chest

Question 1

1.what is it?

S& S of tension pneumothorax

Answer 1

-complete collapse of the affected lung from a hole puncture where pressure displace mediastinum into opposite pleural cavity, vessels may be deformed nad intrathoracic pressure may reduce venous return

• absent breathe sounds on affected side
• narrowing pulse pressures
• JVD
• tracheal deviation
• Tachypnea (rapid breathing)/Tachycardia/ severe Dyspnea (SOB)
• hypoxia
• accessory muscle use
• hypotension
• anxiety

Question 2

pericardial tamponade and S&S

-management

Answer 2

• fluid inside pericardium
• JVD
• weak pulses
• pulsus paradoxus (arge decrease in systolic blood pressure and pulse wave amplitude during inspiration.
• high flow O2 (BVM as necessary)
• cardiac monitor
• pericardiocentesis (fluid aspiration from heart)

Question 3

hemothorax

• how it occurs
• amount of blood it can hold
• where blood came from
• treatment

Answer 3

• blood fills the pleural space
• due to lacerated blood vessel in thorax (can be torn from broke rib)
• vol of blood increase in lungs and put pressure on heart and great vessels
• can develop tension hemothorax
• hemi-thorax can hold 1.5 liters each lungs
• blood from blood vessels aurrounding
• chest tube tx

Question 4

1. rib fractures can cause

2. signs of rib fracture

Answer 4

1. pneumothorax, tension pneumothorax, hemothorax, hemopneumothorax
2. subcutaneous emphysema (crackly feeling under skin from air escape from lung to chest wall).
   - presence of subcutaneous air equal pneumothorax until proven otherwise
   - pain

Question 5

symptoms of rib fracture

-treatment

Answer 5

1. localized tnederness
2. pain on breathing

• tx:
  1. pain control
  2. sling
  3. bulky pillow dressing

Question 6

Flail chest & treatment

Answer 6

• 3 or more rib fracture in 2 or more places (sternum may)
• chest wall segment detached
• causes paradoxical motion

treatment:

• resp support
• O2
• assess pneumothorax possible?
• pain control
• bulku dressing pad

Question 7

traumatic asphyxia & management

Answer 7

or Perte’s syndrome, is a medical emergency caused by an intense compression of the thoracic cavity, causing venous back-flo

• blood driven into neck, brain
• swelling & ecchymosis of neck & face
• petechial rash
• cyanosis in the face/neck
• hemorrahge in the sclera of eyes

management

• high conc O2
• PPV as needed

-

Question 8

1cardiac contusion S&S

2. pulmonary contusion

Answer 8

1. heart bruise
   - chest pain
   - crepitation
   - tachycardia
   - irregular pulse
2. lung bruise develop over hours, provide resp support and supplemental O2

Question 9

Commotio cordis

• cause
• management

Answer 9

agitation of the heart”) is an often lethal disruption of heart rhythm that occurs as a result of a blow to the area directly over the heart (the precordial region), at a critical time during the cycle of a heart beat causing cardiac arrest

• blunt trauma to chest
• young males
• cardiac arrrest
• cpr
• defibrillator