50. Pneumothorax and Its Types

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Hi guys I am back with another video, so today in this very video we will be understanding about pneumothorax.
But in this video, we will be understanding about pneumothorax and its types
So, what is pneumothorax?
Pneumothorax literally means gas in pleural space.
Pneumothorax can be divided into two parts: spontaneous and traumatic. Spontaneous can be further divided into primary pneumothorax and secondary pneumothorax.
Now let us come to spontaneous pneumothorax:
It can be divided into three types: the first one is closed type, open type, tension or valvular type. So, this is all about the basic meaning and classification,
In the next videos we will be knowing a little bit more details about the types of pneumothorax.
See you in the next video, Thank you!

Open, Closed and Valvular Pneumothorax

Hello friends ,
In this video we will be discussing about
A little bit more details on closed type pneumothorax, open type and tension or valvular type .
So what is closed type ?
The communication between the airway and the pleural space seals off as the lung deflates and does not reopen . So there will be no further airflow to the pleural cavity , that is it’s closed and the pressure here will be negative .
There will be spontaneous reabsorption of Air and reexpansion of lung . Infection is also uncommon.
What is open pneumothorax?
Here the communication between the air and the pleural space will fail to close and there will be continuous flow of air into the pleural cavity and back into the airway .
One classical example is broncho pleural fistula and there is chance of infection from airway to the pleural cavity,
Empyema can occur in this case
What is tension or valvular pneumothorax ?
In this the communication between the airway and the airway space will act as a one way valve and allowing air into the pleural space during inspiration . This causes displacement of the mediastinum , it causes compression of the normal length .

This is all about the basic classification, see you in the next video. Thank you!

Primary Spontaneous Pneumothorax

Hi guys I am back with another video . In this video we will be discussing about the primary spontaneous pneumothorax.
It is when there is no history of underlying lung disease.
Most of the patients of spontaneous pneumothorax are smokers with subclinical lung disease, we can even see this in tall
stature
It causes due to rupture of apical blebs .
Now how do we manage primary spontaneous pneumothorax ?
The large pneumothorax should be managed by aspiration of air .
So this is a quick revision of primary spontaneous pneumothorax

In the next video we will be knowing about secondary pneumothorax and its management.
Thank you!

Secondary spontaneous pneumothorax

Hi guys I am back with another video , in this video we will be discussing about the secondary spontaneous pneumothorax.
So here in secondary spontaneous pneumothorax there will be underlying lung disease .
What does those spontaneous lung disease include ?
They includes:
Copd, Asthma , tuberculosis, asthma , lung abscesses, pulmonary infarcts , lung cancer , fibrotic and the last one is cystic lung disease.
And in COVID 19 , caused by staphylococcus aureus .
Now how do we manage it ?
We can manage it by tube thoracostomy .

In the next video we will be learning about the traumatic pneumothorax. thank you!

Traumatic Pneumothorax

Hello friends ,
In this video we will be discussing about the traumatic pneumothorax.
So what causes this traumatic pneumothorax?
It is iatrogenic
Which includes
chest wall injury
Mechanical ventilation
Trans thoracic needle biopsy
Thoracic surgery

This is all about traumatic pneumothorax, In the next video we will be understanding about tension pneumothorax.
Thank you!

Tension Pneumothorax

Hi friends,
In this video we will be discussing about the last type that is the tension pneumothorax.
So, what is tension pneumothorax?
As we have discussed in the earlier video
the communication between the airway and the airway space will act as a one-way valve and allowing air into the pleural space during inspiration.
So here there will be fall in blood pressure or obstructive shock that is obstruction of the blood flow like impaired venous return.
Now how do we manage it?
We have to insert large bore needle in 5th intercostal space and intercostal drainage in the triangle of safety.
Second is insertion of emergency blunt cannula into the pleural space.
Also, insertion of ICD.
This is all about tension pneumothorax, see you in the next video.
Thank you!

Clinical Features of Pneumothorax

Hello friends,
In this video we will be knowing about the clinical features of pneumothorax.
What are they?
Clinical features are:
sudden onset of pleuritic chest pain
The second one is sudden onset of breathlessness
The third one is absent of breath sound.
On examination the symptoms we can see are:
. Severe hypotension
. central cyanosis
. increase in respiratory rate
. the trachea will be shifted to the contra lateral side
. also, the apex beat will be shifted to the contra lateral side
There will be absent and distant breath sounds.
Now what are the clinical features for tension pneumothorax?
There will be rapidly progressive breathlessness,
Tachycardia, hypotension, cyanosis and tracheal shift.
So, this is all about this video, in the next video we will be discussing about the management or treatment of pneumothorax
Thank you!

Management of Pneumothorax

Hi friends I am back with another video, I hope you all are doing well. Today
In this video we will speak about the management of pneumothorax:
How do we treat pneumothorax?
Now if the lung edge is less than 2 cm from chest wall and there’s no symptom of breathlessness, then no interventions are required.
Now as we have discussed earlier in the previous video in order to manage moderate or large pneumothorax Aspiration of air should be done.
In case of secondary pneumothorax, which is as discussed in earlier video, ICD tube insertion should be done.
We have discussed about the management of tension pneumothorax as well that is insertion of blunt cannula. You can go and check the video.
Now where should we do the ICD insertion? This is important to know,
It is usually done on fourth or fifth or sixth intercostal space and in mid axillary line.
Now this is basically called the triangle of safety, where the insertion of ICD is preferred.
Now what are the boundaries of triangle of safety?
On the anterior side we have pectoralis major
On the posterior side we have latissimus Dorsi
And the base is formed by the fifth intercostal space.
So first we have to insert wide bore needle in the second intercostal space in the midclavicular line,
Followed by ICD insertion in the triangle of safety
we need to attach chest tube underwater seal which helps in removing the fluid from the pleural cavity.
So, this is all about the treatment of pneumothorax, see you in the next video, Thank you!

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