Pneumothorax on the USMLE Step 1 exam

Tyler York

In this video Sujata explains the pathophysiology, diagnosis and management of pneumothorax. It is a high yield concept for all steps of the USMLE. Pneumothorax is of four different types and management is guided by the type and severity.

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Full Pneumothorax on the USMLE Step 1 exam video transcript:

Hi everyone. I'm such at the founder of crazy with family and US, Emily alternate achievable

In this video, I would like to go over some important concepts are pneumothorax. So what is pneumothorax? Pneumothorax is the abnormal accumulation of air in the pleural space under physiological. Condition pressure is always negative. When air enters the pleural space, the intrapleural pressure becomes more positive than negative into. Peer pressure is vital to keep the small Airways and alveoli open

It may lead to partial or complete collapse or atelectasis of the lungs with sudden onset of just near tightness in the chest, Florida, chest pain, Because you responded to collapse in tension pneumothorax.

What are the types of pneumothorax? Pneumothorax is a four types. It may be primary secondary traumatic or tension, pneumothorax.

Primary spontaneous pneumothorax is caused by the rupture of Cipro tablets. It is seen, Lee in young tall, and thin individuals and is more common in smokers. It is associated with mutations of the FLC and Gene Gene codes for folicular in which is involved in connective tissue formation.

Secondary spontaneous pneumothorax can be seen with underlying conditions of the land such as bronchiectasis, tuberculosis, asthma-copd excetera some system disorders of connective tissue like other download single Marfan syndrome, rheumatoid arthritis and Ankylosing Spondylitis are common causes of secondary spontaneous pneumothorax as well.

Traumatic pneumothorax can be a result of penetrating trauma to the chest invasive procedures. Like lung biopsy, mechanical ventilation subclavian. Vein catheterization can also lead to pneumothorax.

Tension pneumothorax is a life-threatening disorder, which is caused by penetrating trauma to the chest or the lung the resulting defect acts as a one-way flap wall, that allows the air to get into the Florida, but doesn't allow her to escape as a result are collects in the pleura under high tension.

The positive intrapleural pressure interferes with venous return to the heart. That leads to cardiorespiratory, collapse and shock on physical examination. Breath sounds are absent on the effect of sight. And there is tracheal deviation to the opposite side with mediate mediastinal shift. The point of maximal impulse ships laterally, and jvp is elevated.

The X-ray shows tension pneumothorax on the right, the black shadow on the right is due to air in the pleural space. You can see absence of any kind of lung markings in the area of the pneumothorax, just to the right of the German border. You can see the border of the collapsed lung X-ray. Also shows mediastinal shift towards the left and there is tracheal deviation also towards the left.

Let's review management of pneumothorax management. Will depend on the type and severity of pneumothorax in primary spontaneous pneumothorax. If the size of the pneumothorax is less than 50%. And the patient is asymptomatic, then they can be managed by. Observation alone, severe cases will need a tube for a costume.

In secondary spontaneous. Pneumothorax spontaneous regression is less. Common management is by high-flow oxygen, if the size of the area is 1 cm or less. Then it can be managed conservatively in severe. Cases chest tube drainage or aspiration, correct? Cuz Johnny may be needed. A large bore needle is inserted into the second intercostal space in the middle Caroline as an emergency procedure.

It should be followed by to practice. Tomi, open take tests, you should be used to cover, any penetrating chest wounds

Thanks for watching. Hope you like today's video.
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