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IV.

PATHOPHYSIOLOGY

1. Schematic diagram

Book Based Pathophysiology:


Precipitating/Modifiable
factors
Non Modifiable / Any Chest Injury • Environment
Predisposing Factors • Exposure to
• Age especially infants Pathologic
• Immunocompromised Allows air to enter Microorganism
• Common Colds the pleural space • aspiration of foods or
fluids
• Lung Disease
• Injury/accidents
Manifestations:
Depends on its size and the • Smoking
integrity of the underlying lung.

Pneumothorax
Penetration into the pleural
space by an object external to Internal Mechanism (such as broken
the chest wall (such ash rib or bleb rupture of the lung) air or
knife/needle) Increase intrathoracic blood enters the pleural space.
pressure and reduction in
vital capacity
Open Pneumothorax
Closed
Large Pneumothorax Pneumothorax
Penetrating
/Non Injury to the chest
Hypoxemia
penetrating or respiratory
injuries structures Air filled bleb/blister
on the lung surface 34
Vasoconstriction of the
blood vessels in the ruptures
affected lung.
Manifestations:
Fractured/ • Ipsilateral chest pain
dislocated Chest Medical Cardio • Inc. in RR
ribs Trauma Procedure pulmonary • Dyspnea
that such as resuscitation Air enters the • Inc. HR
penetrates intra (CPR) pleural space but • Asymmetry of chest
the pleura thoracic does not leave • Hyperresonant sound upon percussion
needle
• Breath sounds decreased/absent over the
aspirations,
Other area of the pneumothorax.
intubation, Rapid increase of
Complication and pressure in chest
Hemothorax positive with compression
pressure atelectasis of Spontaneous
ventilation unaffected lung Pneumothorax

Shift in mediastinum to the


opposite side of the chest and Unknown cause Lung Disease History of
Traumatic compression of the vena cava endometriosis
Pneumothorax with impairment of venous
return to the heart Air filled Trapping
blebs rupture of gases & Air may gain access
on TOP of Destruction to the peritoneal
Intrapleural pressure exceeds atmospheric pressure. the lungs. of lung Cavity during
tissue menstruation and
then enter the pleural
Primary Secondary cavity through
Tension diaphragmatic
Spontaneous Spontaneous
Pneumothorax Defect.
Pneumothorax Pneumothorax

Catamenial
Manifestations: Partial/total Pneumothorax
• Structures in the mediastinal space shift toward loss of lung
the opposite side of the chest. function
• Distention of neck veins 35
• Subcutaneous emphysema
Intrapleural pressure Hypoxemia
exceeds atmospheric • Clinical signs of shock
pressure. Life threatening