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Pneumomediastinum occurs due to the escape of air from ruptured alveoli or airways into the mediastinal space. The rupture of alveoli due to increased intrathoracic pressure (e.g., from coughing, vomiting, or trauma) leads to air tracking along the peribronchovascular interstitium which in turn accumulates in the mediastinum.
Pneumomediastinum can also be characterized by the shortness of breath that is typical of a respiratory system problem. It is often recognized on auscultation by a "crunching" sound timed with the cardiac cycle (Hamman's crunch). Pneumomediastinum may also present with symptoms mimicking cardiac tamponade as a result of the increased ...
Hamman's sign (rarely, Hammond's sign [1] or Hammond's crunch [2]) is a medical sign consisting of a crunching, rasping sound, synchronous with the heartbeat, [3] heard over the precordium in spontaneous mediastinal emphysema.
Hamman's syndrome, also known as Macklin's syndrome, is a syndrome of spontaneous subcutaneous emphysema [1] (air in the subcutaneous tissues of the skin) and pneumomediastinum (air in the mediastinum, the center of the chest cavity), sometimes associated with pain and, less commonly, dyspnea (difficulty breathing), dysphonia, and a low-grade fever.
Pneumomediastinum can result from a number of events. For example, foreign body aspiration, in which someone inhales an object, can cause pneumomediastinum (and lead to subcutaneous emphysema) by puncturing the airways or by increasing the pressure in the affected lung(s) enough to cause them to burst. [17]
Unstable patients are managed by operative exploration of the mediastinum. Moribund patients go through an emergency department thoracotomy . This measure is taken because at their arrival in the emergency room, these patients are in such critical condition that they would not survive long enough to be transferred to an operating room.
Monitoring a patient in mechanical ventilation has many clinical applications: Enhance understanding of pathophysiology, aid with diagnosis, guide patient management, avoid complications, and assess trends. In ventilated patients, pulse oximetry is commonly used when titrating FIO2. A reliable target of Spo2 is greater than 95%. [47]
Respiratory sounds, also known as lung sounds or breath sounds, are the specific sounds generated by the movement of air through the respiratory system. [1] These may be easily audible or identified through auscultation of the respiratory system through the lung fields with a stethoscope as well as from the spectral characteristics of lung sounds. [2]