Thoracic & Abdominal Trauma

Question 0

What does thoracic trauma lead to?

Answer 0

Hypoxia
Hypercarbia (increased co2)
Acidosis (increased acidic state)

Question 1

What are 2 mechanisms of injury?

Answer 1

Blunt trauma- compression or crushing forces, shearing forces, deceleration.
Penetrating trauma- velocity (low, medium,high), trajectory.

Question 2

Thoracic trauma complications-

What are impairments to cardiac output?

Answer 2

Hypovolaemic
Cardiac tamponade
Myocardial valve damage
Vascular disruption (very bad!)

Question 3

Thoracic trauma complications

What are impairments in gas exchange?

Answer 3

Atelectasis (full or partial alveolar collapse)
Pulmonary contusion (bruising)
Respiratory tract disruption

Question 4

What is a pneumothorax?

Answer 4

Unwanted air in the lungs

Question 5

Name the types of pneumothorax

Answer 5

1) Simple pneumothorax : non expanding air around the lung
Spontaneous or trauma
2) Open pneumothorax: hole in chest wall allowing air to enter pleural space

Question 6

What is a tension pneumothorax?

Answer 6

One way valve allowing air to enter pleural space, causing a build up of pressure forcing the mediastinum to shift
Signs: (early) tachypnoea, tachycardia, decreased air entry
(Late) JVD, tracheal shift, combativeness (hypoxia), cyanosis

Question 7

Describe heamothorax

Answer 7

Blood in pleural space

Due to pulmonary contusion

Question 8

What is flail chest?

Answer 8

A thoracic trauma injury
2 or more ribs fractured in 2 or more place
Key sign: paradoxical breathing

Question 9

What is an aortic tear?

Answer 9

A thoracic trauma injury
Shearing forces tear aorta
Bleed out instantly, 80-90%?mortality

Question 10

What is cardiac contusion?

Answer 10

Thoracic trauma injury
Behaves like a MI- chest pain, dysrhythmias
Bruise to chest

Question 11

What is cardiac tamponade?

Answer 11

Thoracic trauma injury
Mechanical compression of the heart by large amounts of blood in pericardial space
Instantly symptomatic (JVD, tachycardic, decrease PP)

Question 12

• What is traumatic asphyxiation?

Answer 12

Thoracic trauma injury
Sudden increase in intra thoracic pressure causing increased venous back pressure through right atrium and into superior vena cava, and into head, neck, veins and capillaries

Question 13

• Name 7 life threatening thoracic trauma (ATOMIC)

Answer 13

A- airway obstruction (from trauma not choking)
T- tension pneumothorax
O- open pneumothorax 
M- massive haemorrhage
I- incomplete chest wall (flail chest)
C- cardiac tamponade

Question 14

Name 5 abdominal trauma complications

Answer 14

Haemorrhage
Hypovolaemic shock
Impaired organ function
Contusions, peritonitis (infection of abdomen lining)

Question 15

Name an abdominal trauma injury usually occurring from penetrating trauma

Answer 15

Abdominal vascular injury
Intra abdominal arterial and venous injuries may be life threatening, as areas able to hold lots of blood.
Major vessels frequently injured: aorta, inferior vena cava, renal, mesenteric and iliac arteries and veins

Question 16

Name 3 more abdominal trauma injuries

Answer 16

Ruptured diaphragm
Evisceration- protrusion of internal organs through a wound
Pelvic fracture

Question 17

What is the most significant sign of severe abdominal injury?

Answer 17

Unexplained shock

Question 18

What is evisceration?

Answer 18

Protruding internal organs through wound- a traumatic abdominal injury

Question 19

What is peritonitis?

Answer 19

Infection of abdominal wall