[Masaki, Junnosuke, Hiroki, Takeru] What's the similarity between them??
COLLAPSED LUNG = PNEUMOTHORAX
Pneumothorax
Definition
o Presence of air in pleural cavity
o Air can enters pleural cavity through
§ A wound in chest wall
§ Bronchopleural fistula
§ Rupture of alveoli
o Lead to lung collapse
Degree of collapse of lung depend on:
1. Size of opening in pleura
2. Elastic recoil of lung
3. Air way resistance and bronchial patency
Description
§ Normally, the pressure in the lungs is greater than the pressure in the pleural space surrounding the lungs.
§ However, if air enters the pleural space, the pressure in the pleura then becomes greater than the pressure in the lungs, causing the lung to collapse partially or completely.
§ Pneumothorax can be either spontaneous or due to trauma.
§ If a pneumothorax occurs suddenly or for no known reason, it is called a spontaneous pneumothorax.
§ This condition most often strikes tall, thin men between the ages of 20 to 40.
§ In addition, people with lung disorders, such as emphysema, cystic fibrosis, and tuberculosis, are at higher risk for spontaneous pneumothorax.
§ Traumatic pneumothorax is the result of accident or injury due to medical procedures performed to the chest cavity, such as thoracentesis or mechanical ventilation.
§ Tension pneumothorax is a serious and potentially life-threatening condition that may be caused by traumatic injury, chronic lung disease, or as a complication of a medical procedure.
§ In this type of pneumothorax, air enters the chest cavity, but cannot escape.
§ This greatly increased pressure in the pleural space causes the lung to collapse completely, compresses the heart, and pushes the heart and associated blood vessels toward the unaffected side.
Types of Pneumothorax
A. Closed/ Spontaneous Pneumothorax
o Occur when small opening in thoracic wall
o Spontaneous pneumothorax
o Arise when an emphysematous bulla ruptures and partially fills the pleural space with air
o As thoracic wound is closed, some amount of air will remain trapped in pleural cavity
o This air gradually absorbed into venous blood
o Lung temporary collapse 1 - 2 weeks
o Intrapleural pressure is negative
o Cause:
§ Damage of the lungs caused by conditions such as chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis, and pneumonia.
§ Cigarettes smokers (High possibility to get spontaneous pneumothorax
B. Open
o Large opening/ hole
o Air in pleural cavity remains communicating with atmospheric air - Intrapleural pressure remain atmospheric (0 mmHg)
o Lung separates from chest wall and collapses while thorax expands
C. Valvular
o Flap of tissue over hole on lung or chest wall - Acts as valve that allows air entry during inspiration but prevents its escape during expiration
o Intrapleural pressure becomes positive
o Lungs is severely collapsed
o Thorax expand greatly
Symptoms
Symptoms depend on the size of the pneumothorax. In minor cases, you may not realize you have a pneumothorax. In more severe cases, symptoms will develop rapidly and may lead to shock.
Symptoms may include:
· Sudden occurrence of pleural pain
· Shortness of breath (dyspnea), which may be mild to severe, depending on how much of the lung, is collapsed
· Sudden, severe, and sharp chest pain on the same side as the collapsed lung.
· Shock and becomes cyanosed
· A feeling of tightness in your chest
· In open and valvular types, if condition is bilateral, it will be fatal
· A rapid heart rate
· Because a tension pneumothorax can compress the walls of your heart as well as the unaffected lung, heart function may be impaired, leading to a potentially fatal drop in blood pressure.
o Low blood oxygen levels (hypoxemia).
Because a tension pneumothorax causes near or total collapse of one lung and can compress the other, you take in less air and less oxygen enters your bloodstream.
As a result, you develop lower than normal blood oxygen levels.
Lack of oxygen can disrupt your body's basic functioning, and severely low levels can be life-threatening.
o Respiratory failure.
This occurs when blood levels of oxygen fall too low, and the level of carbon dioxide becomes too high.
Severely low blood oxygen can lead to heart arrhythmias and unconsciousness, and high carbon dioxide levels to sleepiness and confusion.
Eventually, respiratory failure may prove fatal.
o Cardiac arrest.
In a tension pneumothorax, the heart is pushed toward the unaffected lung.
This can interfere with the return of blood to the heart and lead to a sudden loss of heart function.
Cardiac arrest is fatal if not treated immediately.
o Shock.
This critical condition occurs when blood pressure drops so low that the body's vital organs are deprived of oxygen and nutrients.
Shock is a major medical emergency and requires immediate care.
Symptoms may become worse with altitude changes (for instance, flying in an aeroplane/ Scuba diving)
Credit to kcybe
Kibou Yell PV: Take a look at the way Hiroki inhaled just after singing his part (Minute 1:00)
Diagnosis
In most cases, a chest X-ray is used to diagnose a pneumothorax. Your health professional may also perform blood tests to measure the level of oxygen in your blood.
A computed tomography (CT) scan or ultrasound may be needed to diagnose the severity of your condition and help plan your treatment.
Treatment
1. Observation.
If your lung is less than 20 percent to 25 percent collapsed, your doctor may simply monitor your condition with a series of chest X-rays until the air is completely absorbed and your lung has re-expanded.
Because it may take weeks for a pneumothorax to heal on its own, however, a needle or chest tube may be used to remove the air, even when the pneumothorax is small and nonthreatening.
2. Needle or chest tube insertion.
When your lung has collapsed more than 25 percent, your doctor is likely to remove the air by inserting a needle or hollow tube (chest tube) into the pleural space.
Chest tubes often are attached to a suction device that continuously removes air from the chest cavity and may be left in place for several hours to several days.
3. Other pneumothorax treatments.
If you have had more than one pneumothorax, you may have treatments to prevent further recurrences.
The most common is a surgical procedure called video-assisted thoracoscopy, which uses small incisions and a tiny video camera to guide the surgery.
This technique leads to less pain and a shorter recovery time than other types of surgery do because the chest cavity can be accessed without breaking any ribs.
However, because no surgery is risk-free, most health professionals will suggest surgery only after you have had more than one spontaneous pneumothorax.
Chances that a pneumothorax will return
If you have had one pneumothorax, you have an increased risk for another.
Nearly all recurrences happen within 2 years of the first pneumothorax.
If you smoke, quitting smoking can reduce your risk of another pneumothorax.
Spontaneous pneumothorax returns in about 20% to 30% of people who don't have lung disease
People with lung disease have a 40% to 50% chance of having another pneumothorax.
Risk factors
1. Your sex
o In general, men are far more likely to have a pneumothorax than women are, though women can develop a rare form of pneumothorax (catamenial pneumothorax) related to the menstrual cycle. Catamenial pneumothorax, which mainly affects women in their 20s and 30s, seems to occur when endometrial tissue - the tissue that normally lines the uterus - spreads to the lungs, pleura or diaphragm.
2. Smoking
o This is the leading risk factor for primary spontaneous pneumothorax; more than 90 percent of people with a primary pneumothorax are smokers or former smokers. The risk increases with the length of time and the number of cigarettes smoked.
3. Lung disease
o Having another lung disease, especially emphysema, makes a collapsed lung more likely.
4. A history of pneumothorax
o If you've had one pneumothorax, you're at increased risk of another, usually within one to two years of the first episode. This is especially true if the first pneumothorax was small and healed on its own.
Prevention
Preventive measures for a non-injury related pneumothorax include stopping smoking and seeking medical attention for respiratory problems.
If the pneumothorax occurs in both lungs or more than once in the same lung, surgery may be needed to prevent it from occurring again.
If you have a pneumothorax, keep your head elevated with pillows and take acetaminophen or ibuprofen, with your doctor’s approval, to lower any pain.
Get plenty of rest and try not to cough.
When traveling in a motor vehicle, always wear a seatbelt to help avoid serious chest injury in an accident.
*:..｡o○☆ﾟ･:,｡*:..｡o○☆*:..｡o○☆ﾟ･:,｡*:..｡o○☆*:..｡o○☆ﾟ･:,｡*:..｡o○☆
Source: Physiology 1st Year Text Book (Physiology Department, Mansoura University), WebMD, OhioHealth, HealthAtoZ, Milton S. Hershey Medical Center Collage of Medicine
Wonder which degree did they suffer...
I guess Takeru might be spontaneous one and not in really serious condition...
Hiroki's one might be serious as he underwent surgery ne?
Not sure for Taguchi and Aiba...
So, tall thin skinny boys should be careful ne...
I hope Taiyou takes care of his health properly...
Credit: Takeru Sato for his own picture lol
P/S: Ask me if you want the scanned pictures without drawing...
Click to view