & Pleurisy Flashcards
(51 cards)
1
Q
Def of Pneumothorax
A
- It’s an abnormal collection of air in the pleural space.
Normally, there is no air in the pleural space.
2
Q
Types of Pneumothorax
A
3
Q
Types of Pneumothorax
- 1ry
A
Occurs in children without known lung disease.
4
Q
Types of Pneumothorax
- 2ry
A
Occurs as a complication of chronic or acute lung disease.
5
Q
Types of Pneumothorax
- Traumatic
A
6
Q
Types of Pneumothorax
- Iatrogenic
A
- Caused by blunt or penetrating trauma to the chest.
- Penetrating trauma → open or communicating pneumothorax
7
Q
Pathophysiology of Pneumothorax
A
- Occurs as a complication of certain diagnostic or therapeutic procedures such as central line placement or ventilation
8
Q
Pathophysiology of Pneumothorax
- Simple Pneumothorax
A
- The air in the pleural space does allow the lung to collapse.
- It may be asymptomatic.
9
Q
Pathophysiology of Pneumothorax
- Complicated Pneumothorax
A
10
Q
Tension Pneumothorax
- Def
- Pathology
- Complications
- TTT
A
11
Q
Etiology of Pneumothorax
A
12
Q
Etiology of Pneumothorax
- Traumatic
A
- Blunt trauma
- Penetrating trauma
13
Q
Etiology of Pneumothorax
- Iatrogenic
A
- Central venous line
- Mechanical ventilation
- Intubation
- Transbronchial biopsy
- Bronchoscopy
14
Q
Etiology of Pneumothorax
- Malformations
A
Lymphangiomatosis
15
Q
Etiology of Pneumothorax
- Spontaneous
A
- Familial
- Idiopathic
16
Q
Etiology of Pneumothorax
- Infections
A
- TB
- Measles
- Staph. aureus
- P. carinii
- Echinococcal cyst
17
Q
Etiology of Pneumothorax
- Inhalation of Toxins
A
- Caustic fumes
- Cocaine smoking
- Hydrocarbon inhalation
18
Q
Etiology of Pneumothorax
- Congenital
A
Marfan syndrome
19
Q
Etiology of Pneumothorax
- Others
A
- FB aspiration
- Asthma
- Cystic fibrosis
- Tumor
20
Q
CP of Pneumothorax
A
21
Q
CP of Pneumothorax
- Symptoms
A
22
Q
Symptoms of Pneumothorax
- Sudden Chest Pain
A
23
Q
Symptoms of Pneumothorax
- RD
A
Tachypnea - dyspnea - cyanosis
24
Q
Signs of Pneumothorax
A
25
Signs of **Pneumothorax**
- Inspection
26
Signs of **Pneumothorax**
- Palpation
Hyperresonance of affected side
27
Signs of **Pneumothorax**
- Percusiion
- Trachea shifted to the opposite side In tension pneumothorax
- Decreased TVF "Tactile Vocal Fremitus"
28
Signs of **Pneumothorax**
- Auscultation
- Decreased intensity of breath sounds, transmission of voice, thoracic excursion
29
DDx of **Pneumothorax**
- Bronchogenic cyst
- Cystic adenomatoid malformation
- Diaphragmatic hernia
30
Complications of **Pneumothorax**
31
INVx for **Pneumothorax**
32
INVx for **Pneumothorax**
- Rads
33
Rads in **Pneumothorax**
- Chest X-Ray
34
Rads in **Pneumothorax**
- CT
Can detect the cause
35
Labs in **Pneumothorax**
36
Labs in **Pneumothorax**
- ABG
Detect increased alveolar-arterial oxygen gradient
37
Labs in **Pneumothorax**
- Pulse Oximetry
Detect hemoglobin desaturation
38
Labs in **Pneumothorax**
- ECG
Detect changes in the amplitude of QRS complex & the cardiac axis
- "In cases of severe tension pneumothorax with mediastinal shift"
39
TTT of **Pneumothorax**
40
The lungs should be allowed to re-expand slowly, .........
Because rapid re-expansion after evacuation of large collections of air can result in pulmonary edema
- Thus, if pneumothorax is large, it may be best not to apply -- pressure immediately.
41
Suction should be maintained until ......
- It becomes evident that no air is exiting the thoracic cavity then suction can be discontinued and the tube allowed to remain under water seal
42
If no air leak is evident after 24 hours, .....
the chest tube can be removed.
43
Tension pneumothorax is a clinical diagnosis and a medical emergency requiring immediate chest decompression
....
44
Types of **Pleurisy**
- Dry or Plastic pleurisy
- Serosanguineous or serofibrinous Pleurisy
- Purulent Pleurisy "Empyema"
45
Cause of **Dry / Plastic Pleurisy**
1. Acute infection "bacteria - virus"
2. Acute upper resp. tract illness
3. TB
4. CT diseases as Rheumatic fever
46
Pathogenesis of **Dry / Plastic Pleurisy**
- Limited to visceral pleura
- Small amount of yellow serous fluid
47
CP of **Dry / Plastic Pleurisy**
- Pain "Main symptom"
- Grunting
- Pleural rub
48
Causes of **Serosanguineous or serofibrinous
Pleurisy**
1. infections
2. Inflammatory conditions of abdomen
3. Tumor
4. SLE - Rheumatoid arthritis
49
Pathogenesis of **Serosanguineous or serofibrinous
Pleurisy**
- Imbalance () hydrostatic & oncotic pressure
- Permeability of microvascular drainage
- Obstruction of lymphatic drainage
50
Causes of **Purulent Pleurisy
"Empyema"**
51
Pathogenesis of **Purulent Pleurisy
"Empyema"**
Accumulation of pus in plural space
