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Pulm Disease Exam 3
SPC Pulmonary Disease Exam 3 Ch. 23 Pneumothorax
Question | Answer |
---|---|
What are the 2 classifications of Pneumothorax? | Open & Closed |
Define a Closed Pneumothorax? | Gas in the pleura space is not in direct contact with the atmosphere |
Define an Open Pneumothorax? | Condition in which the pleural space is in direct contact with the atmosphere such that gas can move freely in and out. |
Define Tension Pneumothorax? | Pneumothorax in which the intrapleural pressure exceeds the intra-alveolar pressure. |
3 forms of Pneumothorax? | 1. Traumatic 2. Spontaneous 3. Iatrogenic |
Traumatic Pneumothorax | Penetrating wounds to the chest wall from knife, bullet, automobile accident, industrial accident. |
What is a sucking chest wound? | When traumatic pneumothorax occurs the pleural space is in direct contact with the atmosphere and gas can move into and out of the pleural cavity. |
Sucking chest would be classified as what? | Open Pneumothorax |
Closed Pneumothorax is also known as what? | Valvular |
What is a closed tension pneumothorax? | Gas enters pleural space during inspiration but can not leave during expiration because the partial pleura acts as a check valve. |
Spontaneous Pneumothorax? | When a Pneumothorax occurs suddenly w/o any obvious underlying cause. Secondary to certain underlying pathologic process like: pneumonia, COPD, & tuberculosis. |
Spontaneous Pneumothorax occurs in what type of people? | Tall/Thin people 15-35 years |
A spontaneous pneumothorax may sometimes be cause by what? | Small bleb or bulla on the surface of the lung |
Iatrogenic Pneumothorax? | Occurs during specific diagnostic or therapeutic procedures |
What are the possible causes of an Iatrogenic Pneumothorax? | 1. Pleura/Liver Biopsy 2. Thoracentesis 3. Intercostal Nerve Block 4. Cannulation of Subclavian vein 5. Tracheostomy 6. Thoracic Needle Biopsy |
Iatrogenic is always a hazard during what? | Mechanical Ventilation, especially with high tidal volumes and pressures. Common in COPD and HIV related ARDS |
Clinical data at bedside with a pneumothorax? | 1. Tachypnea 2. Hypoxemia 3. ^HR & ^BP w/ small pneumo 4. Cyanosis |
Chest Assessment Findings of a pneumothorax? | 1. Displaced heart sounds 2. Tracheal Shift 3. Diminished Breath Sounds 4. Hyperresonant percussion note |
Pendelluft | A paradoxical movement that during inspiration some of the "rebreathed dead space gas" may move back into the normal lung |
As a result of a pendelluft the patient what? | Hypoventilates |
Thoracostomy Chest Tube | In severe cases of pneumothorax where a chest tube attached to an underwater seal is inserted into the patients pleural cavity |
A pneumothorax 15%-20% of cavity? | Patient may need only bed rest or limited physical activity, reabsorption of gas occurs with in 30 days |
A pneumothorax >20% | Air should be evacuated. |
Where should the chest tube be inserted? | 2nd intercostal space/midclavicular line |