So the whole system works on vacuum. Your lung had what’s called a pleural lining around it which acts as a lubricant. When your diaphragm pulls down it creates vacuum, since it’s a sealed system air comes in your wind pipe. When the diaphragm goes up it forces the air out. So. If you put a hole somewhere else in the system, either from trauma and a rib pokes a hole or from an external puncture (also called a sucking chest wound) then the pleural lining fills with air, collapsing the lung as it fills with more air. Every breath collapses it further.
Speaking from experience as I crashed skiing and my broken rib poked a hole iny lung allowing air to escape into the pleural lining. Literally every breath I was getting closer to death. And yes chest tubes hurt.
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