Pneumothorax is a collapsed lung that occurs when air leaks into the space between the lungs and chest wall. It can be caused by chest injuries, lung diseases like COPD, mechanical ventilation, or ruptured air blisters in the lungs. There are three main types: open pneumothorax involves an open chest wound, closed pneumothorax has no chest wound, and tension pneumothorax traps air in the pleural space. Symptoms include chest pain and shortness of breath. Treatment involves placing a chest tube to drain air and re-expand the lung.

1. Pneumothorax
-HiteshRohit(3rd yearB.P.T.)

2. INTRODUCTION:-
• A collapsed lung.
• This condition occurs when air leaks into the space between the
lungs and chest wall(pleura).
• Approximately 40% of pneumothoraces are traumatic (due to
chest wall trauma or iatrogenic procedures).
• Spontaneous pneumothorax occurs without a precipitating
event in individuals with preexisting lung disease.

3. • The air pushes on the outside of your lung and makes it
collapse.
• Pneumothorax can be a complete lung collapse or a collapse
of only a portion of the lung.

5. CAUSES:-
• Chest injury-
• Any blunt or penetrating injury to the chest,
• Injuries during physical assaults or car crashes,
• Injuries during medical procedures,i.e. insertion of a needle
into the chest.
• Ruptured air blisters- Small air blisters (blebs) can develop on
the top of the lungs. These blebs sometimes burst-allowing air
to leak into the space that surrounds the lungs.

6. • Lung disease - COPD, pneumonia and cystic fibrosis
• Mechanical ventilation - A severe type of pneumothorax can
occur in people who need mechanical assistance to breathe.
• The ventilator can create an imbalance of air pressure within
the chest. The lung may collapse completely.

7. TYPESOFPNEUMOTHORAX:-
• There are three types of pneumothorax-
• 1)open pneumothorax
• 2)close pneumothorax
• 3)tension pneumothorax

8. • 1)Open pneumothorax
• Open pneumothorax occurs when air gets into the pleural
space from an injury to the chest.
• An open pneumothorax means the air in the pleural space
communicates freely with the outside environment.
• When air can move freely through the chest wall, into and out
of the pleural space, the patient is unable to maintain a
negative pleural space pressure.(plu. Pressure= atm. Pressure)

9. • Because an effective negative pleural space pressure cannot
be maintained in both the affected and unaffected hemithorax,
the patient’s ability to move air into the lungs is severely
diminished.
• Lung volumes are decreased, lung compliance is decreased,
ventilation–perfusion mismatching is increased, and gas
exchange is impaired.

10. • 2)Close pneumothorax:-
• Closed pneumothorax is when air or gas gets in the pleural
space without any outside wound.
• This sometimes happens when the lung is already injured
somehow, like from diseases such as cancer or cystic fibrosis.
• Pleural pressure is negative.

12. 3) Tension pneumothorax:-
• Air trapped into pleura due to leak in pleuralspace.
• A tension pneumothorax means air can enter the pleural space
but cannot escape into the external environment.
• This is an acute life-threatening situation.
• As air continues to enter and become trapped in the pleural
space, the intrapleural pressure rapidly increases.
• This causes the lung on the involved side to collapse.
• The mediastinal structures are pushed away from the affected
side.

13. • The increased thoracic pressure causes a decrease in venous
return, cardiac output falls, and systemic hypotension and
shock are the result.
• Lung volumes are significantly reduced, lung compliance is
decreased, and the alveolar-capillary surface area available for
gas exchange is cut by more than 50%

14. CLINICALPRESENTATION:-
• A steady ache in the chest
• Shortness of breath/dyspnea
• Breaking out in a cold sweat
• Tightness in the chest
• Cyanosis
• Severe tachycardia
• Hypotension

15. DIAGNOSIS:-
• Possible deviation of mediastinum toward contralateral side
• Decreased or absent breath sounds with decreased or absent
vocal fremitus on the affected side
• Abnormal chest x-ray showing dense-appearing underlying lung
tissue; thin, fine line at periphery;
and uniform translucency with complete absence of lung markings in
area of pneumothorax;
possible overexpansion of the affected rib cage with
flattening of the hemidiaphragm if pneumothorax is large.

18. TREATMENT:-
• The definitive treatment of an open pneumothorax is the
application of an airtight, sterile dressing over the sucking
chest wound and the placement of a chest tube into the pleural
space of the affected hemithorax.
• The chest tube is connected to suction so that the air and any
fluid or blood within the pleural space can be evacuated.
• These measures will reexpand the collapsed lung.

19. • Mechanical ventilation and supplemental oxygen may be
required until the patient can maintain tissue oxygenation
independently.
• A tension pneumothorax is treated as an emergency by
inserting a needle into the pleural space to allow air to escape.
• This is immediately followed by placement of a chest tube
connected to suction so that air can be continuously evacuated
from the pleural space along with any blood or fluid.

20. • Pleurodesis in patients with repetitive pneumothorax
(a procedure which obliterates the pleural space to prevent
future pneumothoraces)