Question

32. Atelectasis is a collapsed lung. Explain how a pneumothorax miaht result in atelectasis and what should be done to resto the negative pressure of the pleural cavity. 33. Pectus excavatum is a condition in which the anterior thoracic cage is caved inward because of abnormal development of the sternum and ribs. What effect would you expect this condition to have on vital capacity, and why?

Answer 1

32 Ans) Pneumohorax results in a condition called Atelectasis both are involed in Lung collapse.

A pneumothorax occurs when the pleura is punctured, and air becomes trapped in the thoracic cavity, the resulting pressure collapses the lung. To restore the negative pressure, an incision through the chest wall is made to release the air.

Atelectasis results from a blocked airway or pressure outside the lung the causes includes:

• Foreign object in the airway
• Tumor
• Mucus plug
• Lung disease
• Infection
• Fluid buildup around the lung
• Air buildup around the lung

Pneumothorax results from Atelectasis i.e. air from the lung fill the area surrounding the lung. This is usually because of a puncture of the lung from a variety of injuries, including:

• Car accident
• Fall
• Stab wound
• Gunshot
• Surgical injury

Sometimes Pneumothorax occurs without detectable cause. It is more common in people with chronic lung disease, such as chronic obstructive pulmonary disease (COPD).

To restore negative pressure of Pleural cavity following methods are followed:

Normally, the pressure within the pleural cavity is slightly less than the atmospheric pressure, in what is known as negative pressure. When the pleural cavity is damaged/ruptured and the intrapleural pressure becomes equal to or exceeds the atmospheric pressure, pneumothorax may ensue.

Physical tests include are performed for the manifestation of Negative pressure of pleural cavity,

• X-ray: A chest X-ray can identify the presence of blockages or fluids creating pressure.
• Computed tomography (CT) scan: This test combines X-ray and computer technology to produce detailed cross-sectional images of your chest cavity.
• Bronchoscopy: An endoscope (a thin, flexible tube with a light and camera on the end) is inserted into your airway to check for blockages.
• Arterial blood gas: This blood test checks the amount of oxygen and carbon dioxide in your blood and measures your blood’s acidity.
• Pulse oximetry: An oximeter measures the amount of oxygen in your blood with a sensor that’s clipped onto your finger.

A chest tube must be inserted to drain blood and air from the pleural space so it can return to a state of negative pressure and function normally. Commonly, surgery is needed to close off whatever injuries caused the blood and air to enter the cavity.

33 Ans). Pectus excavatum is a malformation of the chest wall in which several ribs and the sternum (breastbone), grow abnormally, resulting in a caved-in, or sunken appearance. It is a relatively common congenital deformity and occurs more often in males than in females.

Usually, the ribs and sternum go outward at the front of the chest. With pectus excavatum, the sternum goes inward to form a depression in the chest. This gives the chest a concave (caved-in) appearance, which is why the condition is also called funnel chest or sunken chest. Sometimes, the lower ribs might flare out.

Effects of Pectus Excavatum on Vital Capacity:

The vital capacity is the quantity of air a person is capable of expiring after the deepest possible inspiration. Pectus excavatum have negative effect on Vital Capacity because inward bending of ribs, Lung capacity may be curtailed because lungs are confined and cannot properly expand. Vital capacity impairs (reduces).

• Vital capacity will decrease because the deformed ribcage limits the volume of air that can be inhaled. air is taken into the lungs.
• An adequate chest drainage system aims to drain fluid and air and restore the negative pleural pressure facilitating lung expansion. The aims for an adequate chest drainage system are to drain fluid and air, prevent these from returning back into the pleural cavity, and restore the negative pleural pressure facilitating lung expansion.

Reasons for impairment in Vital capacity:

Pectus excavatum compensates by engaging the diaphragm in breathing in order to enable the lungs to expand more and obtain adequate oxygen and carbon dioxide exchange for the demands of the body. The additional energy utilized for breathing in this manner contributes to fatigue. Those with severe pectus excavatum often notice that they are incapable of similar levels of activity as others. This is because of the inward bendinding of thoracic cage results in the diaphragm side reduction followed by improper Expiration and Inspiration.

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