IV.

PATHOPHYSIOLOGY 1. Schematic diagram

Book Based Pathophysiology &o! #odi$ia%le " Predisposi!g 'actors "ge especially infants Immunocompromised #ommon #olds "ny #hest Injury

"llo$s air to enter the pleural space

Precipitati!g"#odi$ia%le $actors Environment Exposure to Pathologic Microorganism aspiration of foods or fluids Lung Disease Injury/accidents mo!ing

Manifestations+ Depends on its si,e and the integrity of the underlying lung*

Penetration into the pleural space %y an o%ject external to the chest $all &such ash !nife/needle' (pen Pneumothorax

P!e(mothora)
Internal Mechanism &such as %ro!en ri% or %le% rupture of the lung' air or %lood enters the pleural space*

Increase intrathoracic pressure and reduction in vital capacity

Large Pneumothorax Penetrating /)on penetrating injuries Injury to the chest or respiratory structures -ypoxemia .asoconstriction of the %lood vessels in the affected lung*

#losed Pneumothorax

"ir filled %le%/%lister on the lung surface ruptures

34

0ractured/ dislocated ri%s that penetrates the pleura

#hest 1rauma

(ther #omplication -emothorax

Medical Procedure such as intra thoracic needle aspirations2 intu%ation2 and positive pressure ventilation

#ardio pulmonary resuscitation &#P3'

"ir enters the pleural space %ut does not leave 3apid increase of pressure in chest $ith compression atelectasis of unaffected lung

Manifestations+ Ipsilateral chest pain Inc* in 33 Dyspnea Inc* -3 "symmetry of chest -yperresonant sound upon percussion 6reath sounds decreased/a%sent over the area of the pneumothorax*

pontaneous Pneumothorax

1raumatic Pneumothorax

hift in mediastinum to the opposite side of the chest and compression of the vena cava $ith impairment of venous return to the heart Intrapleural pressure exceeds atmospheric pressure*

4n!no$n cause "ir filled %le%s rupture on 1(P of the lungs*

Lung Disease 1rapping of gases 5 Destruction of lung tissue econdary pontaneous Pneumothorax

-istory of endometriosis "ir may gain access to the peritoneal #avity during menstruation and then enter the pleural cavity through diaphragmatic Defect* #atamenial Pneumothorax 3/

1ension Pneumothorax

Primary pontaneous Pneumothorax

Manifestations+ tructures in the mediastinal space shift to$ard the opposite side of the chest* Distention of nec! veins Intrapleural pressure u%cutaneous emphysema exceeds atmospheric #linical signs of shoc! pressure*

Partial/total loss of lung function -ypoxemia Life threatening