Definition

Pneumothorax, defined as the presence of air within the pleural

space
Its classified as either spontaneous or traumatic
Spontaneous pneumothorax occurs without obvious cause and is
subclassified as either primary or secondary.
Primary spontaneous pneumothorax occurs in the absence of
underlying lung disease.
Secondary spontaneous pneumothorax occurs as a complication of
underlying lung disease.
The incidence of primary and secondary pneumothorax is similar,
with both conditions being more common in males than females.
It is more common in younger persons, with a peak incidence in
the third decade of life, and is rare after age 40
Definition
Traumatic pneumothorax, w/c results from direct or
indirect trauma to the chest, is subclassified as either
iatrogenic or noniatrogenic.
Iatrogenic pneumothorax is the most common type of
pneumothorax.
Pathogenesis
Primary spontaneous pneumothorax results from
rupture of subpleural emphysematous blebs.
The blebs tend to occur more commonly in lung
apices.
Although the etiology of the blebs is unknown,
epidemiological observations that identify risk factors
for primary spontaneous pneumothorax offer clues to
processes that may contribute to their development.
These studies indicate that tobacco use, body habitus,
and family history are risk factors for this condition.
Pathogenesis
Airway inflammation, especially due to tobacco use, also
appears to contribute to development of blebs.
The risk of pneumothorax in one study was seven times
higher in male patients who smoked less than 12 cigarettes
per day compared to nonsmokers but 80-fold higher in
those who smoked more than 22 cigarettes per day.
Primary spontaneous pneumothorax is more common in
tall, thin males
Secondary spontaneous pneumothorax may occur in
almost any lung disease.
Chronic obstructive pulmonary disease (COPD) and
Pneumocystis carinii pneumonia are the most common
causes
Clinical manifestation
Onset:
Acute
Precipitate factor:
Expiration
Quality:
Severe
Radiation:
localized to the side of the pneumothorax
Sign & symptom:
dyspnea & chest pain
Timing:
Persistent
Clinical manifestation
Symptoms of primary and secondary spontaneous
pneumothorax are very similar.
Almost all patients complain of either chest pain or
dyspnea and two-thirds have both symptoms.
Dyspnea is more common and severe in patients with
secondary spontaneous pneumothorax due to their
underlying lung disease.
Both dyspnea and chest pain tend to be acute in onset.
The chest pain is usually pleuritic and localized to the
side of the pneumothorax.
Clinical manifestation
Patients typically develop sudden respiratory distress
and agitation and appear to "fight the ventilator.
Physical signs may include marked tachycardia,
tachypnea with labored breathing