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restrictive diseases -> lung can't expand, inspiration problem,volume
obstructive are -> airways narrow, can'texpire
pneumothorax is^ a^ restrictive^ lung diseas.
it is the^ presence of air in the pleural cavity
piopneumothorax is pus and^ air
insection
Actiology/ causes:
1. primary (simple) spontaneous
-comes suddenly withoutpathology
affects tall, slender males - rare
Small cystcan make apical part burst
2. Secondary Spontaneous
comes bec^ of^ another^ diseas-common
raptured of^ emphysematous bullae^ (ballon)-copd (lungs hyperinflat)
· Rapture of^ Subpleural is
raptute of^ lung abscess
bronchial carcinoma
pulmonary infraction,^ asthma,^ ARDS
Mechanical ventilator patients
- Sarcoidosis, pneumonia, (^) cystic fibrosis
3.Traumatic
-common
penetrating wounds...^ fracture^ ribs,^ crush^ injury,^ faultin^ tracheostomy
Types of^ pneumothorax:
1. closed spontaneous
air goes from lung to pleura if there is a burst.
pleura heals^ and^ closes^ - airwashes^ out^ from^ plural over^ time^ - notdangerous
cause-primary pneumo.
asymptomatic.
2. Open spontaneous
-communication between^ bronchus^ and pleura. result in a bronchopleural fistula
air goes directly to pleura - intraplemual press - tillatmospheric press-to intrapulmonary
preventthe^ re-expansion^ of^ collapsed^ lung
-structures shiftto opposit side
3.Tension (^) (valuular) (^) pneumothorax:
-can keep on breathing
- dangerous -> Most^ common
communication between^ pleura and^ lung
air goes to pleural cavityin inhaltion -> can'tleave -> compress other structures -> intrapleural press More^ than atmospheric
·heartshills (^) - pleura of (^) damaged (^) lung expands clinical (^) symptoms and (^) signs: symptoms-> (^) subjective patienttells^ what's^ wrong:dyspnea, pleuratic chest^ pair signs -objective therapist^ detects^ objective physical signs:
- (^) Cyanosis (^) (lung compressed -> Notalot of (^) a
- Nasal^ having -> notgetting on
3. Accessory m.^ becomes^ prominent
- Thoracoabdominal (^) breathing pattern
5. inspep ratio 1 : 1
1. Asymmetrical chest
inspection and^ palpation:
1. Trachea shifts to oppositside
2. Tactile fermits -> absent -> sound doesn't travel
- (^) resonance-hyperresonance (percussion assessments^ ->other side,^ no sound
4. Anscultations no breath sounds, nowheet, no crackles
- absent (^) bronchophony -^ don't^ do^ egophony, we dont do in (^) pneumothorax
J. Chestexpansion decrese.
on chest^ X-ray:
-full chest, Medashium shifts
Treatment:
pain... Morphine
-Of therapy
- percutaneous aspiration intercostal tube (^) draingle-putother^ side in water (^) (so air cantcome (^) in, water ceased (^) drainage chamber, (^) lateraly (P (^) intercostaland
-pleurodesis (Medication^ to make pleurals collaps on each other)
