pneumothorax

What potential injuries could Hannah have sustained when the deer hit her

cuts, bruises, broken bones, ect

what is a pneumothorax

• When air enters the plural cavity

• Change this pressure and causes a collapsed lung

A normal chest X ray is shown hannahs X ray probably looks similar to X ray B. Dense objects like bone and organs appear white air filled spaces are black and the lungs are mottled gray is a pneumothorax on the left or right side how do you know

• right side

• more tissue

• clearer view between ribs

Will her pneumothorax spread to affect the other lung why or why not

• No each lung is its own plural cavity as well as the heart and thymus gland have its own cavity (mediastinum)

• unless its cavity also sustained injury

Describe the two factors that normally keep the lung inflated against the thoracic wall

1. pressure in pleural cavity

   1. less than alveoli in lung

   2. pressure outside of lung is less than pressure inside lung

2. serous fluid

   1. high surface tension

   2. sticks visceral and parietal pleura together

   3. minimizes chances of lung collapsing

How did the pneumothorax cause Hannah's lungs to collapse

• ruins pressure gradient

  • makes pressure surrounding lungs greater than pressure inside lungs

• elastic recoil

  • lungs are elastic tissue

    • during exhalation lungs recoil

When the adhesive seal was removed why did Brent hear a sucking sound each time hannah inhaled what you can you conclude about the pressure gradient between the atmosphere and the plural cavity

• there was an opening to the outside

  • when taking a breath can hear atmospheric air enter pleural cavity

  • making space larger when lungs expand allows more air to enter cavity

Why will hannahs lungs not reinflate on its own when she inhales refer to the appropriate pressure gradients in your answer

• needs to reestablish pressure gradient

• need to establish adherence of membranes

How will inserting a chest tube into the plural cavity help to reinflate her lung

• allows to remove air from pleural cavity and decrease intrapleural pressure

• gradually drops below intrapulmonary pressure

• slowly lungs are able to expand again on own

• chest tube is only set for air so air cant enter any other exit

why did doctor Harris avoid placing the chest tube inferior to the fifth intercostal space

• where the diaphragm is

• dont want chest tube to interfere

A chest tube also requires careful placement within the intercostal space to avoid significant bleeding research or review the blood supply to the thoracic wall on the diagram draw a line in the intercrossed space to represent where you think Doctor Harris made the instation explained why you placed it in that location

• I placed it closer to the 5th Intercostal than the fourth

• nerves and blood vessels are inferior to each rib

  • avoid significant bleeding and nerve injury

How is a tension pneumothorax different than a typical pneumothorax

• It is an opening into the intrapleural space through the lungs not the outside

  • Keep increased pressure with no exit

  • Increase pressure in interpleural space pushing lungs toward medial chest

  • Decrease Venus return due to pinching off inferior and superior vena cava

Attention pneumothorax can be fatal if not treated quickly what would you do if you didn't have a chest tube available or didn't have time to insert one

• Make a wound to the outside to allow air to exit

• Injury to the respiratory passageway

• Want to change the tension pneumothorax into a normal pneumothorax