Flashcards in Pneumothorax Deck (10):
What is a pneumothorax and how are they classified?
A pneumothorax is an abnormal collection of air in the pleural space. This can result in lung collapse.
1. Primary spontaneous pneumothorax
2. Secondary pneumothorax (associated with underlying disease
3. Traumatic pneumothorax
4. Iatrogenic pneumothorax
What is a tension pneumothorax?
A tension pneumothorax develops from a pneumothorax. As the lungs continues to leak air into the chest, it compresses the mediastinum and causes a shift of other structures int eh chest. This is known as a tension pneumothorax and is life threatening.
How does a pneumothorax present?
chest pain - sudden onset, sharp/tight
Previous pneumothorax- suggests secondary to underlying disease or history of spontaneous pneumothorax
History of recent trauma = Traumatic pneumothorax
What are the risk factors for a pneumothorax?
How is a pneumothorax detected on examination?
Tachycardia (>135 = tension)
Deviated trachea (away from site = Tension)
Decreased chest expansion unilaterally
Hyper-resonant percussion on affected side
Reduced/inaudible breath sounds on affected side
Reduced vocal fremitus
No added sounds
How is a pneumothorax diagnosed?
- Deviated trachea
- Mediastinal shift
- Depressed hemi-diaphragm
- compressed/collapsed lung
- Visible +displaced lung edge
5. ABG's (hypoxia)
What causes a pneumothorax?
= Rupture of cyst/small sac on lung edge
= Genetic susceptibility
= Cystic fibrosis
= Lung cancer
= Trauma e.g. fractured rib, stab wound
= Surgical incision
How is a pneumothorax treated?
Small pneumothorax + no underlying disease = Self-limiting (1-2 weeks)
Large pneumothorax/pneumothorax with underlying disease = Aspiration with/without chest drain to evacuate the air
Where is a chest drain inserted?
A chest drain is inserted in the 'safe triangle':
lower border of axilla in the 5th intercostal space,
lateral border or pectoralis major
lateral border of latissmus dorsi
Overall: 5th Intercostal space in the mid-axillary line