Thoracic Trauma Flashcards
what is the mechanism of injury for tension pneumothorax?
- laceration to lung parenchyma with flap
- mechanical ventilation in patient with pleural injury
what is tension pneumothorax?
- hole in lung parenchyma with flap
- pressure devlops in thorax
what are the signs of tension pneumothorax?
- unequal chest expansion
- hyper-resonant percussion
what is flail chest?
chest wall disconnects from thoracic cage
what is the mechanism of injury for flail chest?
multiple rib fractures (at least 2 fractures per rib in at least 2 ribs)
what is flail chest associated with?
pulmonary contusion
what are the signs of flail chest?
- abnormal chest motion
what should be avoided in the management of flail chest?
over hydration and fluid overload
what is a pneumothorax?
lung laceration with air leakage
what is the management of pneumothorax?
chest drain
what is the cause of haemothorax?
laceration of lung, intercostal vessel or internal mammary artery
how are large haemothoraces treated?
large bore chest drain
what volume of haemothorax warrents surgical exploration?
> 1500ml
what condition is beck’s triad seen in?
cardiac tamponade
what is beck’s triad?
- elevated venous pressure
- reduced arterial pressure
- reduced heart sounds
what are the signs of cardiac tamponade?
- beck’s triad
- pulsus paradoxus
what is the most common potentially lethal chest injury?
pulmonary contusion
what is pulmonary contusion?
bruise of the lung, which causes bleeding and swelling
what is important in the management of pulmonary contusion?
early intubation within an hour if significant hypoxia
what is the mechanism of injury for blunt cardiac injury?
secondary to chest wall injury
what will show on ECG in blunt cardiac injury?
myocardial infarction
what is the sequence of symptoms in blunt cardiac injury?
hypotension –> arrhythmias –> cardiac wall motion abnormalities
what is the mechanism of injury for aorta disruption?
deceleration injuries
what are the signs of aorta disruption?
- persistent hypotension (contained haematoma)
- widened mediastinum
what is the mechanism of injury for diaphragm disruption?
- motor vehicle accidents
- blunt trauma causing large radial tears
what side is diaphragm disruption most likely to occur?
left side
what is seen on CXR in diaphragm disruption?
- non-visible diaphragm
- bowel loops in the hemithorax
- displacement of the mediastinum
what is the mechanism of action of mediastinal traversing wounds?
entrance wound in one hemithorax and exit wound/foreign body in opposite hemithorax
