Pneumothorax and Pleural Effusion

• Pneumothorax


  Presence of air in the pleural space
• Pneumothorax: Types

  • Open - sucking chest wound
• Pneumothorax: Types

  • Closed - intact pleura
• Pneumothorax: Types

  • Tension - mediastinal shift, tracheal deviation to unaffected side
• Pneumothorax or pleural effusion: Hyperresonance

  Pneumothorax
• Pneumothorax or pleural effusion: Dull resonance

  Pleural effusion
• Open pneumothorax emergency intervention:

  Cover the wound with occlusive (petroleum gauze) dressing and tape on 3 sides
• Pneumothorax and pleural effusion cause lungs collapse
• Definitive management is chest tube insertion or thoracentesis to reexpand lungs.
• Pleural Effusion 


  Presence of fluid in the pleural space, greater than 15 mL
• Pleural effusion: Types

  • Hemothorax - blood
• Pleural effusion: Types

  • Pyothorax or Empyema - pus
• Pleural effusion: Types

  • Hydrothorax - water
• Pleural effusion: Manifestations

  • Chest pain during inhalation
  • Dyspnea and diminished breath sounds
  • Decreased fremitus
  • Dull resonance on percussion