Pneumothorax Flashcards
(56 cards)
What is another term for a pneumothorax?
Collapsed lung
What is a pnuemothorax?
It is a condition in which air enters the pleural space – resulting in separation of the lung and the chest wall
What is the pleural space?
It is the cavity between the visceral and parietal pleura
Describe how the lung physiologically inflates, and how this is disrupted in pneumothorax patients
In physiological circumstances, there is a negative intrapleural pressure, this is due to a combination of lung recoiling and expenditure of the chest wall
This negative pressure is present at all stages of respiration, enabling expansion of the lung as it is pulled towards the chest wall
In a pneumothorax, there is an increase in intrapleural pressure resulting in the lung being unable to fully reinflate
What are the three main classifications of pneumothorax?
Spontaneous pneumothorax
Traumatic pneumothorax
Tension pneumothorax
What is a spontaneous pneumothorax?
It is defined the sudden onset of a pneumothorax without any underlying trauma
What are the two subclassifications of a spontaneous pneumothorax?
Primary Spontaneous Pneumothorax
Secondary Spontaneous Pneumothorax
What is a primary spontaneous pneumothorax?
It is defined as the sudden onset of a pneumothorax without any underlying trauma, and in the absence of lung disease
What are the five risk factors of a primary spontaneous pneumothorax?
Tall Thin Young Male
Family History
Smoking
Pregnancy
Marfan’s Syndrome
What is a secondary spontaneous pneumothorax?
It is defined as the sudden onset of a pneumothorax without any underlying trauma, and in the presence of pre-existing lung disease
What five lung diseases are associated with secondary spontaneous pneumothorax?
COPD
Asthma
Pneumonia
Lung Cancer
Cystic Fibrosis
What is a traumatic pneumothorax?
It is defined as the sudden onset of a pneumothorax, related to trauma to the chest wall
What are the two subclassifications of traumatic pneumothorax?
Iatrogenic Traumatic Pneumothorax
Non-Iatrogenic Traumatic Pneumothorax
What is an iatrogenic traumatic pneumothorax?
It is defined as the sudden onset of a pneumothorax, related to trauma to the chest wall which is secondary to medical intervention
What four medical procedures are associated with iatrogenic traumatic pneumothorax?
Central Line Placement
Ventilation
Lung Biopsies
CPR
What is a non-iatrogenic traumatic pneumothorax?
It is defined as the sudden onset of a pneumothorax, related to trauma to the chest wall which is not secondary to
medical intervention
What are the four injured associated with non-iatrogenic traumatic pneumothorax?
Motor Vehicle Accident
Fractured Ribs
Contact Sport injuries
Stab Wounds
What is a tension pneumothorax?
It isn’t defined as a pneumothorax classification, however, is a term used to reflect its severity
It is caused by trauma to the chest wall that creates a one way valve that enables air into the pleural space, however not out
Why are tension pneumothoraxes life threatening?
They create increased pressure inside the thorax
This pushes the mediastinum across, kinks the big vessels in the mediastinum and causes cardiorespiratory arrest
What are the five clinical features associated with tension pneumothorax?
Tracheal Deviation
Air Entry Reduction
Increased Percussion Resonance
Tachycardia
Hypotension
In tension pneumothorax, which side does the trachea deviate to?
It deviates away from the side of the pneumothorax
In tension pneumothorax, which side is there reduced air entry?
The side affected by a pneumothorax
Which two clinical observations makes the diagnosis of tension pneumothorax more likely than simple pneumothorax?
Hypotension
Deterioratoin > Ventilation
How do we treat tension pneumothorax?
We insert a large bore cannula into the second anterior intercostal space in the midclavicular line
Once pressure has been relieved, a chest drain is inserted for definitive management
