Chapter 29- Chest Injuries Flashcards
The thin membrane that covered each of the lungs and the thoracic cavity.
Pleura
The muscle that separates the thoracic cavity from the abdominal cavity.
The diaphragm
The nerve that supplies the diaphragm
Phrenic nerve
Where does the phrenic nerve exit the spinal cord?
C3, C4, and C5
Patients with spinal cord injuries at C3, or above can lose their ability to…
Breathe entirely.
Minute volume
The amount of air that enters the lungs within a minute.
Closed chest injury
Injury in which the skin is not broken
If the heart is damaged by contusions it can cause
Cardiogenic shock
Bruising in the lungs can lead to
Less surface area for oxygen and carbon dioxide exchange, leading to hypoxia and/or hypercarbia
Open chest injury
Something that penetrates the chest wall itself.
Signs and symptoms of chest injury
- pain at the site of injury
- bruising to the chest wall
- localized chest pain with increased breathing
- crepitus
- any penetrating injury
- dyspnea
- hemoptysis (coughing up blood)
- failure of one or both sides of the chest to expand normally with inspiration
- rapid, weak pulse and low blood pressure
- cyanosis around the lips or fingernails
Tachypnea
Rapid respirations
Patients with chest injuries often have tachypnea and shallow respirations because…
It hurts to take a deep breath.
Paradoxical potion
The motion of the portion of the chest wall that s detached in a flail chest
Basically the opposite of normal chest wall movements
Occlusive dressing
An airtight dressing that protects a wound from air and bacteria
Questions about the event surrounding the incident should focus on the…
MOI
Pneumothorax
Commonly called a collapsed lung
Condition where air entered through a hole in the chest wall or the surface of the lung as the patient attempts to breathe, causing the lung on that side to collapse.
Absent breathe sounds in chest trauma can indicate
A pneumothorax or a tension pneumothorax.
Open pneumothorax/ sucking chest wound
An open penetrating wound to the chest wall
The purpose of dressing a chest wound is too…
Seal the wound and prevent air from being sucked into the chest through the wound.
Flutter valve
Part of vented occlusive dressing, allows air to leave the chest cavity but not return.
Simple pneumothorax
Any pneumothorax that does not result in major changes in the patient’s cardiac physiology
Tension pneumothorax
A pneumothorax that has progressively increased pressure in the chest that interferes with cardiac function with potentially fatal results.
Patients with a tension pneumothorax will exhibit:
- chest pain
- tachycardia
- respiratory distress
- absent lung sounds
- JDV
- tracheal deviation
Hemothorax
Where blood collects in the pleural space from bleeding around the rib cage or from a lug or great vessel.
Suspect a hemothorax when;
The patient has signs and symptoms of shock without any obvious external bleeding or apparent reason for the shock state
Or decreased breath sounds on the affected side
The presence of air and blood in the pleural space:
Hemopneumothorax
Cardiac tamponade
Occurs when the protective membrane around the heart fills with blood or fluid, compressing the heart and dramatically affecting its ability to pump blood throughout the body.
A condition in which three or more ribs are fractured in two or more places or in association with a fracture of the sternum so that a segment of the chest wall is effectively detached from the rest of the thoracic cage
Flail chest
Pulmonary contusion
Injury or bruising of lung tissue that results in hemorrhage
Always expect this with patients who have a flail chest
A pattern of injuries seen after a severe force is applied to the chest, forcing blood from the great vessels back into the head and neck
Traumatic asphyxia
Myocardial contusion
Bruising of the heart muscle
Commotio cordis
A blunt chest injury caused by a sudden, direct blow to the chest (over the heart) that occurs only during a critical portion of a person’s heartbeat
