Thoracic Trauma

Question 1

How many vertebrae are in the thoracic region?

Answer 1

12

Question 2

If a patent injures their spinal cord at C5 or below, what could happen?

Answer 2

They lose their ability to innervate their intercostal muscles but can still breath.

Question 3

If a patient injures their spinal cord at C3 or above what can happen?

Answer 3

Completely lose their ability to breath spontaneously

Question 4

What is pleuritic pain?

Answer 4

Irritation or damage to the plural surfaces that causes a “sharp” or “stabbing” pain with each breath

Question 5

What is hemoptysis?

Answer 5

Spitting or coughing up blood

Question 6

What does hemoptysis indicate?

Answer 6

Damage to the lung parenchyma or air passages leading to lungs

Question 7

What is a cardiac tamponade?

Answer 7

Accumulation of fluid in the pericardium

Question 8

What is a pericardiocentesis?

Answer 8

Procedure where fluid is aspirated from the pericardium

Question 9

How much blood can the lungs hold?

Answer 9

1500 mL

Question 10

How much blood can the chest cavity hold?

Answer 10

2000-3000 mL of blood

Question 11

What is pulmonary contusion?

Answer 11

Bruising of the lung.

Question 12

What are three physical mechanisms for creating a pulmonary contusion?

Answer 12

Implosion effect
Inertial effect
Spalding effect

Question 13

What is the implosion effect of pulmonary contusions?

Answer 13

Overexpansion of air in lungs after trauma which results in rapid, excessive stretching and tearing of the alveoli

Question 14

What is the inertial effect regarding pulmonary confusions?

Answer 14

Strips alveoli from the heavier bronchial structures when accelerated at varying rates by a concussive wave

Question 15

What is the Spalding effect regarding pulmonary contusion?

Answer 15

The gas exchange is disrupted by shock wave

Question 16

What type of injuries are more common with pericardial temponade?

Answer 16

Penetrating injuries

Question 17

How does fluid in the pericardium (pericardial temponade) effect the heart?

Answer 17

It prevents blood from filling during diastole which prevents blood from circulating adequately and lowers bp

Question 18

What does centesis mean?

Answer 18

Puncture

Question 19

What is the Beck Triad?

Answer 19

Classic signs for diagnosing cardial temponade

Narrowing pulse pressure
JVD
Muffled heart tones

Question 20

What is the most common site of aortic rupture?

Answer 20

Ligamentum arteriosum

Question 21

What Is the ligamentum arteriosum?

Answer 21

Where aortic shearing is most common

Part of the descending aorta at the isthmus just distal to the left subclavian artery

Question 22

What are five findings of an aortic dissection/rupture?

Answer 22

Retrosternal or interscapular pain
Dysphagia
Ischemic pain of extremities
Decreased femoral pulse
Harsh systolic murmur over the precordium

Question 23

Where is the precordium?

Answer 23

Anterior body that lies over heart and lower thorax or interscapular region

Question 24

What three injuries do you restrict fluids?

Answer 24

Pulmonary contusion
Flail segments
Sternal fracture (if pulmonary contusion is suspected)

Question 25

What are two signs of an aortic tear?

Answer 25

Unequal blood pressures

Unequal pulses

Question 26

What is hemotemesis?

Answer 26

Vomiting blood

Question 27

Where does the diaphragm rise in an individual who is lying down or who has just completed exhalation?

Answer 27

Up to the nipple line