Pneumothorax Lecture Notes

Vocabulary flashcards covering the anatomy, pathophysiology, types, diagnosis, and management of pneumothorax based on the lecture notes.

Visceral pleura

The layer of the pleura that covers the lung and fissures.

Parietal pleura

The outer layer of the pleura composed of the costal pleura (lining the thoracic cage), diaphragmatic pleura (covering the diaphragm), and mediastinal pleura (covering the mediastinum).

Pleural cavity

The extremely narrow space located between the visceral and parietal layers of the pleura.

Pleural fluid

A small volume of fluid, approximately $10-20\,ml$, normally present in the pleural cavity that acts as a lubricant to facilitate lung movement.

Intra Pleural Pressure (IPP)

The pressure in the pleural sac, normally $-3\,mmHg$ at the end of normal expiration and $-6\,mmHg$ at the end of normal inspiration.

Pneumothorax

The presence of air in the pleural space resulting in partial or complete collapse of the lung on the affected side.

Primary spontaneous pneumothorax

A type of pneumothorax occurring in the absence of significant lung disease, often in young, tall, thin patients with a male to female ratio of $6:1$.

Secondary spontaneous pneumothorax

A pneumothorax occurring in the presence of an existing lung disease, such as COPD, bronchial asthma, or interstitial lung diseases.

Subpleural bleb

A common cause of primary spontaneous pneumothorax, typically occurring at the apex due to a congenital defect in the alveolar wall connective tissue.

Iatrogenic pneumothorax

A traumatic pneumothorax resulting from diagnostic or therapeutic techniques such as pleural aspiration, biopsy, or mechanical ventilation.

Tension pneumothorax

A medical emergency where a pleural tear acts as a one-way valve, allowing air into the pleural space during inspiration but preventing its expulsion during expiration, leading to positive intrapleural pressure.

Mediastinal shift

The displacement of the mediastinum toward the contralateral side, which occurs in tension pneumothorax and leads to decreased venous return.

Pleuritic chest pain

A sudden onset of unilateral pain that is a common clinical manifestation of pneumothorax.

Hyperresonance

The percussion note heard on the affected side during the physical examination of a patient with pneumothorax.

Unilateral hypertranslucency

A chest X-ray finding in pneumothorax showing a distinct convex visceral pleural line and an absence of lung markings outside that line.

Large Pneumothorax (PNX)

Defined by a distance of $\ge 2\,cm$ from the lateral edge of the lung to the inner wall of the ribs, implying a $50\%$ collapse of the lung.

Re-expansion pulmonary oedema

A potential complication that may occur following the treatment of a pneumothorax.

Simple aspiration

A procedure involving the insertion of a $16$ French gauge cannula in the $2nd$ intercostal space at the MCL to remove up to $2.5\,L$ of air.

Needle decompression

The urgent insertion of a large bore needle into the second intercostal space at the midclavicular line to treat tension pneumothorax.

Intercostal Tube (ICT) drainage

Active management indicated for tension pneumothorax, dyspnea, large pneumothorax ($> 20\%$), or patients on mechanical ventilation.

Pleurodesis

A surgical management technique indicated for recurrent pneumothorax or persistent air leaks.