pneumothorax Flashcards
define pneumothorax
Accumulation of air in the pleural space, causing the lungs to collapse
5 types of pneuomothorax
- Spontaneous
- Traumatic
- Iatrogenic
- Lung Pathology
- Tension
typical pateint of pneumothorax
a tall thin young male who might have a connective tissue disorder, be a smoker or have had some kind of trauma.
what causes pneumothorax
can be primary - spontaneous/no underlying cause
or
can be secondary - due to pathology/trauma
pathophysiology of pneumothorax
- Pleural space is usually just a vacuum containing no air.
- Therefore has negative intrapleural pressure.
- Any breach in pleura due to trauma etc. will lead to flow of air into pleural place.
symptoms of pneumothorax
- SOB
- One sided sharp pleuritic chest pain
signs of pneumothorax
- Hyperresonant percussion note ipsilaterally
- reduced breathing sounds
what is the gold standard and first line investigation for pneumothorax
chest x ray
what does chest x ray for pneumothorax show
- Absent lung markings
- Affected area much darker than normal - excess fluid appears black
- Tracheal deviation to opposite side
which investigation is more appropiate for smaller pneumothoraxes
CT because it is more sensitive imaging
how to treat Small PTX with no SOB
consider discharge and follow up CXR
usually self healing
how to treat Larger PTX and/or SOB
- needle aspiration
or - chest drain (more of a longer term Tx)
how to treat recurrent PTX
surgical management - pleurodesis
what is tension pneumothorax
a medical emergency
One way valve mechanism - air can flow into the pleural space but can’t leave.
With every breath the intrapleural pressure goes up
clinical presentation of tension pneumothorax
Cardiopulmonary deterioration:
- Hypotension
- Respiratory distress
- Low sats
- Tachycardia
- Shock
Severe chest pain
