lecture 11: thoraic injuries Flashcards
3 main groups in chest cavity
pulmonary
vascular
gi tract
where is the scapular
ribs 2-7
spine at t3
where is the lung apex
2.5 cm above clav
where is the coracoid process
lines up w first rub
where is the nipple
level of rib 4
where is the heard
level of hibs 2-6
what are the most commonly injured ribs
5-10
what are the true ribs
1-7
what are teh faslse ribs
8-10
what are the floating ribs
11-12
explain the breathing mecahsism
exhalation: pressure is postive and gases are forced out
inhialtion: oressure in neg so air comes in
what nervers supplies diagphram
phrenic nerve (c345)
if there is an injury to c3 orn above what happens
cannot breath
when diagprah contacts andx relaxewhat happens
chest cavity enlarges reducing pressure (asir rushes in )
then disgaphrm revalxes and pushed out air
if thre is an increase in co2 what happens to breathing rate
increase
chest injuries that go unrecognized can lead to…
1) tissue hypozia
2) hypercarbia (increase co2)
3) acidosis
what is assessment for thoraic injuries
uabcs secondary assessment (observe, palpate, asuticulate, percussion) bitals treatment decision
what ar some observations to look out for
bruses
cyanosis
vein distensioin
open chest wounds
is tracheal deviation an early or late sign
late sign
true ro false: trachean should move inferior on inspiration
true
when you are palmpating you are looking for
tenderness deformtity swelling crepitus emphysema
what si the respiotry breathing assessment
rate deptjh rythm sounds other diagnostic sounds
what is the treatment for anything that affects airway exhange and oxygenation
improve oxygenation and transport rapid
what is the treatment for a major problem that is blood losss
imporove oxygen
shock
rapid transport
whta are some respirtry problems involving blood loss
hemothorax, shear to aorta
athletes with mild contusion may RTp after how long
15 minutes
what are the conditoons for return to play
vitals normal
no pain (refered or interfer)
protection
no respisration alterantion
true or false: respitory distress deveols more rapidly in adults
false in children
what are some common throacic injuries
pectoralis major ruptur clavicle AC/SC speration rib injuries (fracrures, costchondral sep) sternum pnneumothorz
what are signs and symtoms of thoracic injuries
pain at site pain with braathing crepitus dyspnea hemoptysis (coughing blood) cuanosis rapod weak pulse shllow respons low BP
what is the MOI rfor pec rupture
direct trauma
excessive load with partial to full failure
what atre the SS for ruptured PEC
hemmorage, rupture/disfunction
TX for pec major rupture
ice sling rest analgesic (surgery might be needed for complete tear)
what is the most common fractured part of the thoriax
clav
wwhat is the MOI for clavic
FOOSh
lateral shoulder impart
what are the SS for clav
distal third common
easilty palp deformity
what is the treatment for clv fractiure
immobilize
tubular sling, acillary roll, swatche, ice xray
wjat is the MOI for SC joint
direct’indirect impact
bilarteral compression of shoulders
SS of SC joint sepration
tendor to pal
pain w ROM
visible defromtity
breathing issues
if there is onyl mild sepetaoru, what is treatment
immobilize
pier
refer
if severe seperation
ice 911 o2
why is xrrays important for clav sepration
able to see if its pushing on structures
what is costochondral sepratior
discontinution between rib and sternal attachment
will you hear a pop for costchondral sepration
yes
what is the MOI of chostochondral sepration
direct trauma
lateral fall on thorax (rib anterio)
what are the SS for chostochondral sepration
pain on pal[ and inspritation
sjhallow breathing
derfomrinty
giarding
what is the treaatament for chrostchondra
calm, ice, refferal, sling spring etc
whata is the MOI for rib fracatuer
firect truama
true or false: ribs fractures to 1-4 are very common
false
why are rib favtures from 8-12 caution
because at the level of the spleen liver and kidneys
true or false: floating ribs are commonly injured
false
what are the SS for a rib fracture
locaal tendernus sharp [ain crep shallow rbeaths coughing blood flail chest
what is rib fracture treamtment
shock, respirtory effort,
manual supper
ref xray and ref
what is support for ribs thorax
triagnualr badage inside folded towel
apply around affected around and add tubular sling for supprt of arm
what is flail chest
2 or more fractured ribs in 2 or more planes
MOI for flair chest
firect trauma,crush
what is paradoxial breathin
inspiration=contrcts
exhalation’expands
what are the SS for flail cehst
flail, sharp pain. tenderness
crep
pain with inhalation
paradoxial breathing
what is flail chest treatment
911 respitory suppert with bvm
o2
support flair woth bnressing
tue ro false: sternum fracure is more serious tha nthe damage to inderneath
false
what is MOI for sternum
dircet trauma from fall
impact
decleipation
what are SS for sternum
pain on pal
crep
swelling
marfan
what is pneumothorax
air in chest cavity, outside of lungs
what are the 2 types of pneumothorax
open aand closed
what is the MOI for pneumothroax
penetraating injruies
what is another name for open pneumo
sucking chest wound
what is the tramtent for sucking chest wound
non occulsive cause on the hole
what can be used instead of non occulsive dressing
chest seal
what is another name for clsoed pneumothroax
tension
what is tension pneu
further pressure build up since air cannot espace
what can tension pneuthorax lead to
more pressure
eventually affect unijured long
TRACHEAL DEV
true or false: trachel deviation is an early sign
false
