Pneumothorax

Hemothorax is a type of pleural effusion in which blood accumulates in the pleural space. The excess fluid can interfere with normal breathing by limiting expansion of the lungs.

Air escaped from the lung into the pleural space. Eventually, enough air collected in the pleural space to cause the mediastinum to shift twoard the right. The collapsed left lung, increased intrapleural pressure, and rightward shift make it difficult to ventilate A.W.

Pulmonary: Respirations unlabored. Symmetrical chest expansion. Clear to auscultation bilaterally. No rales, rhonchi, wheezing or diminished breath sounds noted.

There is no enlargement of the lymph nodes, pleural fluid or consolidation of a lung. There is no significance change in the appearance of the chest. The minimal subsegmental basal atelectasis is present. The compression fracture of a vertebra at the thoracolumbar junction, T12 or L1 is visualized. Radiographic images show atelectasis in lower part of the lung due to decrease amount of air in the alveoli resulting in volume loss and increase in density. The bilateral ribs are free of acute facture. There is no osseous expansile or destructive process. Pleural effusion or pneumothorax is rule out from this case

A hemothorax is a collection of blood in the space between the chest wall and the lung. The medical term for this space is the pleural cavity. It is also called the pleural space. The most common cause for this condition is a chest injury. It can also happen from:

To ensure that adequate oxygen is available to the tissues, supplemental oxygen may be needed. Pulmonary injuries fall into several categories: upper airway injury; inhalation injury below the glottis, including carbon monoxide poisoning; and restrictive defects. Upper airway injury results from direct heat or edema. It is manifested by mechanical obstruction of the upper airway, including the pharynx and larynx. Because of the cooling effect of rapid vaporization in the pulmonary tract, direct heat injury does not normally occur below the level of the bronchus. Upper airway injury is treated by early intubation. Inhalation injury below the glottis results from inhaling the products of incomplete combustion or noxious gases. These products include carbon monoxide, sulfur oxides, nitrogen oxides, aldehydes, cyanide, ammonia, chlorine, phosgene, benzene, and halogens. The injury results directly from chemical irritation of the pulmonary tissues at the alveolar level. Inhalation injuries below the glottis cause loss of ciliary action, hypersecretion, severe mucosal edema, and possibly bronchospasm. The pulmonary surfactant is reduced, resulting in atelectasis (collapse of alveoli). Expectoration of carbon particles in the sputum is the cardinal sign of this injury. Carbon monoxide is probably the most common cause of inhalation injury because it is a

There are two types of pneumothorax: primary spontaneous pneumothorax which is rupture of an air-filled bleb on the surface of the lung because of alveolar pressure and the secondary spontaneous pneumothorax, which is more serious because is associated with, lung disease that cause trapping of gases and destruction of lung tissue. The most common cause of secondary spontaneous pneumothorax is emphysema and it is a life-threatening due to poor compensatory reserves (Grossman & Porth, 2014).

During inhalation the air sacs pull in oxygen and during exhalation the air sacs let out carbon dioxide. This gas exchange should happen without complication but with pulmonary edema fluid fills up in the alveoli in place of air, averting the bloodstream from absorbing oxygen. Pulmonary edema usually requires a hospital stay of a few days or longer. Patients are seen by several specialists during their hospital stay. Once the condition is controlled, outpatient treatment with a cardiologist or a pulmonologist is recommended (Mayo Clinic

Patients with parapneumonic effusions and patients with a history of pleural effusions whose condition has deteriorated should be admitted

Mrs. Schafer completed her pulmonary function test prior to the appointment time and she was evaluated by Dr. Theodore J Standiford. Mrs. Schaefer provided an acute report of her injury and symptoms she was experiencing. Dr. Standiford replied that Mrs. Schaefer lung capacity was reduced by a third. (1/3). I inquired if it was the result of the injuries in the MVA. Dr. Standiford replied that they are a contributing factor i.e. flail chest and fluid in her lungs from aggravated congested heart failure. Dr. Standiford noted left crackles breath sounds on his examination and recommended that Mrs. Schaefer return to her cardiologist and that a high resolution CT scan of her lungs be obtained prior to the next appointment to determine if she has

Ineffective airway clearance related to adventitious lung sounds, rhonchi auscultated bilaterally at the patient’s bases as evidence by CT scan displaying pleural effusion and basilar atelectasis. Y.B.’s ability to clear his airway is ineffective due to his current disease state. His alveoli are deflated due to pleural effusion. The pleural effusion is a result of blocked lymphatic drainage from the pleural cavity, possible caused by malignant cells (Lewis, Dirksen, Heitkemper, & Bucher, 2014). The goal for Y.B. is to maintain a clear, open airway, and improvement in lung sounds before discharge. Ensuring the patient uses the upright position, maintaining the head of the bead above 30o, will keep his abdominal contents from inhibiting lung expansion. This intervention will be evaluated by assessing lung sounds, pulse oximetry, assessing if Y.B. is using accessory muscles to breath, and a chest X-ray. In the article titled,

For pneumonthorax, thorax drainage should be performed excpet in asymptomaic patients with occult pneumothorax, and should be close monitor. Thorax drainage is perfomed to drain air and blood to help reduce the air leak due to bronchopulmonal fistulas. It is necessary to use negative pressure to the drain system to maintain lung expansion, however, it can increase the fistula flow and retard closure. For those who are mechanically ventilated need immediately treatment with a tube thoacostomy to prevent the development of tension pneumothorax (Ragaller & RIchter, 2011 .

Such phenomenon would inflict pain when breathing, and evidently promote long-term suffocation. Many firefighters experience these types of symptoms when battling furious fires. The smoke and chemicals that the firefighters breathe in actually evaporate a huge portion of their surfactant. That is why in the news firefighters are reported suffering from smoke inhalation. They experience collapsed alveoli and struggle breathing. It is also important to mention the complication that come along with pneumothorax, and serious condition that involves aire between the lungs and intercostal muscles. We know that when we breathe air flows down the trachea, into the bronchi, and spread throughout the lungs. However, what happens when there is a hole punctures in one of the pathways for air. This phenomenon would cause air to accumulate in the chest, instead of going into the lungs. We expand our chest to increase volume, and decrease the pressure inside. Because atmospheric pressure is exceedingly higher that it is in the lungs, air will flow from high pressure to low pressure. This phenomenon cannot happen with

On examination, he was saturating at 96% on room air. His lung fields revealed reduced air entry but no significant wheeze or

This case emphasizes that physicians should consider pneumothorax as one of the potential complication in patients with chronic Scleroderma with underlying advanced pulmonary fibrosis and sub pleural cysts. Early recognition of pneumothorax can direct physicians to appropriate and timely management and save patient from fatal respiratory