Pneumothorax & chest tube final year mbbs lecture
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This document discusses pneumothorax, its causes, signs, symptoms, and treatments. Pneumothorax is the presence of air in the pleural space causing lung collapse. It can be spontaneous due to lung diseases or trauma. A tension pneumothorax causes respiratory distress and tracheal deviation. Chest drains are used to treat pneumothorax, haemothorax, and drain fluids from the pleural space. Placement and care of chest drains is important to prevent complications.
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2. Thymomas are the most common primary mediastinal neoplasm, typically occurring in patients over 40 and appearing on CT as well-defined solid masses in the anterior mediastinum that can demonstrate calcification.
3. CT is useful for staging thymomas and identifying features like invasion of surrounding tissues or distant metastases that indicate more advanced disease.
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- 4. Pneumothorax Collapsed Lung. The Presence Of Air Or Gas In The Cavity Between The Lungs And The Chest Wall, Causing Collapse Of The Lung.
- 5. Pneumothorax (Clinical Points) Shortness of Breath ± Pain. Tall Thin Male. Smoker. History of Travel. Trauma/COPD/Asthma/TB? Breath Sounds? Vocal Resonance? Percussion?
- 6. Causes of Pneumothorax Spontaneous: Primary; Idiopathic / Young Tall Men. Smoking / Familial. Secondary; Lung Diseases (COPD/TB/Asthma/Cystic Fibrosis). Traumatic (Blunt or Sharp Wound). Iatrogenic (Central Venous Catheter Insertion).
- 7. Investigations; Chest X-Ray. CT Scan. D-Dimer. CT Pulmonary Angiography.
- 10. Tension Pneumothorax Respiratory Distress. Tracheal Deviation to Contralateral Side. Ipsilateral Decreased Breath Sounds. Hyper-Resonant. Raised JVP. Displaced Apex Beat. Hypotension.
- 11. Haemothorax Blood Accumulating In The Pleural Cavity. Cause Is Usually Traumatic.
- 13. Massive Haemothorax Drainage of >1500ml blood from chest cavity on insertion of chest drain. Shock. No Breath Sounds. Dull Percussion. JVP Raised? Decreased?
- 14. Treatment (Massive Haemothorax) Simultaneous Drainage of ; Haemothorax. Fluid Resuscitation. Wide Bore (>32 Fr) Chest Drain. Thoracotomy?
- 15. Chest Drains
- 18. Hazards; Damage to Intra-Thoracic Organs. Damage to Neurovascular Bundle. Infection. Subcutaneous Emphysema. Abnormally Placed Tube.
- 19. Care; Post-Procedure CXR. Never Use Trocar. Never Clamp the Drain. Drain Bottle Should Always be Below Chest Level. Pain Management.
- 21. Mr. ABC is 20 years old male with height of 6.5 feet. He has attended the emergency complaining of some left sided chest pain; there was no relief with paracetamol. He has recently made trip to Australia for diving. There is no significant medical or family history. How would you investigate this patient? What signs would suggest a tension pneumothorax? What are the causes of pneumothorax?