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pneumothx
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IV. PATHOPHYSIOLOGY
1. Schematic diagram
Book Based Pathophysiology:
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Precipitating/Modifiable factors
Environment Exposure to
Pathologic Microorganism
aspiration of foods or fluids
Lung Disease
Injury/accidents
Smoking
Non Modifiable / Predisposing Factors Age especially infants Immunocompromised Common Colds
Any Chest Injury
Pneumothorax
Allows air to enter the pleural space
Increase intrathoracic pressure and reduction in vital capacity
Penetration into the pleural space by an object external to the chest wall (such ash knife/needle)
Open Pneumothorax
Penetrating/Non penetrating injuries
Internal Mechanism (such as broken rib or bleb rupture of the lung) air or blood enters the pleural space.
Injury to the chest or respiratory structures
Closed Pneumothorax
Air filled bleb/blister on the lung surface ruptures
Manifestations:Depends on its size and the integrity of the underlying lung.
Large Pneumothorax
Hypoxemia
Vasoconstriction of the blood vessels in the affected lung.
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Fractured/dislocated ribsthat penetrates the pleura
Hemothorax
Chest Trauma
Other Complication
Medical Procedure such as intra thoracic needle aspirations, intubation, and positive pressure ventilation
Cardiopulmonary resuscitation (CPR)
Traumatic Pneumothorax
Tension Pneumothorax
Intrapleural pressure exceeds atmospheric pressure.
Rapid increase of pressure in chest with compression atelectasis of unaffected lung
Air enters the pleural space but does not leave
Spontaneous Pneumothorax
Primary SpontaneousPneumothorax
Air filled blebs rupture on TOP of the lungs.
Unknown cause Lung Disease
Catamenial Pneumothorax
Air may gain access to the peritoneal Cavity during menstruation and then enter the pleural cavity through diaphragmaticDefect.
History of endometriosis
Secondary Spontaneous Pneumothorax
Trapping of gases & Destruction of lung tissue
Shift in mediastinum to the opposite side of the chest and compression of the vena cava with impairment of venous return to the heart
Intrapleural pressure exceeds atmospheric pressure.
Manifestations: Ipsilateral chest pain Inc. in RR Dyspnea Inc. HR Asymmetry of chest Hyperresonant sound upon percussion Breath sounds decreased/absent over the
area of the pneumothorax.
Manifestations: Structures in the mediastinal space shift toward
the opposite side of the chest. Distention of neck veins Subcutaneous emphysema Clinical signs of shock
Partial/total loss of lung function
Hypoxemia
Life threatening
Recommended