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Your lungs don't have muscle in them. They can't pull themselves open. They inflate because the space around them, the pleural space, is sealed and held at a slight negative pressure. When your diaphragm drops and your chest wall expands, that pressure drags the lung open with it. So the whole system depends on the seal — break it, and the lung stops following the chest wall.
That's the mechanism behind almost every injury here. Open pneumothorax is the seal broken from outside. Tension pneumothorax is air building up inside with nowhere to escape. Hemothorax is blood filling that space instead of air. Cardiac tamponade is different — the sac around the heart filling up, not the pleural space. We'll take them one at a time.
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