EC Chp 27 Chest and Abdominal Trauma

Question 1

Chest injuries can include:

Answer 1

Blunt Trauma
Penetrating Objects
Compression

Question 2

Compression injuries occur from

Answer 2

severe blunt trauma in which chest is rapidly compressed. Ex when driver strikes his chest on steering wheel or when person is trapped in trench wall collapse

Question 3

Fracture of 2 or more adjacent ribs in two or more places that allows for the free movement of the fractured segment is a condition known as

Answer 3

Flail chest: it leaves a portion of the chest unstable and affects breathing and lung expansion leading to hypoventalation

Question 4

Movement of ribs in a flail segment that is opposite to the direction of movement of the rest of the chest cavity is known as

Answer 4

Paradoxical motion

Question 5

because maintaining positive thoracic pressure may reduce the degree of flail segment some systems allow the use of a noninvasive positive pressure ventilation for patients with Flail chests as long as they have…

Answer 5

Flail chests with an inadequate breathing.

Question 6

Open chest wound usually means that not only is the skin broken but the…

Answer 6

chest wall is also penetrated. Ex bullet or a knife

Question 7

when air enters the chest cavity from a open chest injury the delicate pressure balance within the chest is destroyed, This causes the lung on the injured side to…

Answer 7

collapse

Question 8

Sucking chest wound is an open chest wound in which air is “sucked” into the chest cavity. The patient will develop…

Answer 8

severe difficulty breathing with signs showing:

• wound to the chest
• may or may Not be sucking sound
• gasping for air

Question 9

with an Open Chest wound you should provide care in the following order:

Answer 9

1. Maintain open airway
2. Seal the open chest wound as quickly as possible
3. Apply Occlusive dressing (at least 2in wider than wound)
4. administer high concentration oxygen
5. care for shock
6. transport as soon as possible

Question 10

Flutter valve dressing involves a…

Answer 10

3 sided occlusive dressing by leaving a side or corner unsealed to allow air that is trapped out of the chest

Question 11

Blood vessels in the chest are largest in the body. Injuries to these are often fatal but can hold up to __ liters of blood and never spill a drop outside the body

Answer 11

3 liters

Question 12

Air int he chest cavity (thorax area) possibly causing the collapse of a lung is called

Answer 12

Pneumothorax and will have diminished or absent lung sounds.

• uneven chest wall movement
• reduction of breath sounds
• distended neck veins

Question 13

Tension Pneumothorax is a type of pneumothorax in which

Answer 13

air that enters the chest cavity is prevented from escaping. Ex. sealed occlusive dressing, closed chest wound

Question 14

the results of a tension pneumothorax include

Answer 14

reducing cardiac out and lungs ability to oxygenate blood

Question 15

a very late sign of pneumothorax and one that is difficult to detect is

Answer 15

trachea may shift to the opposite side

Question 16

A condition in which the chest cavity fills with blood is called

Answer 16

Hemothorax

Question 17

With a Hemopneumothorax the chest cavity fills…

Answer 17

with both blood and air

Question 18

Hemothorax can be caused when

Answer 18

penetrating object or fractured ribs that cause lacerations within the chest cavity

Question 19

The Sudden compression of the chest in which the sternum and the ribs exert severe pressure on the heart and lungs forcing blood out of the right atrium and up into the jugular veins in the neck is associated with

Answer 19

Traumatic Asphyxia

- patients neck and face will be darker color than rest of body

Question 20

Traumatic Asphyxia signs include darker color to patients neck and face but also include

Answer 20

bulging eyes
distended neck veins
broken blood vessels in the face
swollen blue tongue and lips
chest deformity

Question 21

Cardiac tamponade is when

Answer 21

An injury to the heart causes blood to flow into the surrounding pericardial sac and compresses the chambers to a point where they will no longer adequately fill, backing up blood into the veins

Question 22

Distended neck veins, very weak pulse, low BP

signs of shock and narrowed pulse pressure are signs of what condition?

Answer 22

Cardiac Tamponade

Question 23

Damage to the Aorta without trauma can be caused by Degeneration of the Aorta. Examples of this include:

Answer 23

high blood pressure or other diseases causes weakening of this large vessel causing to balloon and cause an aneurysm.

Question 24

a Patient can have differences in pulse or blood pressure between right an left arms/legs

Answer 24

In proximal to aortic injury / in abdominal aortic injury

Question 25

when someone gets hit in the center of the chest just when the heart is vulnerable which causes the heart to go into ventricular fibrillation is called

Answer 25

Commotio Cordis or (commotion/disturbance of the heart)

Question 26

signs of Aortic Injury or dissection:

Answer 26

• Tearing Chest Pain
• Differences in Pulse or BP between right left extremities
• palpable pulsating mass (if abdominal aorta involved)
• Cardiac arrest

Question 27

an intestine or other internal organ protruding through a wound in the abdomen is known as

Answer 27

Evisceration

Question 28

A more common condition than evisceration is blunt trauma to one or more organs. the Most commonly injured organ is

Answer 28

the Liver because of its large size and position in the RUQ and under the lowermost ribs.

Question 29

Two very very vascular organs that can cause life-threatening blood loss when injured are?

Answer 29

Liver (RUQ) and Spleen (LUQ)

Question 30

When hollow abdominal organs such as the stomach, small and large bowels, gallbladder and urinary bladder are injured their contents will spill into the abdominal cavity causing…

Answer 30

severe irritation and often Peritonitis

Abdominal muscles can also involuntary contract leading to rigidity to abdominal wall

Question 31

Pain, cramps, nausea, weakness, and thirst can be common signs of…

Answer 31

an Abdominal injury.

Question 32

A patient with rigid or tender abdomen and tries to lie very still with legs drawn up in effort to reduce the tension are signs of what?

Answer 32

an Abdominal injury

Question 33

For both closed and open abdominal injuries you should follow the necessary steps:

Answer 33

• Stay Alert for Vomiting
• Place Patient on back, legs flexed at the knees
• If there are signs of Hypoxia treat for shock
• Give NOTHING by mouth to the patient
• Monitor Vital Signs
• Transport ASAP

Question 34

Do not touch or try to replace any eviscerated or exposed organs. Instead you should…

Answer 34

apply a sterile dressing moistened with sterile saline over the wound site to ensure the organs do not dry out.

Question 35

A Patient who collapses in cardiac arrest after a force is applied to the center of his chest should still

Answer 35

receive CPR and defibrillation like any other arrest from cardiac cause

Question 36

Closed chest wounds are sometimes difficult to distinguish or may occur together you should…

Answer 36

Asses the patient

including breath sounds, maintain ventilation and oxygenation.