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penetrating chest trauma can be immediately life-threatening and needs urgent medical intervention this is particularly the case where the wound communicates with the chest cavity causing an open pneumothorax potentially collapsing the affected lung the lungs are normally soft and compliant and fill the pleural cavity on inhalation the intercostal muscles lift the ribcage expanding it and creating a negative pressure with an open airway the lung expands to fill the space this is assisted by the muscular sheet known as the diaphragm contracting and flattening also enlarging the chest cavity and expanding the lungs in open pneumothorax a wound creates an open passage between the external environment and the pleural cavity air can potentially pass in and out of the chest cavity through the hole in the chest with the loss of negative pressure in the pleural space which would normally hold the lung in an expanded state the lung on the affected side will now collapse with inspiration the ri
