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Related to Tension pneumothorax: flail chest, open pneumothorax


(no͞omōthôr`ăks), collapse of a lung with escape of air into the pleural cavity between the lung and the chest wall. The cause may be traumatic (e.g., gunshot or stab wound), spontaneous (rupture due to disease or localized weakness of the lung lining), or environmental (extreme change in atmospheric pressure). The only symptom may be a sudden pain in the chest. Physical and radiological examination reveals characteristic signs of lung collapse. Simple pneumothorax of only one lung generally requires only rest; the break in the pleura usually heals quickly after collapse of the lung has taken place. In tension pneumothorax (where there is high intrapleural pressure), or if both lungs are collapsed, it is mandatory to remove the air from the pleural cavity immediately. An artificial pneumothorax is one deliberately induced, as in the treatment of tuberculosis of the lung before modern drugs became available, or in the diagnosis of lung disease.
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The following article is from The Great Soviet Encyclopedia (1979). It might be outdated or ideologically biased.



a condition characterized by the accumulation of air or gas in the pleural cavity. Three types are distinguished according to origin: traumatic, spontaneous, and artificial.

Traumatic pneumothorax arises as a result of both open chest wounds, such as knife or gunshot wounds, and closed injuries, with no breaking of the skin; either type of injury is accompanied by rupture of a lung. In an open pneumothorax constant communication is maintained between the pleural cavity and air outside the body. Spontaneous pneumothorax arises as a result of sudden impairment of lung tissue, as with pulmonary emphysema or rupture of congenital pulmonary cysts. In some cases, there may be a flap of lung tissue covering the site of the rupture; this flap functions as a valve to prevent air from returning to the bronchus during exhalation. Such a valvular pneumothorax is accompanied by complete collapse of the lung, which then loses respiratory function, and by displacement of the heart, folding of major blood vessels, and circulatory disturbances.

The main symptoms of pneumothorax are pain in the chest and dyspnea. Auscultation reveals weak or absent respiration on the affected side. Air may also accumulate in the subcutaneous tissue of the chest, neck, face, or mediastinum with characteristic distention and crackling sensation upon palpation; these conditions are called subcutaneous emphysema and mediastinal emphysema. Complications of pneumothorax include pleurisy and hemopneumothorax, which results from the entry of blood into the pleural cavity. First aid for open pneumothorax requires prompt application of a bandage to cover the wound. In valvular pneumothorax the pleural cavity must be punctured and the air removed to prevent the lung from collapsing and the heart from shifting.

Artificial pneumothorax, the intentional introduction of air into the pleural cavity to compress the lung, was proposed by the Italian physician C. Forlanini in 1882. It is now used in the treatment of cavernous forms of pulmonary tuberculosis.


Spontannyi (patologicheskii) pnevmotoraks. Moscow, 1973.


The Great Soviet Encyclopedia, 3rd Edition (1970-1979). © 2010 The Gale Group, Inc. All rights reserved.


The presence of air or gas in the pleural cavity.
McGraw-Hill Dictionary of Scientific & Technical Terms, 6E, Copyright © 2003 by The McGraw-Hill Companies, Inc.
References in periodicals archive ?
Hanrath, "Severe transmyocardial ischemia in a patient with tension pneumothorax," Critical Care Medicine, vol.
To relieve a tension pneumothorax, a 14- or 16-gauge needle with a catheter is often inserted into the 2nd intercostal space along the mid-clavicular line, immediately superior to the 3rd rib to avoid injury to the internal thoracic (mammary) artery.
After review of the literature, the investigators developed the CP instrument relative to the care of patients with battlefield injuries, specifically tension pneumothorax, cardiac tamponade, and hypovolemic shock.
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Clamping the chest tube to prevent blood return is prohibited, as this may result in a tension pneumothorax. Instead, the chest tube drainage system is elevated on an intravenous (W) pole to maintain water seal protection and also keep the blood in the pleural space.
A left-sided tension pneumothorax was treated with a chest tube.
A tension pneumothorax (see Case study 1) occurs when air is forced into the thoracic cavity but cannot escape due to the development of a 'one-way-valve' air leak from the lung or through the chest wall.
In the patient with a tension pneumothorax, most physicians are familiar with the practice of inserting a needle into the pleural space to achieve pleural decompression.
Although RFR has grown to include eight critical steps, the emphasis is still on the treatment of three preventable combat deaths: massive extremity hemorrhage, tension pneumothorax, and airway obstruction.
all of the marines were trained in tactical combat casualty care, and were capable of stabilizing a massive hemorrhage, a tension pneumothorax, an airway obstruction, and other injuries.