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Pneumothorax is the presence of gas in the pleural space.
Tension pneumothorax usually occurs during mechanical ventilation or resuscitative efforts.
Treatment involves placing a thoracostomy tube.
Pneumothorax mean air within the cavity that houses the lung. The ribs and their muscles form an expansile and closed structure for the lungs. Normally, the air should be in the small spaces within the lung. Tension pneumothorax means there is progressive pressure due to increasing air locked behind the rib cage and its muscles. Most common causes of this air-trapping would be trauma, and medical procedures that insert tubes into the thorax.
Shock means very low to absent blood perfusion. Since the heart is next to the lungs, if there is pressure within the cavity that houses the lung - this will impose pressure on the heart as well. Since the heart is inadequately pumping- this leads to shock.
Tension pneumothorax must be treated emergently, by relieving the pressure buildup.