Lungs Mediastinum◦ Heart◦ Aorta and great

vessels◦ Esophagus◦ Trachea

Diaphragm contracts Moves down Increasing the volume of the

thoracic cavity When the volume increases, the

pressure inside ________.◦ aka?

Pressure within the lungs is called intrapulmonary pressure

Phrenic nerve stimulus stops Diaphragm relaxes This ______ the volume of the

thoracic cavity Lung volume decreases,

intrapulmonary pressure _____.

If two areas of different pressure communicate, gas will move from the area of higher pressure to the area of lower pressure

◦ Parietal pleura ◦ lines the chest wall

◦ Visceral pleura (pulmonary) ◦ covers the lung

Parietal pleura Visceral pleura

Normal Pleural Fluid Quantity: Approx. 10-20 mL per lung

Lung

RibsIntercostal muscles

• The area between the pleura is called the pleural space (sometimes referred to as “potential space”)

• Normally, vacuum (negative pressure) in the pleural space keeps the two pleura together and allows the lung to expand and contract

• If air or fluid enters this space, there is a potential for impaired breathing.

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Diagnostic tests Client position Treatment depends on severity◦ Chest tube◦ Heimlich valve on chest tube

Also called “thoracic catheters ” Different sizes

From infants to adults Small for air, larger for fluid

Different configurations Curved or straight

Types of plastic PVC Silicone

Coated/Non-Coated Heparin Decrease friction

In what setting/environment is a chest tube placed?◦ A. Operating Room◦ B. Bedside◦ C. Emergency Room◦ D. All of the above◦ E. None of the above

Sterile technique Small incision Tube is sutured Dressing applied◦ What type?

Choose site

Explore with finger

Place tube with clamp

Suture tube to chest

Photos courtesy trauma.org\