mechanisms of injury and associated conditions Flashcards
What is a blunt trauma?
when a large surface area of the skin in impacted by a larger object and may not penetrate the skin. This results in the injury pattern being dispersed.
eg, rtc, being struck with objects like a bat, fall from height, compression/crush injury
What is a penetrative trauma?
an object’s entire energy is concentrated on one general area of skin, breaching it; the object will enter the body and create a more localised injury pattern
eg knife wound, gunshot wound, impalement
What are the benefits of determining the mechanisms of injury?
-help determine injury severity
-to develop assessment and treatment plan
-validate clinical findings for further care
-manage/monitor progressive injury
What is the pathophysiology of flail chest?
-A fracture of the ribs in multiple places means a section is completely disconnected, resulting in paradoxical movement of that section during breathing
-often contusion with oedema and some bleeding in adjacent lung tissue
-when flail segment is large, the mediastinum can be pushed back and forth, changing pressures in the thoracic cavity, leading to reduced cardiac output
-hypoxia can result from limited expansion of the lungs
What are the signs and symptoms of flail chest?
visible paradoxical movement of the flail segment,
hypoxia, hypotension
What is the pathophysiology of pneumothorax? What are the different types?
-air enters the pleural cavity causing the separation of the pleural membranes
-this can prevent expansion of the lungs, causing atelectasis
-open pneumothorax is when air enters the pleural cavity through an opening in the chest wall due to trauma. air can leave through the opening.
-a closed pneumothorax is when air enters the pleural cavity from an opening in the internal airways
-tension pneumothorax is when the the opening acts as a one way valve, allowing air in but not out
What are the signs and symptoms of pneumothorax?
-unequal lung expansion
-reduced breath sounds over atelectatic area
-dyspnea, cough, chest pain
-deviated trachea
-hypoxia, hypotension, tachycardia
What is the pathophysiology of heamothorax?
It is a type of pleural effusion when blood collects in the pleural cavity due to trauma or illness such as cancer.
it can cause atelectasis and pressure on the mediastinum
What are the signs and symptoms of heamothorax?
-dyspnea, chest pain, tachycardia, tachypnea
-dullness to percussion
-absence of breath sounds over the affected area
-tracheal deviation
-hypotension
What is the pathophysiology of cardiac tamponade?
-the accumulation of pericardial fluid, blood, pus or air in the pericardium, restricting cardiac filling and decreasing cardiac output
-may be caused by infection, trauma or cancer
What are the signs and symptoms of cardiac tamponade?
-distended neck veins
-tachycardia, hypotension
-chest pain, dyspnea, fatigue, weakness
-faint heart sounds
-pulsus paradoxus: a fall in systolic blood pressure by 10mmhg during inspiration
What is the pathophysiology of aortic rupture?
-can be preceded by aortic aneurysms caused by atherosclerosis, hypertension, infections or trauma
-trauma such as car crashes can cause rupture, can be blunt or penetrative trauma.
-leads to massive blood loss and hypovolemia
What is the mnemonic for limb assessment and what does it stand for?
SLIPDUCT
Swelling
Loss of movement/sensation
Irregularity
Pain
Deformity
Unnatural movement
Crepitus
Tenderness
What is a simple fracture?
A single break in the bone. The bone stays in alignment.
What is a comminuted fracture?
There are multiple fracture lines and bone fragments.
