Thoracic Trauma Flashcards
How many vertebrae are in the thoracic region?
12
If a patent injures their spinal cord at C5 or below, what could happen?
They lose their ability to innervate their intercostal muscles but can still breath.
If a patient injures their spinal cord at C3 or above what can happen?
Completely lose their ability to breath spontaneously
What is pleuritic pain?
Irritation or damage to the plural surfaces that causes a “sharp” or “stabbing” pain with each breath
What is hemoptysis?
Spitting or coughing up blood
What does hemoptysis indicate?
Damage to the lung parenchyma or air passages leading to lungs
What is a cardiac tamponade?
Accumulation of fluid in the pericardium
What is a pericardiocentesis?
Procedure where fluid is aspirated from the pericardium
How much blood can the lungs hold?
1500 mL
How much blood can the chest cavity hold?
2000-3000 mL of blood
What is pulmonary contusion?
Bruising of the lung.
What are three physical mechanisms for creating a pulmonary contusion?
Implosion effect
Inertial effect
Spalding effect
What is the implosion effect of pulmonary contusions?
Overexpansion of air in lungs after trauma which results in rapid, excessive stretching and tearing of the alveoli
What is the inertial effect regarding pulmonary confusions?
Strips alveoli from the heavier bronchial structures when accelerated at varying rates by a concussive wave
What is the Spalding effect regarding pulmonary contusion?
The gas exchange is disrupted by shock wave
What type of injuries are more common with pericardial temponade?
Penetrating injuries
How does fluid in the pericardium (pericardial temponade) effect the heart?
It prevents blood from filling during diastole which prevents blood from circulating adequately and lowers bp
What does centesis mean?
Puncture
What is the Beck Triad?
Classic signs for diagnosing cardial temponade
Narrowing pulse pressure
JVD
Muffled heart tones
What is the most common site of aortic rupture?
Ligamentum arteriosum
What Is the ligamentum arteriosum?
Where aortic shearing is most common
Part of the descending aorta at the isthmus just distal to the left subclavian artery
What are five findings of an aortic dissection/rupture?
Retrosternal or interscapular pain Dysphagia Ischemic pain of extremities Decreased femoral pulse Harsh systolic murmur over the precordium
Where is the precordium?
Anterior body that lies over heart and lower thorax or interscapular region
What three injuries do you restrict fluids?
Pulmonary contusion
Flail segments
Sternal fracture (if pulmonary contusion is suspected)
What are two signs of an aortic tear?
Unequal blood pressures
Unequal pulses
What is hemotemesis?
Vomiting blood
Where does the diaphragm rise in an individual who is lying down or who has just completed exhalation?
Up to the nipple line
