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Arthridities - Tri 5 - Trauma - Tommy > Chest Wall Trauma > Flashcards

Chest Wall Trauma Flashcards

1
Q

_______ fractures are a common consequence of trauma and can cause life-threatening complications

A

Rib fractures

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2
Q

What ribs are most commonly fractured?

A

4-10 ribs

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3
Q

Ribs __-__ are associated with high-energy trauma and potential serious complications including vascular, neurological and pulmonary damage

A

1-3 rib

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4
Q

When the rib is fractured twice what term is used to describe the free fracture fragment?

A

floating rib

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5
Q

What three or more contiguous floating ribs are present this is called _____

A

Flail chest

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6
Q

___% of cases are due to MVA, falls, assaults… all blunt trauma

A

50%

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7
Q

What are some other ways that a rib can be fractured?

A
  • Pathologic (mets, myeloma, radiation)
  • Stress fractures (high level athletes)
  • Non-accidental injuries (children - posterior rib most frequently)
  • Cardiopulmonary resuscitation (CPR) (1-3 cases)
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8
Q

1-3 rib fractures most commonly involve what vessels/nerves?

A

Brachial plexus/subclavian A.&V.

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9
Q

10-12 rib fractures most commonly involve what organs?

A

Liver, Kidney, and spleen

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10
Q

What is the most frequent condition to occur in relation to the lungs with rib fracture?

A

Pneumothorax/Hemothorax

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11
Q

Plain film x-rays will miss up to ____% of rib fractures even with dedicated oblique rib projections.

A

50%

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12
Q

What imaging modality is most sensitive to rib fractures?

A

CT

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13
Q

What are the radiographic views performed in a rib series?

A

AP upper/lower
Oblique upper/lower
PA CHEST

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14
Q

Many researchers and radiologists say to get rid of dedicated rib series and to just perform __ and ___ chest radiographs to evaluate what 2 complications?

A
  • Pneumothorax/hemothorax

- Intrathoracic/Pulmonary

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15
Q

In cases of severe trauma CT scanning is required to evaluate ______ complications

A

intrathoracic/abdominal complications

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16
Q

In flail chest, during inspiration, the floating ribs will move where?

A

Posteriorly [into the lung region]

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17
Q

In flail chest, during expiration, the floating ribs will move where?

A

Anteriorly [away from the lung region]

18
Q

Clavicular fractures are common and account for ____% of all fractures

A

2.6-10%

19
Q

The vast majority of clavicle fractures occur in the _____

A

Midshaft [69-82%]

20
Q

Why do the majority of clavicle fractures occur in the midshaft?

A

Thinnest part of the bone [not reinforced by muscle or ligaments]

21
Q

What common carpal fracture mechanism also causes clavicular fractures?

A

FOOSH

22
Q

What radiograph views are required to view a clavicular fracture? Are they easy to identify?

A

AP with Cephalad tilt (15-30 degrees)

Easy to identify

23
Q

Why does the limb sometimes appear displaced?

A

Upper limb weight pulling down, SCM pulling up

24
Q

Comminuted clavicular fractures require what imaging modality?

A

CT

25
Q

Traditionally, midshaft fractures of the clavicle have been treated with what?

A

Immobilization, sling, figure 8 dressing

26
Q

What is the record of non-union rates for clavicular fractures?

A

Low

27
Q

If there is displacement, angulation, shortening (>2cm) or comminution what is the method of treatment?

A

ORIF [for increased union rates]

28
Q

How often to scapular fractures occur?

A

3% of all shoulder fractures

29
Q

What is the usual mechanism of action to develop a scapular fracture?

A

MVA [50%]

30
Q

Where are most scapular fractures located?

A

Through the body [HORIZONTALLY]

31
Q

Due to the high energy trauma that usually causes scapular fractures, what complications may result?

A

Pneumothorax

32
Q

What views are used to assess and identify these fractures?

A

AP, Axillary view, True lateral [lateral is taken to view the glenoid fossa, IMPORTANT]

33
Q

If there is chest involvement from a scapular fracture, what is the imaging modality of choice?

A

CT

34
Q

In approximately 5% of blunt chest trauma, what bony structure is involved?

A

Sternum, manubrium is most common

35
Q

What is a common mechanism of injury?

A

MVA [steering wheel]

36
Q

What view is this best viewed on?

A

Lateral sternal

37
Q

What is the modality of choice for this type of injury? (sternal fx)

A

CT - sagittal is most sensitive for anterior cortical breach and posterior cortical breach.

38
Q

Posterior cortical breach [where the fx site has been displaced posteriorly into the chest cavity] is associated with what types of injuries?

A

Neurovascular and intrathoracic

39
Q

If the sternal fx is severe one would expect what mortality rate?

A

High, due to visceral involvment

40
Q

What is found in 5% of the population that can be confused with a sternal fracture that is a NORMAL ANATOMICAL VARIANT

A

Sternal foramen (perforated sternum) [this is commonly found in the inferior aspect of the sternal body and can LITERALLY be mistaken for sternal fx]

Arthridities - Tri 5 - Trauma - Tommy (3 decks)

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