Modifiable factor Modifiable factor

PATHOPHYSIOLOGY 14
Non-modifiable factor Militaries, accidents
Motor/vehicular crashes
Violent behaviour when drunk or under
Figure 1 Direct blow, falls,
Increasing age (>65) drug influence
External compression
Blunt thoracic trauma
Rib fracture Sports/activities and jobs (Softball,
Penetrating trauma
Flail chest kickboxing, wrestling, fraternity,
Pulmonary S/S: construction worker, militaries, Penetration of foreign object
Rib fracture divers)
contusion
Chest wall loses Severe pain, point
stability Pain on respiratory effort Injury to an organ
tenderness, muscle
Lung parenchyma injury and spasm over the area of
Detached part of its capillary network the fracture that is No coughing
the rib segment aggravated by coughing, Pneumothorax Hemothorax
moves in Lung parenchyma injury deep breathing and Tracheobronchial secretions are not mobilized
paradoxical movement, bruise,
manner Serum protein and plasma respiratory insuffiency Traumatic Tension Intercostal artery
Diminished lung secretion Simple
leaks bleeds

Atelectasis and pneumonia Rupture of a bleb or a Laceration of the Lacerated lung

Less air drawn Osmotic pressure happens Blood accumulates
broncho-pleural fistula lung
into the lungs in the pleural space
↑ loss of fluid from the capillaries Air enters the pleural space Blood/air enters Air is drawn into
On expiration,
the pleural the pleural
flail segment
Blood, edema and cellular debris enters the lungs space space
bulges outward S/S:
and accumulate the bronchioles and alveoli Lung collapse

Pleuritic and sudden pain, slight Ball valve mechanism

Impaired Interference with gas exchange S/S: chest discomfort, tachypnea, acute happens S/S
exhalation respiratory distress, anxiety, dyspnea,
↓ breath sounds, tachypnea, Each breath, tension is increased Hypovolemia, ↓
use of accessory muscles, central
tachycardia, chest pain, hypoxemia, within the affected pleural space breath sounds,
cyanosis, severe hypoxemia,
Mediastinum shifts to the blood-tinged secretion, frank dullness on
diminished breath sounds,
unaffected side bleeding, respiratory acidosis, percussion,
Lung collapse
changes in sensorium, cyanosis, dyspnea, ventilator
Paradoxical action results in ↑ dead space, ↓ agitation, frothy bloody secretions, failure,
airway secretions and atelectasis Heart, great vessels and trachea shift
productive cough.
to the unaffected side , ↓ airway
Hypoxemia and respiratory acidosis

Hypotension, inadequate tissue perfusion and

metabolic acidosis