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Flashcards in Pneumothorax Deck (23):
1

What can cause pneumothorax?

Can be spontaneous (esp in thin young men), chronic lung disease, infection, trauma, iatrogenic, carcinoma, connective tissue disorders such as mar fans syndrome

2

What are the classifications of pneumothorax?

Spontaneous primary and secondary, trauma

3

What is a primary spontaneous pneumothorax

Rupture of sub pleural bleb (air sac at apices of lung) which allows air from lungs into pleural cavity. There is no evidence of any underlying causative disease

4

What is a secondary spontaneous pneumothorax

Underlying lung disease that causes perforation of pleura

5

Name the two most common symptoms

Sudden unilateral pleuritic pain and/or breathlessness

6

Which genda tend to be more susceptible

Male

7

Secondary spontaneous pneumothorax tends to occur in what group of people?

Males over 55

8

A larger pneumothorax (>15% of hemidiaphragm) may result in what upon auscultation?

Absent breath sounds

9

What is a tension pneumothorax?

Where the airway and pleural space act as a one way valve causing air to enter but cannot leave resulting in pressures far greater than atmospheric in the pleural cavity causing mediastinal displacement

10

What does the tension pneumothorax result in?

Rapidly progressive breathlessness, tachy, hypotension due to vena cava kinking, cyanosis, tracheal displacement

11

When might a tension pneumothorax not result in a mediastinal shift?

When due to malignancy as scarring splints the mediastinum in place

12

What is a closed pneumothorax

When the communication of air between the two areas stops and lung stays deflated

13

What is good about a closed pneumothorax?

The pleural pressure remains mean negative and over a few days re-inflates itself and infection is uncommon

14

What can happen in a open pneumothorax?

Infection can enter the pleural cavity

15

What is the key investigation?

CXR

16

Management if lung edge less than 2 cm from chest wall without SOB

Usually resolves itself and therefore consider discharge

17

If the patient suffers a spontaneous pneumothorax and is young how would you treat?

Needle aspiration which avoids the need for a chest drain. If this fails retry and if this fails give chest drain

18

How would you treat a secondary spontaneous pneumothorax?

Intercostal chest drain in mid axillary line at ICS 4 or 5 or 6

19

When should you remove the chest drain

24 hours after lung re-inflates

20

When should surgery be done

If there is bubbling in water after 5-7 days for pleuradhesion

21

What should people with a closed pneumothorax NOT do for a few weeks

Fly, closed air expands at low pressures of high altitude

22

When else might you do a pleurodesis?

If pneumothorax recurs

23

What is a pneumothorax?

A pneumothorax is the presence of air in the pleural cavity