Resp 180 Exam 3: Pneumothorax

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Resp 180 Exam 3: Pneumothorax
2012-11-14 17:46:03
Resp180 respiratory disease

Gas buildup in pleural space, separating visceral & parietal pleura, allowing the lungs to collapse & the chest wall to move outward. Alveoli are compressed and get atelectatic, and veins are also compressed, --->lower venous return to heart.
Show Answers:

  1. What is the definition of Pneumothorax?
    Gas buildup in pleural space--->seperating visceral & parietal pleura---->allowing lungs to collapse & chest wall to move outward--->veins & alveoli compressed, get atelectatic--->lower venous return to heart
  2. Where does gas enter the pleural space in a pneumothorax?
    • Lungs-hole in visceral pleura
    • Surounding atmosphere- opening in chest wall
    • Gas forming microorganism in empyema
  3. What happens with gas in a closed & open pneumothorax?
    • Closed: not in direct contact with the atmosphere
    • Open: direct contact, air movies freely in & out
  4. What happens with the intrapleural pressure in a tension pneumothorax?
    Intrapleural pressure exceeds intra-alveolar pressure
  5. What causes a traumatic pneumothorax and is it open or closed?
    • penetrating chest wall wounds
    • knife, bullet & impaled objects
    • Open wound
    • Sucking chest wound
  6. What is a spontaneous pneumothorax?
    Occurs suddenly & withough obvious cause
  7. Who is a spontaneous pneumothorax common in?
    • Young tall people
    • 15-35 yrs old
  8. What could a spontaeous pneumo cause?
    Valvular pneumo-which is both a closed & tension pneumo
  9. Intrapleural pressure is greater than atmospheric pressure on one side. What type of pneumo?
    Tension pneumothorax
  10. A crush injury could cause a sharp end of fractured rib to pierce the visceral pleura and let gas leak into the pleural space. What type of pneumo is this?
    Closed pneumothorax
  11. When does a iatrogenic pneumothorax occur?
    • During diagnostic or therapeutic procedure
    • pleural or liver bx
    • thoracentesis
    • nerve block
    • IV start
    • trach
  12. What happens with a pendelluft & what does it lead to?
    • pnuemo on one side
    • on inhalation-mediastinum shifts away from the bad side to good
    • on exhalation-mediastinum shifts toward bad to good
    • Leads to hypoventilation
  13. What are the signs & symptoms of pneumothorax?
    • Increased: RR-stim of PCRs & deflation, irratant & J receptors
    • Increased: pulse, C.O. & BP
    • Decreased: C.O. & BP if tension
    • Increased: thoracic volume on affected side
    • Cyanosis
  14. What happens with O2 levels with a pneumo?
    • Increase: shunt & O2 extraction
    • Decrease: O2 delivery & SvO2
  15. What pressures and resistance are decreased with a pneumothorax?
    • SV
    • SVR
    • PCWP
  16. What pressures & resistance are increased with a pneumothorax?
    • CVP
    • RAP
    • PAP
    • PVR
  17. What are the signs you hear of a pneumothorax?
    • Hyperresonant percussion note over affected area
    • Decreased BS
  18. What are the ABGS of a pt. with a small & large pneumothorax?
    • Small: acute alveolar hyperventilation with hypoxemia
    • Large: acute ventilatory failure with hypoxemia
  19. What's the PFT of a pneumo show?
  20. What does the chest x-ray of a pneumothorax show?
    • Darker(air)
    • mediastinal shift away
    • flat diaphragm
    • atelectasis
  21. How do you manage a small pneumothorax?
    • small pneumo: 15-20% may reabsorb in a month
    • bed rest
    • limit activity
  22. How do you manage a large pneumothorax?
    • If greater than 20%
    • Remove gas from pleural space
    • Leave tube in another 24-48 hrs before
    • PRN 100% O2
    • Hyperinflate for atelectais