| Question | Answer |
| What is the definition of pneumothorax | free air in the chest outside of the lung |
| what can happen if the visceral pleura is perforated or the chest wall and parietal pluera are perforated | air enters plueral space, negative pressure is lost and lung on affected side collapses = pneumothorax |
| What are the 4 classifications of pneumothorax | spnontaneous
traumatic
iatrogenic
tension** |
| Which type of pneumothorax occurs w/o injury air enters pleural cavity via the airway and can be further divided between primary and secondary | spontaneous pneumothorax |
| pneumothorax in pt w/ no known lung disease caused by rupture of a bulla in the lung most often in tall thin men between 20 and 40 yrs old often occurs during exercise | spontaneous primary pneumothorax |
| pnuemothorax in patient w/ known lung disease most often COPD but could be TB, Pneumonia, Asthma, cystic fibrosis, lung cancer. Often severe and life threatening | spontaneous secondary pneumothorax |
| pneumothorax often caused by an injury to the chest wall further classified as open or closed | traumatic pneumothorax |
| What is an open traumatic pneumothorax | air enters pleural cavitity from the outside w/ free communication between exterior and pleural space through an open wound (blowing wound, sucking wound)
May be caused by stab, gunshot or impaled object |
| traumatic pneumothorax w/ air enters the pleural cavity via lungs caused by blunt chest trauma (crushing injury often car crash, fall or crushing chest injury | Closed Pneumothorax- not as apparent as open pneumothorax |
| What pneumothorax is caused by procedure or treatment often gone bad | iatrogenic pneumothorax |
| Type of pneumothorax where air accumulates in the pleural space w/ each breath. increase in intrathoracic pressure shifts mediastinum away from affected lung, compress intrathoracic vessels, can lead to cardiovascular collapse | tensino pneumothorax |
| pneumothorax that can be caused by a piece of tissue forms a one-way valve that allows air to enter the pleural cavity but not to escape, overpressure can build up with every breath | tension pneumothorax |
| the following are common causes of what type of pneumothorax
* insertion of a central line
* thoracic surgery
* thoracentesis
* pleural or transbronchial biopsy. | iatrogenic pneumothorax |
| if a scuba diver ascends to quickly what type of pneumothorax are they likely to develop | traumatic closed pneumothorax |
| What are the clinical manifestations of pneumothorax | sudden sharp chest pain
asymmetrical chest expansion
dyspnea
cyanosis
hyper resonance or tympany
breath sounds diminished or absent
respiratory distress
O2 sat decreased
tachypnea
tachycardia
restlessness/anxiety |
| What are the s/s of open pneumothorax | crepitus, sub q empphysema, sucking chest wound |
| what are the s/s of a tension pneumothorax | decreased CO
hypotension
tachycardia
tachypnea
mediastinal shift and tracheal deviation to unaffected side
cardiac arrest
distended neck veins |
| what will you likely see on ABG's in pneumothorax | intial PaCO2 decreased respiratory alkalosis
later= hypoxemia, hypercapnia, acidosis |
| what is the treatment for open pneumothorax | cover immediately with occlusive dressing made air tight with petroleum jelly or clean plastic sheeting |
| what is the tx for small pneumothorax | spontaneous recover- bed rest, generally resolves in 1 to 2 weeks
or remove air with small bore needle inserted into pleural space |
| What is the tx for a larger pneumothorax | chest tube
surgery repair
pleurodesis (glue, very painful, prep with analgesic), O2, |
| What are the complications from recurrent pneumothorax and what should patient stop doing | cardiac damage
d/c smoking, high altitudes, scuba diving, flying in unpressurized aircraft |
