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Methods 3 B > Chest > Flashcards

Chest Flashcards

1
Q

Immediate life-threatening Chest injuries

A

T. PneumoT
massive haemoT
Cardiac tamponade
open PneumoT
Flail chest & pulm. contusions
Major tracheobronchial injuries

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2
Q

Where should ETT sit?

A

Just above carina

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3
Q

Why are small penetrating wounds bad?

A

can act as valve leading to Tension PnuemoT

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4
Q

Quickest fix for large sucking wounds?

A

Cover to allow ventilation

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5
Q

What can # to 1st or 2nd rib indicate?

A

Aortic/ great vessel injury
Tracheo-bronchial rupture
C spine #
Brachial plexus injury

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6
Q

which ribs are most commonly injured?

A

4-10th

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7
Q

Most common injuries associated with 10-12th rib #

A

hepatic or splenic injuries.

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8
Q

Common MOI for sternal #

and what can be associated with this injury?

A

Front-impact e.g. seat belt or steering wheel.

Aortic compression, dissection or rupture

flail chest

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9
Q

Whats defined as flail chest?

A

3 consecutive ribs broken in 2places or

4 consec ribs in 1 place

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10
Q

Which part of ribs are more unstable?

A

anterior

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11
Q

how can a closed T. pnuemoT occur?

A

Valve mechanism or venae cavae obstructed

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12
Q

what is a open pnuemo T?

A

inability to generate negative air pressure.

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13
Q

what % of Chest trauma leads to pneumoT

A

40

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14
Q

Where does free air collect when Pt is supine?

A

Anterior and medial pleural space, caudally

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15
Q

Tension pnuemoT radiographic appearance

A

Radiolucent lung (affected side)
Flattening of hemidiaphragm (affected side)

Shift of mediastinum and heart (to nonafflicted side).

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16
Q

Tension pnuemoT pt. presentation

A

Decreased breath sounds (in affected hemithorax)

Tracheal shift

Distended neck veins (SVC obstruction).

17
Q

Where does bleeding typically occur in haemoT

A

lacerated low pressure pulm vessels. but life threatening if great vessels involved.

18
Q

Can a haemothorax be left alone?

A

I mean … no treat the damn thing, but there is a chance it could subside on it own

19
Q

Hameothorax radiographic appearance

A

Veiling opacity over one or both lungs

Apical pleural cap

Homogenous curvilinear or crescentic opacity between chest wall and the lung

20
Q

How much blood is needed for a haemoT to be visible on SUPINE CXR

A

300-500 ml

21
Q

What else can be associated with pneumomediastinum?

A

sub. cute. emphysema in cervical region (can follow trachea up)

22
Q

Common trauma for lung parenchyma injuries and pulm contusions

A

Blunt

23
Q

MOI for lung parenchyma injuries and pulm contusions

A

differential acceleration of organ and tissue produces shearing force
* disruptive forces occur at gas-fluid interfaces
* rapid compression and expansion of gas bubbles
rupture the alveoli

24
Q

What else can sometimes be seen with lung parenchyma injuries and pulm contusions

A

air bronchiogram

25
Q

What can also develop with lung parenchyma injuries and pulm contusions

A

ARDS

26
Q

Why do heart or great vessel injuries typically hvae 75-80& mortality rate?

A

Tamponade and exsanguination in heart

and rupture or dissection in G vessels (can be laceration or blunt )

27
Q

What to look for on CXR for Aortic injury?

A

Right sided deviation of the trachea
* Widening of the mediastinum
– >9cm above the level of the carina – >25% of the width of the chest
* Blurring of the contours of the aortic arch * Depression of the left main bronchus
* Apical pleural cap

28
Q

type of injury that a
aortic injury associated with

A

Sternal / rib # from deceleration

29
Q

How can diaphragm be injured?

A

Penetrative wtih other viscera dmg.

or blunt trauma -> abdo compression from another abdo injury,

30
Q

Which diaphragm is typically more likely to be injured?

A

Left (90:75) due to liver absorbing impact on right.

31
Q

What considerations might you have with oesphageal injuries?

A

gastrografin swallow instead of barium as most of these injuries are typically penetrative.

32
Q

Radiographic appearance of damaged diaphragm

A
  • pleural effusion
  • lack of definition/basal opacity
  • elevation of the diaphragm/hemidiaphram

Methods 3 B (5 decks)

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