PULMONARY Traumatic Flashcards
Acute Respiratory Distress Syndrome (ARDS)
A common clinical syndrome of acute respiratory failure as a result of diffuse lung inflammation and oedema. ARDS can be precipitated by a variety of causes. The pathophysiology of ARDS is complex and involves the activation and dysregulation of multiple overlapping and interacting pathways of injury, inflammation, and coagulation, both in the lung and systemically. Mechanical ventilation can contribute to a cycle of lung injury and inflammation. Resolution of inflammation is a coordinated process that requires downregulation of proinflammatory pathways and upregulation of anti-inflammatory pathways
Occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream. This deprives your organs of the oxygen they need to function.
SYMPTOMS: The first symptom of ARDS is usually shortness of breath. Other symptoms of ARDS are low blood oxygen, rapid breathing, and clicking, bubbling, or rattling sounds in the lungs when breathing. ARDS can develop at any age.
CAUSE: The most common cause of ARDS is sepsis, a serious and widespread infection of the bloodstream. Inhalation of harmful substances. Breathing high concentrations of smoke or chemical fumes can result in ARDS , as can inhaling (aspirating) vomit or near-drowning episodes
Airway Obstruction
Also known as foreign body airway obstruction, happens when a small item gets stuck in a child’s throat or upper airway and makes it hard for the child to breathe.
SYMPTOMS: choking or gagging.
sudden violent coughing.
vomiting.
noisy breathing or wheezing.
struggling to breathe.
turning blue.
CAUSE: The airway can become narrowed or blocked due to many causes, including: Allergic reactions in which the trachea or throat swell closed, including allergic reactions to a bee sting, peanuts and tree nuts, antibiotics (such as penicillin), and blood pressure medicines (such as ACE inhibitors)
Atelectasis
A complete or partial collapse of the entire lung or area (lobe) of the lung. It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid. Atelectasis is one of the most common breathing (respiratory) complications after surgery. *A collapsed lung happens when air enters the pleural space, the area between the lung and the chest wall. If it is a total collapse, it is called pneumothorax. If only part of the lung is affected, it is called atelectasis
SYMPTOMS: Difficulty breathing.
Rapid, shallow breathing.
Wheezing.
Cough.
CAUSE: by a blockage of the air passages (bronchus or bronchioles) or by pressure on the outside of the lung. Atelectasis is not the same as another type of collapsed lung called pneumothorax, which occurs when air escapes from the lung.
Infant Respiratory Distress Syndrome
aka Newborn respiratory distress syndrome (NRDS) happens when a baby’s lungs are not fully developed and cannot provide enough oxygen, causing breathing difficulties. It usually affects premature babies. It’s also known as infant respiratory distress syndrome, hyaline membrane disease or surfactant deficiency lung disease.
SYMPTOMS: Fast breathing very soon after birth.
Grunting “ugh” sound with each breath.
Changes in color of lips, fingers and toes.
Widening (flaring) of the nostrils with each breath.
Chest retractions - skin over the breastbone and ribs pulls in during breathing.
CAUSE: a lack of surfactant in the lungs. The lungs of a fetus start making surfactant during the third trimester, which starts after the 26th week of pregnancy. Surfactant is a foamy substance that keeps the lungs fully expanded so that newborns can breathe in air once they are born
Pneumothorax
A collapsed lung occurs when air escapes from the lung. The air then fills the space outside of the lung between the lung and chest wall. This buildup of air puts pressure on the lung, so it cannot expand as much as it normally does when you take a breath. An open pneumothorax describes when an injury creates a hole in the chest wall that allows air from the environment to enter the pleural cavity, whereas a closed pneumothorax refers to air that enters the pleural cavity from the lungs themselves. A closed pneumothorax occurs due to a defect of or damage to the pulmonary parenchyma, the portions of the lungs involved in gas exchange, including the alveoli, alveolar ducts, and respiratory bronchioles. A lung disease – such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, lung cancer, or pneumonia – can be the source of the damage. However, damage can also occur spontaneously in predisposed individuals, a phenomenon called “spontaneous pneumothorax.”
SYMPTOMS: Sharp, stabbing chest pain that worsens when trying to breath in.
Shortness of breath.
Bluish skin caused by a lack of oxygen.
Fatigue.
Rapid breathing and heartbeat.
A dry, hacking cough
CAUSE: can be caused by a blunt or penetrating chest injury, certain medical procedures, or damage from underlying lung disease. Or it may occur for no obvious reason. Symptoms usually include sudden chest pain and shortness of breath. On some occasions, a collapsed lung can be a life-threatening event.
Thoracic Injuries with Pulmonary Implications
Chest wall and pulmonary injuries range from rib fractures to flail chest, pneumothorax to hemothorax and pulmonary contusion to tracheobronchial tree. All patients with three or more rib fractures or those with displaced fractures are at increased risk for pulmonary complications. The most common thoracic injuries were lung contusions followed by haemothorax, rib fractures and then pneumothorax. Pneumothoraces in blunt thoracic trauma are most frequently caused when a fractured rib penetrates the lung parenchyma
Flail chest — defined as two or more contiguous rib fractures with two or more breaks per rib — is one of the most serious of these injuries and is often associated with considerable morbidity and mortality. It occurs when a portion of the chest wall is destabilized, usually from severe blunt force trauma.
SYMPTOMS: Bruising, discoloration, or swelling in the area of the broken bones.
Marks from being thrown against a seat belt (after a car accident)
Sharp, severe chest pain.
Difficulty inhaling or getting a full breath.
CAUSE: almost always linked to severe blunt trauma, such as a serious fall or car accident, in terms of cause. But it can develop as a result of less severe impacts. There are cases of flail chest occurring as a result of bone disease or deterioration in older patients, but these are very rare.
