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CM- pulm -12- Pneumothorax

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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  


   






 
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