Pneumothorax and Atelectasis: Similarities, Differences & Causes

Pneumothorax and Atelectasis: Similarities, Differences & Causes
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  • 0:43 Pneumothorax
  • 3:59 Atelectasis
  • 6:01 Lesson Summary
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Lesson Transcript
Instructor: Artem Cheprasov
This lesson will discuss two conditions, both of which are sometimes called a collapsed lung, that have some similarities and some major differences. These two conditions are known as pneumothorax and atelectasis.

Commonly Confused Terms

Let's face it. We all sometimes use an inappropriate word, like 'they're' instead of 'their,' by accident. Sometimes we even get similar-looking or -sounding terms confused in terms of definition, like 'ascent' and 'assent.'

Of course, if you make this mistake of coming up with the wrong word at the wrong time, you can just hit the backspace and be done with it. No harm done. But if you do this in a medical setting, then you're setting yourself up for some trouble.

This lesson will discuss two often-confused conditions, both of which have been called a collapsed lung. You'll notice that both cause difficulty breathing and may be a result of trauma, but the differences of what they actually are are quite stark.

What Is a Pneumothorax?

The first condition that is sometimes called a collapsed lung is known as a pneumothorax. A pneumothorax more technically is air in the pleural space. The pleural space is the space between the visceral pleura and the parietal pleura. The visceral pleura is a thin membrane that covers the lungs, and the parietal pleura is a thin membrane that covers the inside of the chest wall. The space between the two is known as the pleural space.

Another way of thinking about this is by cracking open something like a walnut. The nut itself, with its bilobed nature, actually reminds me of the two lungs sitting inside of the hard and protective chest cavity. That brown covering you can scrape off of the surface of the nut itself is like the visceral pleura. The inside lining of the hard shell can also be scraped off with your fingernail, and that's like the parietal pleura.

Long story short, there should be no air in the pleural space. The absence of air in the pleural space establishes a pressure gradient within the chest that allows for lungs to inflate. But if air enters this space, the pressure gradient is broken. This means the lung is unable to expand against the pressure the air is exerting upon the lung from the pleural space.

There are two main reasons for why air would find its way into the pleural space. The most easily understood explanation is introduction of the air from outside of the body. For example, if a sharp object punctures your chest wall, it creates a hole through which air can enter into the chest.

However, air can enter inside the pleural space from the lungs themselves. If, for example, mechanical ventilators force too high a pressure of air into the lungs, then this may cause one or more air sacs (alveoli) to burst open. In this case, the air entering into these air sacs as you breathe in will leak from the lungs and into the pleural space, resulting in a pneumothorax.

Shortness of breath, a.k.a. dyspnea, and chest pain may be indicative of pneumothorax, and prompt medical attention should be sought. While clinical signs and obvious things, like gaping holes in someone's chest, are clues to a pneumothorax, a chest X-ray (radiograph) should be taken as well. It will reveal a lung that looks like it has shriveled from a big inflated balloon into a little deflated one. This results in increased radiolucency, or darkness, on a radiographic film in the space where the lung should be inflated all the way up to in normal patients.

Treatment varies from doing nothing at all in a very small pneumothorax all the way up to inserting a needle connected to a syringe or inserting a tube into the chest all in order to literally suck out the excess air in order to re-establish the pressure gradient that existed before and allowed for the lungs to expand normally.

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