Pneumothorax: Assessment

Pneumothorax: Air in the pleural space causes partial or complete lung collapse.  Normally, the pleural space is under negative pressure; when air enters, the negative pressure is neutralized, and the lung collapses. Pneumothorax can be caused by trauma, causing air to enter through an opening in the chest wall, or may be spontaneous, causing air to enter the pleural space through a rupture in the lung wall. Tension pneumothorax occurs when air trapped in the pleural space increases, compressing the lung and shifting the mediastinum to the unaffected side.

Assessment findings include:


  • unequal chest expansion. 
  • with a large pneumothorax, the patient will have increased respiratory rate, increased heart rate, anxiety, bulging interspaces, and possibly cyanosis


  • tactile fremitus decreased or absent. 
  • tracheal shift to the unaffected side of the chest. 
  • chest expansion decreased on the affected side.


  • hyperresonant


  • breath sounds decreased or absent 
  • voice sounds decreased or absent

An x-ray of pneumothorax, from the University of Utah