Introduction
A pneumothorax develops when the lung skin is injured or when the air bubble bursts. A sharp pain is felt locally at the site of the event. Afterwards, the pain disappears again, unless the traumatic event leaves additional painful damage.
When the pleura is punctured, the lung loses its function of developing and adequately filling with air. Those affected experience this as breathing difficulties. Initially, breathing difficulties occur during stressful situations (such as sports or climbing stairs), and later also at rest.
In the case of shortness of breath, the blood can no longer be sufficiently charged with oxygen, and those affected automatically breathe faster (tachypnea) in order to enrich the blood with more oxygen. If this does not succeed, first the mucous membranes of the oral cavity, later lips, fingertips and toes turn blue due to the lack of oxygen enrichment in the blood (cyanosis). Coughing can also occur (especially if there is additional blood in the lungs).
The lungs have a natural tendency to contract. The pleura counteracts this effect by pulling apart at the lungs during inhalation so that air can flow into them. This fur represents a fold, consisting of two leaves, which is filled with liquid in its gap.
Thus, both leaves can adhere to each other, like two panes of glass with water between them. If air enters this liquid gap, the two leaves become detached from each other, the lungs can no longer be pulled apart and purr together. In the case of a pneumothorax, the lung can also be injured, especially if the cause is traumatic.
In this case, additional blood enters the lung. Fluid in the lungs automatically causes coughing, as the body wants to get rid of the invasion as quickly as possible. The trauma that triggers the pneumothorax leads to severe pain in the chest and ribs.
In spontaneous pneumothorax, it is the burst air bubble that also causes pain. Those affected can localize this pain precisely and describe its temporal occurrence. Afterwards the pain disappears again.
Skin emphysema is an accumulation of air in the lowest layer of the skin. The lowest layer (subcutis) is formed by fat, blood vessels and nerves. Air can accumulate here, which is released from air-filled organs or pathologically formed air bubbles.
In the case of a tension pneumothorax, the air that has penetrated cannot leave the thorax. It expands and displaces all surrounding structures. If a valve is not created in time, the air cannot escape. It presses into the lowest layer of the skin to find room. In a tension pneumothorax, this usually occurs in the skin over the tips of the lungs and in the neck area.
