Chest pain and shortness of breath can be symptoms of many complications that require medical treatment. Pneumothorax is one of these complications that can be treated by doctors. Pneumothorax is simply a collapsed lung. A number of things can happen to cause a pneumothorax including: trauma to the chest, previously damaged lung tissue, or the rupture of air blisters called blebs (Mayo Foundation for Medical Education and Research, 2014).
The lungs and thoracic cavity are lined with visceral pleura and parietal pleura respectively. The space between the two layers, called the pleural space, is filled with a lubricant that holds the lungs and thorax together. When a pneumothorax occurs, a hole is made in the lung and air escapes into the
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Trauma includes any blunt force trauma to the chest or surgery involving the thorax. Damaged tissue can be a result of many different lung conditions. Blebs can form for many different reasons and can cause a spontaneous pneumothorax. There are risk factors that increase the chances or having a pneumothorax. Males typically are more likely to have a pneumothorax. Height to weight ratio, age, genetics and several other characteristics can affect the chances of a pneumothorax. One study on spontaneous pneumothorax, studying 214 patients, found the mean age to be 38.8 years of age (Uramoto, Shimokawa, & Tanaka, 2012). An article from Mayo Foundation for Medical Education and Research also says that a pneumothorax is more likely to occur in people ages 20-40 …show more content…
Depending on the severity of the collapsed lung, different procedures may be done to correct it. If only a small portion of the lung has collapsed, observation and periodic chest x-rays may be done to monitor the self-repair of the lung. Oxygen may be given to the patient to help the process. A full collapsed lung will require a chest tube or needle to remove the excess air between the lung and the thoracic cavity. A chest tube will be inserted between two ribs and is often connected to a machine that suctions the excess air out. A needle, also inserted between two ribs, can be used to remove the air from the chest cavity “just like a syringe is used to pull blood from a vein (Mayo Foundation for Medical Education and Research, 2014).” A chest tube may need to be left in for several days before the lung is completely reinflated. During this time the patient would need to be hospitalized. If a chest tube fails, surgery is the next procedure that should be done to repair the lung. If the leak in the lung is large, this is the best way to repair it. Surgery can also help prevent future incident. Tension pneumothorax is the most severe type of pneumothorax because it places pressure on the heart making it difficult for it to beat (Cipolle, Rhodes, & Tinkoff, 2012). This type of pneumothorax can cause death if the pressure is not relieved within a reasonable amount of time. Paramedics are not always trained
Unpleasant breathlessness that comes on suddenly or without expectation can be due to a serious underlying medical condition. Pneumonia can impact the very young and very old, asthma tends to affect young children, smokers are at greater risk of lung and heart disease and the elderly may develop heart failure. However, medical attention always needed by all these conditions as it can affect any age group and severe breathlessnes. There are short and long term causes of dyspnea. Sudden and unexpected breathlessness is most likely tend to be caused by one of the following health conditions. There is accumulating evidence that in many patients, dyspnea is multifactorial in causes, and that in most patients, there is no single, all-encompassing explanation for dyspnea.
Collapsed lungs happen most often as the result of some sort of trauma to the chest. This trauma includes but is not limited to rib fractures, gunshot wounds, knife wounds, or a hard hit to the chest, often the result of car accidents. There are also nonviolent causes for lung collapses, such as damaged lung tissue which is a result from smoking or other unhealthy activities. Unhealthy hung tissue is weaker than healthy lung tissue so it allows the lung to collapse more easily. Underlying undiagnosed medical conditions such as pneumonia, cystic fibrosis, tuberculosis, and lung cancer could also be causes of a collapsed lung. Another possible culprit of a collapsed lung is air blebs, small air filled blisters that present themselves on the outer lining of some people’s lungs. When air blubs rupture, they have the capacity to cause atelectasis.
Imaging: CT scan of the chest dated September 2, 2015, which was personally reviewed demonstrates a subpleural opacity at the right lung apex, which appears to have decreased in size since the last study. The small subpleural opacity of the medial right lung apex with a predominately band like configuration is decreased in size since the last study measuring approximately 1.7 x 0.5 cm in the axial plane on axial imaging 19 previously measuring 1.8 x 0.7 cm. They are certainly a qualitative decrease as well.
A tension pneumothorax can be caused by a blunt or penetrating trauma, in the case study provided it would be a blunt trauma. The trauma to the chest area causes damage to the plural cavity; either the visceral (lines either lung) or parietal plura (lines the thoracic wall), or can be caused by trauma to the traceobronchial tree (Daley, 2014). The trauma to the chest area causes the formation of a one-way-valve, this allows for the air to flow into the plural space on inhalation, but on exhalation cannot be expelled (Curtis, Ramsden, & Lord, 2011). As the trapped air in the lungs build up within the affected side it can cause serious complications. In the case study it is the left lung that is in distress, and as the pressure increases within the left lung it can cause an impaired venus return to the right atrium (Daley, 2014). The increased pressure can eventually affect the right lung as the pressure builds in the left side and causes mediastinal shift which increases pressure on the right lung, which decreases the patients ability to breath, and diffuse the bodies tissues appropriately. The increase in pressure on the left side where the original traum...
Patients with atelectasis will vary in their manifestations, depending on the degree of area affected. Typically, breath sounds will be reduced or diminished on the side of the alveolar collapse and oxygen saturation will be decreased because air is unable to fill the alveolar sacs where the process of ventilation-perfusion is supposed to take place (Lewis et al., 2014). According to Porth (2015), the patient may also exhibit tachypnea, diminished chest expansion, intercostal retractions, dyspnea, and tachycardia. These symptoms demonstrate how the body reacts and its attempt to compensate for the lack of oxygen. This lack of oxygenation to tissues results in cyanosis (Porth, 2015). An individual undergoing such difficulty to breath will present distressed and anxious. A thorough assessment of the patient and presence of some of these manifestations contribute to the diagnosis of atelectasis, which would be supplemented by a chest radiograph for confirmation (Porth, 2015). Most post-operative patients who fall victim to atelectasis and present with the signs and symptoms described, usually have risk factors that increase their probability of acquiring the
Person, A. & Mintz, M., (2006), Anatomy and Physiology of the Respiratory Tract, Disorders of the Respiratory Tract, pp. 11-17, New Jersey: Human Press Inc.
Wildgruber and Rummeny (2012) define tension pneumothorax is a life-threatening condition where air enters the pleural cavity during inspiration but cannot escape during expiration. It is more common in patients with chest traumas and those with mechanical ventilations (Briggs, 2010). Increased the thoracic pressure will compress against the heart and the unaffected lung impairing cardiac functions and ventilation (Pons, & National Association of Emergency Medical Technicians, 2011). Rapid intervention is required to prevent fatal conditions include hypoxia, shock, cardiorespiratory arrest and death (Wildgruber & Rummeny, 2012; Day, 2011; Bethel, 2008).
Pneumonia is an inflammatory response that results in an excess amount of fluid in the interstitial spaces, the alveoli, and the bronchioles. It is caused by the inhalation of organisms or irritants that move into the alveoli when the immune system is not strong enough to combat it. Once these organisms or irritants enter the lungs, they reach the alveoli where they begin to multiply. This multiplication of these organisms results in white blood cells traveling into the area subsequently causing local capillaries to become edematous, leaky, and to create exudate. The combination of this results in thickening of the alveolar wall due to fluid collection within and around the alveoli. Impaired gas exchange, which is the ...
The main symptom of the disease is shortness of breath, which gets worse as the disease progresses. In severe cases, the patient may develop cor pulmonale, which is an enlargement and strain on the right side of the heart caused by chronic lung disease. Eventually, this may cause right-sided heart failure. Some patients develop emphysema as a complication of black lung disease. Others develop a severe type of black lung disease in which damage continues to the upper part of the lungs even after exposure to the dust has ended called progressive massive fibrosis.
In normal breathing, the lungs expand and contract easily and rhythmically within the ribcage. To facilitate this movement and lubricate the moving parts, each lung is enveloped in a moist, smooth, two-layered membrane (the pleura). The outer layer of this membrane lines the ribcage, and between the layers is a virtually imperceptible space (the pleural space), which permits the layers to glide gently across each other. If either of your pleurae becomes inflamed and roughened, the gliding process is impeded and you are suffering from pleurisy. Pleurisy is actually a symptom of an underlying disease rather than a disease in itself. The pleurae may become inflamed as a complication of a lung or chest infection such as pneumonia or tuberculosis, or the inflammation may be caused by a slight pneumothorax or chest injury. The pleural inflammation sometimes creates a further complication by causing fluid to seep into the pleural space, resulting in a condition known as pleural effusion. However, pleurisy is not the only condition that can lead to pleural effusion, it may also be produced by diseases such as rheumatoid arthritis, liver or kidney trouble or heart failure. Even cancer spreading from the lung, breast or ovary can cause pleural effusion. If you have pleurisy, it hurts to breathe deeply or cough, and chest pain is likely to be severe. Accompanying the pain are any other symptoms associated with the underlying disorder. The pain will disappear if a pleural effusion occurs as a consequence of pleurisy, because fluid stops the layers of the pleura from rubbing against each other; however, you may become breathless as the fluid accumulates. In most cases, the risks are those of the underlying cause. A big pleural effusion can compress the lungs and cause breathlessness. Any effusion may lead to empyema. A chest X-ray examination may be required.
The causes of Pulmonary Fibrosis vary from a patient’s occupation to their medical conditions. Pulmonary Fibrosis is caused by environmental factors along with genetic factors. Genetics plays a role in the contraction by determining a person’s vulnerability. A person being in an environment with asbestos fibers, silica dust, grain dust, and bird or animal droppings is at risk for this disease. Patients who also have gone through radiation could be at risk depending on how much the lung was exposed and how long it was exposed to the radiation. Medications can also factor in to the cause of the disease. Chemotherapy drugs, heart medications, and some antibiotics have been linked to Pulmonary Fibrosis. A patient’s previous medical conditions can aid in the formation of this disease such as pneumonia, tuberculosis, scleroderma, and systemic lupus erythematosus. Some other known causes are smoking and lung infection.
Emphysema causes the patient to use more muscles to push the air out of the alveoli which causes barrel chest. Other symptoms that can occur includes shortness of breath and dyspnea that will increase. Circumoral cyanosis and symptoms of right ventricular heart failure can also occur as the disease progresses. Emphysema diagnosis is normally symptomatic, which helps in the proper diagnosis. Emphysema can be diagnosed by patient history and clinical exam, pulmonary function studies and radiologic chest studies also help in the diagnosis. Due to the fact that emphysema is not asymptomatic, the diagnosis is much easier when present in the medical office. Certain signs that doctors look for any breathing difficulties, hypertension, polycythemia, wheezing and barrel chest appearance. Other symptoms that can occur include hepatomegaly, edema, blue-ish discoloration around the mouth and clubbed fingers which encourages treatment options that need to be considered. Drug therapy treatment options for emphysema includes adrenergic sympathomimetic drug or can be used in combination with corticosteroid. Other treatment options include medications for GERD, oxygen therapy and in certain cases surgery could be considered. Treatment methods encourage the patient to avoid any pulmonary irritants, getting their flu shot annually, and pulmonary rehabilitation. Unfortunately, the prognosis for emphysema is very poor. This disease is actually one of the most common causes of death in the U.S.. Prevention of emphysema is basic education about health risk that can occur from long-term smoking. Also parents should make sure to prevent repeated respiratory infection from occurring to limit the
Asthma is a chronic disease that makes it difficult to breathe. The airways to the lungs swell up and become inflamed, which narrows the air passageway to the lungs and the lungs cannot receive the amount of oxygen that it needs. “Mucus builds up inside the airways so you have trouble getting air in and out of your lungs.” (Pope, 2002, p.44). If the lungs do not receive the essential amount of air, it will cause a lot of distress and wheezing to the patient.
Healthy lung tissue is predominately soft, elastic connective tissue, designed to slide easily over the thorax with each breath. The lungs are covered with visceral pleura which glide fluidly over the parietal pleura of the thoracic cavity thanks to the serous secretion of pleural fluid (Marieb, 2006, p. 430). During inhalation, the lungs expand with air, similar to filling a balloon. The pliable latex of the balloon allows it to expand, just as the pliability of lungs and their components allows for expansion. During exhalation, the volume of air decrease causing a deflation, similar to letting air out of the balloon. However, unlike a balloon, the paired lungs are not filled with empty spaces; the bronchi enter the lungs and subdivide progressively smaller into bronchioles, a network of conducting passageways leading to the alveoli (Marieb, 2006, p. 433). Alveoli are small air sacs in the respiratory zone. The respiratory zone also consists of bronchioles and alveolar ducts, and is responsible for the exchange of oxygen and carbon dioxide (Marieb, 2006, p. 433).
Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.