Pneumo's

[Sammy_Jane]

This is a question I had on a exam. I am really confused of the answer that is the "Right" one. So please help me out here.. Why did you say what you did...

I said D: Simple Pneumothorax on the right..Cause the trachea deviated to the unaffected side!!!

Please help me with this....

[chbare]

Tracheal deviation is a late and often ominous sign that would be associated with a tension pneumothorax, if you are going that route.

Take care,

chbare.

[AnthonyM83]

That question's very tricky. I guess it's testing to see if you know the exact definition of each. The way it was taught to me is simple pneumothorax is more the rip itself...the collection of air around the lungs (which could have associate symptoms like chest pain and shortness of breath).

A tension pneumothorax is when the air from an originally simple pneumothorax is or has actively built up around the lung to the point that it's collapsing the lung and pushing other structures in the chest to the side. A sign of this is tracheal deviation (trachea is one of the structures that gets pushed).

You'd be tempted to say D (Right side Simple Pneumothorax), because if it tugs toward the left, then the air (rip) is on the right side...BUT the very fact it's causing tracheal tugging (aka tracheal deviation) means it's progressed from a simple pneumo to a tension pneumo.

So, you'd be incorrect to call it a simple pneumo. It would really be a tension pneumo in the right side....BUT since your only answer with "tension pneumothorax" in it is A (not specificying left or right), you're forced to pick A.

I'm sure that was more wordy than necessary for you to understand, sorry.

[Sammy_Jane]

So then my real question is why does the answer that i got from the answer key say that it is Simple Pneumo to the LEFT? I really do understand that the whole part of the Tension and that was my 2nd choice.....but yea... Still quite confused on why the Answer is really Simple to the LEFT.

[yoyo]

I'd say the answer is wrong! Not like that's never happened before in an answer key - or even a certification exam!

[AnthonyM83]

Is it an online quizz? I found a lot of really bad prep material online....

I'd say it's probably wrong..

[ERDoc]

This is a real nit-picky (-5 for making up my own word). In a tension pneumo you can see deviation of the trachea to the side opposite of the pneumo. The trapped air in the chest is pushing the mediastinal contents to the other side, pulling the trach with it. In a large simple pneumothorax I imagine you would see the trach tug to the collapsed side during inspiration. The reason being that the good lung is inflating while the pneumo side is not so you would see the trach get "tugged" to the collapsed side during inspiration. Just a thought.