Thoracic Trauma
Terms
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- What percent of all motor vehicle deaths are due to the thoracic trauma?
- 25%, about 12,000 per year in the US
- Define tracheobronchial tree
- The structures of the trachea and the bronchi
- Define co-morbidity
- Associated disease process
- The increase on _________________ trauma in urban areas is associated with violent crime.
- penetrating
- Pericardial tamponade, open pneumothorax, esophageal disruption, cavitational lung injuries and comminuted rib fxs are almost exclusively associated with what type of trauma.
- Penetrating
- Pneumothorax (paper bag syndrome), traumatic asphyxia, aortic aneurism, and myocardial contusion are almost exclusively associated with what type of trauma?
- Blunt
- What are the 3 subdivisions of blunt trauma mechanisms?
-
Blasts
Crush (Compression)
Deceleration - When a blast occurs in a confined space, the pressure may be contained and _________________.
- accentuated or increased
- Define shear force
- The force of an organ moving against the point of fixation
- True or false: The age of a blunt trauma pt may affect the seriousness of the trauma received.
- True
- What age group is likely to have more minor signs of injury, few rib fxs, and a greater incidence of serious internal injury as a result of blunt trauma?
- Pediatrics. The cartilaginous nature of their thorx spares them from rib fxs, but more easily transmits the energy of trauma to the internal organs.
- True or false: Due to the calcification of the skeletal system, geriatric patients are more likely than any other group to sustain rib fxs.
- True
- How are shotgun wounds classified?
- Accirding to the distance between the victim and the shotgun.
- Type I shotgun wounds have what characteristics?
-
Target is > 7 meters from the gun barrel at discharge
Usually does not penetrate deeper than into the skin and subcutaneous tissue - Type II shotgun wounds have what characteristics?
-
Target is 3-7 meters from the barrel of the gun
Pellets penetrate into the fascia with possible internal organ damage - What are the characteristics of a Type III shotgun wound?
-
Target is < 3 meters from the barrel
Usually involves massive tissue destruction and life-threatening injuries - What is the most common injury associated with chest trauma?
- Chest wall injuries
- Chest wall contusion is the most common result of _________________ injury to the thorax.
- blunt
- Rib fxs are found in more than ____% of cases of significant chest trauma from blunt mechanisms.
- 50
- Which ribs are most likely to be fractured?
- 4-8
- Which rib group results in mortality in up to 30% when they are fractured?
- The first 3
- Which rib group is less likely to fracture, but may allow for better transmision of energy to internal organs?
- 9-12. Fractures to these ribs is frequently associated with serious trauma and splenic or hepatic injury.
- Mortality associated with rib fxs increses with the number of _____________, extremes of _______, and associated chronic ______________________ or ________________ problems.
- fractures, age, respiratory, cardiac
- Laceration of in intercostal arteries may result in __________________, while damage to the intercostal nerves may result in a ___________________ deficit.
- hemothorax, neurologic