case study
Mohammad is a 41-year-old gentleman, unlucky enough to crash his car into a tree at 5.30 am. He smokes a lot but is otherwise healthy. His injuries are significant and include right-sided hemopneumothorax, multiple ribs fractures and cerebral contusions. On arrival to Emergency Department he is very unwell; in severe pain, pale and diaphoretic with decreased level of consciousness. His vital signs are abnormal and arterial blood gases - concerning. The essay below draws on the case study as described above. It consists of three parts that consecutively explain the impact of Mohammad’s injuries and habits on his respiratory function, hemodynamics and arterial blood gases.
Respiratory changes
Normal tidal respiration is a two-phasic mechanical process embracing inhalation and exhalation. Inspiration is produced by contraction of inspiratory muscles, which increases the size of thoracic cavity. The expiration is passive; inspiratory muscles relax. Thoracic cavity corresponds with lungs via pleurae; parietal pleura adheres to the thoracic wall and superior diaphragm and visceral - clings to the lungs. Normally the pleurae can glide against each other but resist separation because of surface tension created by the lubricant - pleural fluid. Therefore when healthy thoracic cavity expands, the lungs are stretched out and opened up and when healthy thoracic cavity decreases in size lungs spontaneously recoil. The opposite forces created by inward pull of lungs (naturally recoiling to the smallest possible dimensions) and outward pull of thoracic wall (inherently stretching out) creates intrapleural pressure that is always negative in respect to that inside of alveoli (intrapulmonary pressure) (Marieb and Hoehn, 2012). Mohammad developed traumatic noniatrogenic, non penetrating haemopneumothorax. Rapid deceleration forces inherent to motor-vehicle crash (MVC) compressed Mohammad chest fracturing his ribs, tearing visceral pleura, rupturing the alveoli and causing
Respiratory changes
Normal tidal respiration is a two-phasic mechanical process embracing inhalation and exhalation. Inspiration is produced by contraction of inspiratory muscles, which increases the size of thoracic cavity. The expiration is passive; inspiratory muscles relax. Thoracic cavity corresponds with lungs via pleurae; parietal pleura adheres to the thoracic wall and superior diaphragm and visceral - clings to the lungs. Normally the pleurae can glide against each other but resist separation because of surface tension created by the lubricant - pleural fluid. Therefore when healthy thoracic cavity expands, the lungs are stretched out and opened up and when healthy thoracic cavity decreases in size lungs spontaneously recoil. The opposite forces created by inward pull of lungs (naturally recoiling to the smallest possible dimensions) and outward pull of thoracic wall (inherently stretching out) creates intrapleural pressure that is always negative in respect to that inside of alveoli (intrapulmonary pressure) (Marieb and Hoehn, 2012). Mohammad developed traumatic noniatrogenic, non penetrating haemopneumothorax. Rapid deceleration forces inherent to motor-vehicle crash (MVC) compressed Mohammad chest fracturing his ribs, tearing visceral pleura, rupturing the alveoli and causing