PNEUMOTHORAX - Chapter 23 (RC122 Respiratory Care Pathophysiology)

Vocabulary flashcards covering key terms, definitions, and management concepts related to pneumothorax as presented in the notes.

Pneumothorax

Gas in the pleural space causing partial or complete collapse of the lung.

Pleural space

Potential space between the visceral and parietal pleura where air or fluid can accumulate.

Visceral pleura

Membrane that covers the surface of the lungs.

Parietal pleura

Membrane lining the chest wall, diaphragm, and mediastinum.

Tension pneumothorax

Air enters the pleural space during inspiration but cannot exit during expiration, causing increased pressure and mediastinal/tracheal shift.

Tracheal deviation

Displacement of the trachea away from the affected side, often seen in tension pneumothorax.

Needle decompression

Emergency insertion of a needle into the second intercostal space at the midclavicular line to relieve tension pneumothorax.

Thoracostomy

Insertion of a chest tube to evacuate air or fluid from the pleural space.

Open pneumothorax

Pleurals space communicates with the atmosphere; air can move in and out through a chest wall wound.

Closed pneumothorax

Gas in the pleural space not in direct contact with the atmosphere.

Spontaneous pneumothorax

Sudden pneumothorax without an obvious cause; often due to rupture of blebs/bullae, common in tall, thin individuals aged 15–35.

Traumatic pneumothorax

Pneumothorax caused by penetrating chest trauma (knife, bullet, impaling object).

Iatrogenic pneumothorax

Pneumothorax caused by diagnostic or therapeutic procedures (biopsy, thoracentesis, nerve blocks, subclavian cannulation, tracheostomy, high ventilation pressures).

Blebs and bullae

Small air-filled sacs on the lung surface that can rupture and cause spontaneous pneumothorax.

Hyperresonance

Increased resonance on percussion over the pneumothorax due to air in the pleural space.

Diminished breath sounds

Reduced breath sounds on the affected side.

Pendelluft

Paradoxical movement of air between lung regions due to unequal pressures, seen with pneumothorax and chest wall injury.

Atelectasis

Collapse or incomplete expansion of lung tissue.

V/Q mismatch

Ventilation-perfusion imbalance contributing to hypoxemia in pneumothorax.

Intrapulmonary shunting

Blood passes through unventilated alveoli, lowering PaO2.

Pleurodesis

Procedure that causes the pleural surfaces to adhere, preventing recurrent pneumothorax.

Talc pleurodesis

Use of talc to induce inflammation and adhesions between pleural surfaces.

Underwater seal

Water-filled seal in the chest-tube system that prevents air from re-entering the lung while allowing drainage.

Chest tube

Tube inserted into the pleural space to drain air or fluid; connected to an underwater seal and possibly suction.

Suction pressure

Negative pressure applied to the chest tube; typical maximum about -12 cmH2O (often -5 cmH2O is sufficient).

Mediastinal shift

Movement of mediastinal structures due to pressure changes; usually away from the affected side in tension pneumothorax.

Depressed diaphragm on imaging

Lowered hemidiaphragm on the side of the pneumothorax seen on radiographs.

Increased lucency on CXR

More radiolucent (air-filled) side on chest X-ray corresponding to the pneumothorax.

Open chest wound (sucking chest wound)

Traumatic open pneumothorax with chest-wall defect allowing air to be drawn into the pleural space.

Management thresholds for collapse

15–20% lung collapse: bed rest; >20%: chest tube or needle aspiration; may include pleurodesis and supportive therapies.

Oxygen therapy in pneumothorax

Supplemental oxygen to accelerate resorption of intrapleural air and improve oxygenation.