MEDICAL BIOLOGY, HUMAN ANATOMY, PHYSIOLOGY AND PATHOLOGY - Y.I. Fedonyuk 2010

ANATOMY, PHYSIOLOGY, PATHOLOGY

CHAPTER 6. THE RESPIRATORY PROCESS AND ITS PATHOLOGY

RESPIRATORY SYSTEM DISEASES

PNEUMOTHORAX

Pneumothorax is the accumulation of air within the pleural cavity. It can be caused by trauma, rupture of an emphysematous bulla, lung abscess or cyst into the pleural cavity, destruction of the bronchial wall due to tumor breakdown or a tuberculous focus, etc.

Depending on The Nature of the communication with the external environment, pneumothorax is classified into closed and open. Valvular (tension) pneumothorax is distinguished as a special form.

If the air trapped in the pleural cavity does not communicate with the atmosphere, the condition is referred to as a closed pneumothorax.

In open pneumothorax, There is a free communication between the pleural cavity and the external atmosphere. Compression of the lung by atmospheric air on the affected side leads to The Development of so-called paradoxical Respiration. During inspiration, air enters the intact lung not only from the external environment but also from the lung on the injured side; during expiration, part of the air from the healthy lung flows into the injured lung, causing it to inflate slightly. Thus, in an open pneumothorax, the affected lung performs weak respiratory movements that are opposite to those of the healthy lung.

Valvular pneumothorax occurs when the configuration of the wound tract or lung injury allows air to enter the pleural cavity during inspiration but prevents its escape, as the wound tract is sealed by the surrounding Tissues during expiration (in external valvular pneumothorax) or by lung tissue (in internal valvular pneumothorax). As a result, air accumulates in the pleural cavity, and its pressure progressively increases, leading to tension pneumothorax. This is accompanied by compression of the lung and mediastinal Veins, mediastinal shift toward the healthy side, and severe respiratory and hemodynamic disorders.