Chapter 29 Flashcards
chest injuries can involve the …, …, and …
may be the result of blunt trauma, penetrating trauma, or both
heart; lungs; great blood vessels
immediately treat injuries that interfere with normal breathing function:
internal bleeding can compress the … and …
air may collect in the chest, preventing …
lungs; heart; lung expansion
the chest (thoracic cage) extends from the lower end of the … to the …
neck; diaphragm
thoracic skin, muscle, and bones: similarities to other regions
also unique features to allow for … such as …
ventilation; striated muscle
the … lies closely along the lowest margin of each rib.
the … covers each lung and the thoracic cavity–> a small amount of pleural fluid between the parietal and visceral pleura allows the lungs to move freely against the … during respiration
neurovascular bundle; pleura; inner chest wall
vital organs, such as the heart, are protected by the … –> connected in the back to the …
connected in the front to the …
ribs; vertebrae; sternum
the … contains the heart, great vessels, esophagus, and trachea–> a … can develop in this area of the chest
the … is a muscle that separates the thoracic cavity from the abdominal cavity
mediastinum; thoracic aortic dissection; diaphragm
the … muscles (between the ribs) contract during inhalation. the … contracts at the same time. they relax during exhalation.
the body should not have to work to breathe when in a resting state
intercostal; diaphragm
patients with a spinal injury below … can still breathe from the diaphragm
patients with a spinal injury above … may lose the ability to breathe
C5; C3
… (minute volume): amount of air moved through the lungs in 1 minute = … x …
patients with a decreased tidal volume will have an increased … rate
minute ventilation
normal tidal volume x resp rate
resp
(chest injuries) closed chest injury:
can cause significant … and …
if the heart is damaged, it may not be able to refill with blood/blood may not be pumped with enough force out of the heart
lung tissue bruising can result in exponential loss of …
… fractures may cause further damage
cardiac; pulmonary contusion; surface area; rib
(chest injuries) in an open chest injury, an object penetrates the … itself–> knife, bullet, piece of metal, or broken end of fractured rib
do not attempt to move/remove object
chest wall
(chest injuries) blunt trauma to the chest may cause:
…, …, and .. fractures
brusining of the .. and …
damage to the …
vital organs to be torn from their attachment in the chest cavity
rib; sternum; chest wall
lungs; heart
aorta
(chest injuries) signs and symptoms: pain at the site of injury localized pain that is aggravated or increased with ... ... to the chest wall ... with palpation of the chest ... injury to the chest ...
breathing bruising crepitus penetrating dyspnea
(chest injuries) signs and symptoms contd:
….
failure of one or both sides of the chest to expand normally with …
…, … pulse
… blood pressure
…a round the lips/fingernails
hemoptysis; inspiration; rapid, weak; low; cyanosis
chest injury patients often have … and .. respirations:
hurts to take a deep breath
patient may not be moving air
auscultate multiple locations to assess for adequate breath sounds
rapid; shallow
primary assess–> airway and breathing:
look for e… of the chest wall
check for … motion
apply occlusive dressings to all penetrating injuries
be alert for decreasing ox sat or impending …
equal expansion;
paradoxical
tension pneumothorax
for isolated chest injury for secondary assess examine … and … aspects of the chest wall and changes in respirations
anterior; posterior
pneumothorax:
commonly called a …
accumulation of … in the pleural space–> blood passing through the collapsed portion of the lung is not …,
you may hear diminished, absent, or abnormal breath sounds
collapsed lung; air; oxygenated
(pneumothorax) type of open chest wound:
often called an … or a … wound
rapidly seal the wound with an … dressing
a … valve is a one-way valve
carefully
carefully monitor the patient for tension pneumothorax
open pneumothorax; sucking chest wound; occlusive; flutter
Simple pneumothorax
Does not result in major changes in the patient’s cardiac physiology
Commonly due to blunt trauma that results in …
Can often worsen, deteriorate into tension pneumothorax, or develop complications
fractured ribs
Tension pneumothorax
Results from ongoing … in the pleural space
Increased pressure in the chest.
Commonly caused by a blunt injury where a fractured rib lacerates a … or …
air accumulation; lung; bronchus
hemothorax:
Blood collects in the pleural space from bleeding around the … or from a … or …
Prehospital treatment
EMT cannot control this kind of bleeding.
Provide rapid transport.
The presence of air and blood in the pleural space is a ….
rib cage; lung; great vessel; hemopneumothorax
cardiac tamponade:
The protective membrane (pericardium) around the heart fills with …or ….
The heart cannot adequately pump the blood.
Prehospital treatment
Support ….
Provide rapid transport.
blood; fluid; ventilation
rib fractures:
common, esp in older people
a fracture of one of the … is a sign of a very substantial MOI
may cause a pneumothorax, hemothorax, or hemopneumothorax
give supp ox
upper four ribs
flail chest:
Segment of chest wall becomes …from the rest of the thoracic cage
Detached portion moves … of normal
Prehospital treatment
detached; opposite
Pulmonary contusion
Suspect in a patient with a …
Pulmonary alveoli become filled with …, leading to hypoxia
Provide oxygen and positive-pressure ventilation.
flail chest; blood
Other fractures
…fractures: Increased index of suspicion for organ injury
… fractures: Possible damage to neurovascular bundle
Suspect …. in medial clavicle fractures.
Be alert to pneumothorax development.
Sternal; Clavicle; supper rib fractures
Traumatic asphyxia
Characterized by …, cyanosis in the face and neck, and hemorrhage in the … of the eye
distended neck veins; sclera
Traumatic asphyxia (cont’d)
A sudden, severe … of the chest
Suggests an underlying injury to the heart and possibly a …
Provide ventilatory support with oxygen, and monitor vital signs during immediate transport.
compression; pulmonary contusion
Blunt myocardial injury
… of the heart muscle
The heart may be unable to maintain adequate blood pressure.
Suspect in all cases of severe … to the chest
Monitor pulse and blood pressure, provide oxygen, and transport immediately.
Bruising; blunt injury
Commotio cordis
Injury caused by a … to the chest during a critical portion of the heartbeat
May result in immediate …
Ventricular fibrillation responds positively to defibrillation within the first 2 minutes of the injury.
sudden, direct blow; cardiac arrest
Laceration of the great vessels May result in rapidly fatal ... Prehospital treatment: CPR Ventilatory support and oxygen Immediate transport Monitor for shock and changes in vital signs.
hemorrhage
