Trauma abdo et thorax

Question 1

[…] is most commonly injured in blunt trauma because of the fixation of the vx between the left subclavian art and the ligamentum arteriosum.

Answer 1

the proximal descending aorta

Question 2

dx?
bruising of the anterior chest wall
hypotension
hypertension in the upper extremity and hypotension in the lower
unequal blood pressure in the extremities
hoarseness of the voice
thoracic outlet expanding hematome
systolic murmur audible over the base of the heart or betwwen the scapulae
palpable fx of the sternum and ribs
or flail chest

Answer 2

Blunt thoracic vascular injury

ex. rupture aortique

Question 3

suspicion ++ rupture aortique.

conduite #1?

Answer 3

ABC

–> intubation endotrachéale

Question 4

contexte de trauma
RX thorax: élargissement du médiastin
dx + prob?

Answer 4

rupture (partielle) de l’aorte thoracique

Question 5

ddx médiastin élargi?

Answer 5

anomalie vasculaire
pneumomédiastin
poumon: atélectation, masse pulmonaire ''abutting'' le médiastin
ADNP du médiastin
art pulm élargies
lipomatose médistinale
masses (antérieure, moyenne, post)
thymus
hernie diaphragmatique
élément technique du RX

Question 6

Chest wall motion on spontaneous breathin is known a […] and is caracteristic of the flail chest.

Answer 6

paradoxical chest wall motion:

it moves in the opposite direction of the uninjured normal-functioning chest wall

Question 7

[…] occurs when 3 or more adjacent ribs are broken in two places, compromising the structural stability of the chest wall.

Answer 7

Volet thoracique

Question 8

examen pour confirmer dx de volet thoracique?

Answer 8

RX thorax

3 or more adjacent ribs are broken in two places

Question 9

conduite fx de côte non déplacée, non compliquée?

Answer 9

pain management (AINS, opioïde, bloc intercostal)
and
respiratory care

Question 10

En trauma, 3 causes principales d’hypotension?

Answer 10

PTX
tamponnade cardiaqe
hémorragie

Question 11

the most commonly injured intra-abdo organ is..?

Answer 11

the spleen

Question 12

sites de saignement à rechercher chez un pt en choc qui n’a pas de PTX, tamponnade, ni de saignement externe objectivable, qui ne s’améliore pas malgré bcp de volume iv?

Answer 12

abdo
pelvis
fémur

Question 13

Examen pour saignement intra-abdo/pelvis?

Answer 13

FAST écho

Question 14

examen pour dx blunt aortic injuries chez pt Hd stable?

Answer 14

TDM thorax
c+
avec angiographie

Question 15

examen pour dx blunt aortic injuries chez pt Hd instable?

Answer 15

ETO

Question 16

interventions pour dommage traumato aorte?

Answer 16

• thoracotomie
• cardiopulmonary bypass surgery
• endovascular stent grafts
• aortic valve replacement

administration of short-acting BB (labetalol or esmolol) to control HR is also one temporizing measure as it maintains distal aortic perfusion

Question 17

Because of its speed and accuracy, multidetector helical computed tomography has become the primary method for ..?

Answer 17

identifying intra-abdominal injury.

Question 18

dx? au RX abdo:

air outlining psoas margin and tracking superiorly below the hemidiaphragms and up int the chest.

Answer 18

rétro-pneumopéritoine

Question 19

dx? –> cause?
au RX abdo
loss psoas outiline,
loss of the fat planes around the bladder and
loss of definition of the inferior liver outline

Answer 19

free peritoneal fluid

*rupture vessie

Question 20

[…] is the preferred dx examination for the evaluation of trauma in HD stable pt with blunt trauma to the abdo.

Answer 20

TDM abdo

Question 21

[…] of the duodenum is the part most prone to rupture in blunt abdo trauma.

Answer 21

D2

being retroperitoneal and least mobile, it will be easily crushed between the vertebral column and the solid object as the seat belt in a car accident.