Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Trauma > Chest Injuries > Flashcards

Chest Injuries Flashcards

1
Q

what are the most common rib fractures

A

3-8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

if there is a fracture to ribs 8-12 what else may be damaged?

A

spleen, kidney or liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what rib fractures have a high mortality rate and why?

A

1 and 2 because of the forces required to fracture these ribs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the sings and symptoms of fractured ribs?

A 
Pain upon movement
shallow breathing 
crepitus
deformity
local tenderness
hypoventilations 
potential for pneumothorax/heamothorax
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a flail chest?

A

When 2 or more ribs are fractured to produce a free moving segment
causes paradoxical moment when breathing. It can also occur if the sternum is fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the sings and symptoms of a flail chest?

A 
pain with movement 
decreased ventilatory volume 
potential pneumo/heamothorax
lung contusion
potential (flared sternum)
-cardiac tamponade or traumatic asphyxia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is an open pneumothorax?

A

Hole in the chest wall and involves lung collapse on inspiration but expands only slightly on expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

when will air pass through the hole rather than the diameter

A

if the hole is > 2/3 diameter, air passes through it rather than the trachea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sings and symptoms of open pneumothorax

A 
Decreased breath sounds on affected side
respiratory distress
pain 
air bubbling from wound 
heamotomis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do we do with an open pneumothorax?

A

Basics
DRABCD
do not occult the wound
cover with appropriate dressing if required only for heamorrage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a pneumothorax?

A

Air in the plural space which affects lung begins to collapse as pleural space expands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the causes of a pneumothroax?

A

Spontaeous (lung bleb/tall skinny)

Trauma- rib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What history would you expect for a pneumothorax?

A

Sudden onset of pain

SOB on exertion or SOB at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the sings of a pneumothorax?

A 
Pain
Decreased breath sounds not always 
Respiratory rate normal to increased 
Respitroy distress on exertion- at rest
Sometimes unremarkable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the treatment for a pneumothorax?

A

Basics
Monitor vital sings
Respiratory status assessment
Oxygen and pain management if necessary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a heamothroac?

A

Blood in the pleural space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How much blood can each side of the chest hold?

A

2500-3000ml of blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the causes of a traumatic heamothorax?

A

Can come from the damage to any structures in the thoracic cavity: lungs, intercostal vessels, heart
Or abdominal structures (liver, spleen) when the diaphragm is ruptured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are patients at risk for if they have a heamothorax?

A

Heamodynamically unstable due to loss of intravascular volume

  • compromised central venous return due to increased pressure
  • lung compression due to massive blood accumulation
  • respiratory compromise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the sings and symptoms of a heamothroax?

A 
Related more to blood loss than lung collapse
Pain 
resp distress
absent/decreased breath sounds 
blood pressure drop
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the treatment for a heamotorax?

A

Basics
oxygen
Watch PSA and RSA
Hypovolemic heammorage CPG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the three patterns of blunt cardiac injury?

A

Myocardial contusion
Electrical conduction system
Myocardial rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why is the right ventricle usually injured in blunt cardiac chest trauma?

A

because it is located behind the sternum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What may be the only clue that there is a blunt cardiac injury?

A

tachycardia out of proportion with the other injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are the sings and symptoms of a blunt cardiac chest injury?

A 
Chest pain similar to MI
palpitations 
Dysrhythmias
- sinus tachycardia
- PAC/PVC/RBBB/AVNB
ECG changes- ST segment, T-wave
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the treatment for a blunt cardiac chest injury?

A

Basics- DRABCD
Rule out MI prior to motor vehicle collision
watch for ECG changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the pathophysiology of cardiac (pericardial) tamponade?

A

Collection of blood between heart and pericardium

blood can be from coronary arteries or myocardium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How much blood can the pericardiumm hold? when will symptoms start developing?

A

Can hold up to 200ml of blood

SS after about 20-30ml of blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

When does pericardial tamponade occur?

A

In 2% of penetrating injury, rare in blunt force trauma

Can occur when as little as 10-20ml of blood in pericardium

30
Q

What are the sings and symptoms of pericardial tamponade?

A 
Becks train 
Low material blood pressure 
distended neck veins
muffled heart sounds 
tachycardia
paradoxical pulse
narrowing pulse pressures
SS of shock
31
Q

What is the treatment for pericardial tamponade?

A

Basics DRABCD
Administer desil
Be aware of sudden hypotension, bradycardia and PEA

32
Q

What are the main causes of a traumatic aortic disruption?

A

MVA
usually in frontal crashes
falls
caused by fractures in ribs 1-2, sternum or thoracic spine

33
Q

what are the site of aortic ruptures?

A

Isthmus
Ascending and distal depending
Commonly in the ligament arteriosum near distal portion of aortic arch

34
Q

What is the mortality rates of aortic ruptures?

A

80-90% die initially

of those who arrive at hospital will die 90% of the time

35
Q

what are the signs of an aortic rupture?

A

may have little evidence of serious chest trauma
physical assessment findings may rarely be helpful
weak leg pulses with elevated pressure in the arms may be present
signs of shock

36
Q

what is the mamangment for traumatic aortic rupture?

A

if conscious - basics

If unconscious- traumatic cardiac arrest

37
Q

what is the epidemiology of a pulmonary contusion?

A

Most common and lethal chestt injury

Subtle respiratory distress and failure over time which isn’t even dent until 12-24 hours after the injury

38
Q

how is a pulmonary contusion developed?

A

when bruising of the lung occurs due to passive of shock wave through the issue
causes microscopic disruption at air-tissue interface
interstitial and alveoli bleeping tithing the lung
interstitial fluid bu collects between capillaries and alveoli decreasing oxygenation
can lead to repository failure

39
Q

what is other injury usually associated with a lung contusion?

A

A flail segment

40
Q

what are sings and symptoms of a pulmonary contusion?

A

Pain
fine crackles head
dyspnoea and increased respiratory rate (stiffness of the lung)

41
Q

what is the mamangment or a pulmonary contusion?

A

Basics- DRABCDE

- watch for slow deterioration, especially for long transports

42
Q

What is traumatic asphyxiation?

A

crushing chest injury which forces blood out of the right side of the heart and into veins of upper chest and neck
Blood forced into head and neck producing micro-rupture, CVA a seizures and JVD

43
Q

what are the signs of traumatic asphyxiation?

A

cyanosis of head and neck
Profund JVD
Puffy eyes
Protuding eyes

44
Q

what is the management of traumatic asphyxiation?

A

basics

Emphasis on aggressive airway/ventialtion management

45
Q

how many patients with a diaphragmatic injury have other injuries?

A

70-80%

46
Q

what is a traumatic diaphramatic injury associated with?

A

poem/heamothorax, pul wary contusion, and any penetration injury bewow the 4th rib or scapula

47
Q

what causes a traumatic diaphragmatic injury?

A

compression of anterior abdomen wh resulting in abdomen content herniated into the ththorax catchy more commonly in the left side which is more serious

48
Q

what does a traumatic diaphragmatic injury do to the lungs?

A

decreases expansion

49
Q

what are the signs of a traumatic diaphragmatic injury?

A 
Abdominal pain 
dyspnea
decreased breath sounds 
bowl sounds in checks 
signs of shock
50
Q

what is the management of a traumatic diaphragmatic injury?

A

Basics

51
Q

what are tracheal/brachial ruptures associated with?

A

the rupture of other vessels

52
Q

where does the rupture of the trachea/brachials occur?

A

located in the upper trachea, laryngitis or brunch just below the carina

53
Q

how common is a tracheal/bronchial rupture?

A

less than 3% of patients with blunt or penetrating trauma

54
Q

what are the sings and symptoms of bronchial/tracheal rupture?

A

Dyspnea, cyansoso, sere hypoxia, spitting blood, tachycardia, sings of shock, subcutaneous emphysema

55
Q

what is the management for a tracheal or bronchial rupture?

A

Basics

Observe for deterioration

56
Q

what percentage of patient die if they have an oesophageal rupture?

A

nearly 100% fatal in untreated

57
Q

what I mediastinis and why does it occur wth a ruptured oesophagus?

A

swelling and inflammation of the mediations due to leaking stomach fluids

58
Q

what are the signs of an oesophageal rupture?

A

Pain, chocking, coughing blood, vmomiting blood, subcutaneous emphysema

59
Q

what is the management for an oesophageal rupture?

A

Basics and check for other injuries

60
Q

what is the incident rate of integration prehospital tension pneumothorax?

A

between 0.2 and 35%

61
Q

what is the incident rate of prehospital tension pneumothorax in Australia?

A

5.2 and 35%

62
Q

how many patients would you expect to have a tension pneumthorax if you worked for 10 years?

A

one every ten years

63
Q

what are the widespread finding of a tension pneumothorax in a conscious breathing person?

A

Chest pain and respitroy distress

64
Q

what are the general 50-75% findings in patients with a tension pnumothorax who are conscious?

A

tachycardia, decreased air entry on the affected side

65
Q

what are the uncommon/rare <10% findings on a conscious pt with a TNP?

A

cyanosis, decreasing level of conciousnes, tracheal deviation

66
Q

what are the non-consistent fading in conscious TPT patients?

A

Low oxygen saturation

hypotension

67
Q

what are the widespread findings in unconscious ventilated patients with a TPT?

A

Rapid onset, immediate progression to decreased SPO2, immediate reduction in BP

68
Q

What are the general 30% findings in unconscious ventilated pts with a TPT?

A
  • high ventilation pressure

Affected side: Hyper-expansion, hyper mobility and decreased air entry

69
Q

what are the non consistent 20% findings in unconscious TPT patients?

A

Surgical emphysema and venous distension

70
Q

how long does it take for a ventilated patient to tension if they have a pneumothorax?

A

within minutes due to the higher pressures.

71
Q

when is it likely for a pneumothorax to become a tension pneumothorax?

A

In the setting of traumatic chest injury or asthma

72
Q

What are the indications for immediate chest decompression?

A 
SPO2 leas than 90 on oxygen 
BP <90 
RR <10 
Decreased GCS <10 
Cardiac arrest

Trauma (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions