Simple / open pneumothorax vs Tension pneumothorax
How to tell Simple / open pneumothorax and Tension pneumothorax apart when a board question makes them look alike.
Tension is pneumothorax plus obstructive shock physiology; open is defined by chest wall communication.
Side by side
Simple pneumothorax is pleural air without shock or mediastinal shift; open pneumothorax adds a chest wall wound communicating with pleural space.
Pressurized pleural air causes severe respiratory distress, absent unilateral breath sounds, hyperresonance, hypotension, JVD, and mediastinal shift.
Air enters the pleural space and collapses lung without progressive pressure severe enough to obstruct venous return.
A one-way valve effect traps air under pressure, shifting mediastinum and decreasing venous return to the heart.
Pleural line without distal lung markings and stable vitals points simple pneumothorax; sucking chest wound points open pneumothorax.
Shock, worsening distress, contralateral mediastinal/tracheal shift, and unilateral absent breath sounds points tension pneumothorax.
The trap
Tracheal deviation is late; do not wait for it if shock physiology and absent unilateral breath sounds are present.
Watch it explained
The repair move
For pneumothorax, decide whether air is merely present, openly communicating, or pressurized enough to cause shock.
Try a free question
CoreA tall thin young adult has sudden pleuritic chest pain and decreased breath sounds on one side. Chest x-ray shows a pleural line without mediastinal shift, and blood pressure is stable. Which diagnosis is most likely?
Show answer and explanation
Answer: A. Simple pneumothorax. Simple pneumothorax is air in the pleural space without tension physiology or mediastinal shift.
Why the other choices are tempting
- B. Tension pneumothorax causes obstructive shock physiology from pressurized pleural air.
- C. Open pneumothorax requires a chest wall wound communicating with the pleural space.
- D. PE causes vascular obstruction and hypoxemia risk rather than a pleural line without lung markings.
- E. Pleural effusion is fluid in the pleural space.
Flashcards
Tap a card to flip it.
What is the fastest separator for Simple / open pneumothorax vs Tension pneumothorax?
Tension is pneumothorax plus obstructive shock physiology; open is defined by chest wall communication.
What clue should make you choose Simple / open pneumothorax?
Simple pneumothorax is pleural air without shock or mediastinal shift; open pneumothorax adds a chest wall wound communicating with pleural space.
Quick answers
What is the fastest way to tell Simple / open pneumothorax from Tension pneumothorax?
Tension is pneumothorax plus obstructive shock physiology; open is defined by chest wall communication.
What is the key clue for Simple / open pneumothorax?
Simple pneumothorax is pleural air without shock or mediastinal shift; open pneumothorax adds a chest wall wound communicating with pleural space.
What is the key clue for Tension pneumothorax?
Pressurized pleural air causes severe respiratory distress, absent unilateral breath sounds, hyperresonance, hypotension, JVD, and mediastinal shift.
What is the common trap with Simple / open pneumothorax vs Tension pneumothorax?
Tracheal deviation is late; do not wait for it if shock physiology and absent unilateral breath sounds are present.