Anatomic Alterations
Physical Findings
Imaging
Treatment
Terminology
100
What anatomic alteration would you see with both flail chest and pneumothorax?
Atelectasis
100
What physical findings would you expect to see with both?
Increased vitals, tracheal shift away, cyanosis and diminished breath sounds
100
What would you expect to see on an xray of flail chest?
Broken ribs
Atelectasis
100
What three treatment therapies would you expect to perform with both a pneumothorax and flail chest?
Oxygen therapy
LET
Mechanical ventilation
100
Describe a flail chest
Double fractures of at least three or more adjacent ribs, which causes the thoracic cage to become unstable.
200
Define a pulmonary contusion
A bruised lung. An injury to the lung parenchyma leading to edema and blood collecting in the alveolar spaces
200
What are the red arrows pointing to?
Hint: You can feel this on a physical examination
Subcutaneous emphysema
200
Name three x ray findings you could see with a pneumothorax only
Increased radiolucency on affected side
Mediastinal shift to unaffected side
Depressed diaphragms
Lung collapse
200
A patient has a pneumothorax that has been classified at 17%. What treatment would you expect?
Bedrest 15-20%
200
Define paradoxical movement
Normal chest movements of respiration are reversed
300
What is a closed pneumothorax?
When air or gas is in the pleural space without any outside wound
300
What initial blood gas results would a respiratory therapist expect to find in a patient with a mild flail chest?
Increased pH and decreased SaO2
300
What are the arrows pointing to?
Deep sulcus sign
300
What four treatments are recommended for a flail chest?
Analgesia
Bronchial Hygiene
Chest stabilization-Paralytics and PEEP
300
Describe a spontaneous pneumothorax
Occurs suddenly and without any obvious underlying cause
400
Name the four anatomic alterations you would see with a pneumothorax
Lung Collapse
Chest wall expansion (tension penumo)
Compression of great veins
Decreased cardiac venous return
400
What is this image showing?
Tracheal Deviation
400
Which pathology would you expect associated with this xray?
Flail Chest
400
What is a procedure to reduce the occurrences of future pneumothoraces?
Pleurodesis
400
What is an Iatrogenic pneumothorax?
A pneumothorax that occurs during specific diagnostic or therapeutic procedures
500
Name six anatomic alterations seen with flail chest
Double fracture of numerous adjacent ribs
Rib instability
Lung volume restriction
Pneumothorax
Lung contusion
Secondary pneumonia
500
What physical finding would you associate these with?
Cyanosis
500
What surgical correction is this for a flail chest?
Rib plating
500
While assessing a patient with a CDS for an air leak, the respiratory therapist asks him to take a deep breath and cough. As the patient coughs, bubbling occurs in the water-seal column. What does the respiratory therapist conclude
The patient has an intermittent air leak
500
Describe Pendulluft
Transient movement of gas out of some alveoli and into others when flow has stopped at the end of inspiration, or such movement in the opposite direction at the end of expiration