Presented by:

Generalao Ongsiu Portillio Ramos Recio Redillas Roxas Sanchez Taleon

Mr. Z, 30 year old male

Brought to ER due to sudden onset of chest
pain and difficulty of breathing
Condition started as sudden chest pain on
right upper portion
Has to exert too much effort to breath

Chronic smoker
Had lung infection One year ago
Was treated for 6 months with antimicrobials
Non-compliant with the medication
No previous hospitalizations
No major illnesses

Apex beat at 6th ICS anterior axillary line

No heaves
No thrills
Increased rate at 130/min
Normal rhythm
No murmur

There is asymmetrical chest expansion

Hyperresonance on percussion of right lung
field area
No right sound on right hemithorax
No rales nor wheezes on left

Deviation of tracheal shadow to the left

Displaced cardiac silhouette to the left
darker appearance of right hemithorax

trachea (windpipe) has shifted more towards

one side, either left or right
Trachea can shift towards the lung problem
Trachea can shift away from the problem

When pressure within the pleural cavity

increases on one side
the mediastinum (including the trachea)
shifts away from the affected side

Pneumothorax
Pleural effusion
Tumors

When pressure within the pleural cavity

decreases on one side
the upper mediastinum (including the
trachea) shifts towards the affected side.

Atelectasis
Pleural fibrosis
Pneumonectomy
Lung agenesis/aplasia

http://www.radrounds.com/photo/normalchest-xray-and-lung
http://www.healthhype.com/trachealdeviation-causes-of-a-trachea-windpipeshift.html