Thoracic Trauma Flashcards Preview

Respiratory Emergencies > Thoracic Trauma > Flashcards

Flashcards in Thoracic Trauma Deck (29)
Loading flashcards...
1

Ruptured diaphragm happens when

Abdominal contents herniate into the chest and compress the lungs, heart, and mediastinum

2

What side does a diaphragm usually tear on?

Left.. the right has the liver to protect you

3

How can a diaphragm rupture?

Air bag -- bulls stepping on cowboy stomach

4

What happens to the heart during diaphragm rupture

It gets shifted to the right side of chest - heart sounds over right side

5

Why does dysphagia happen to ruptured diaphragm

Esophagus is all twisted up

6

Ribs 1-3

Short, STRONG
Great force to break

If you break these..it's probably the least of your problems - 40% die

Great vessel injury

7

Ribs 4-12

Long bone
Easily fractured

8

What lies under ribs 4-9

Lung

9

What lies under 10-12 on the right

Liver

10

What lies under 10-12 on the left

Spleen

11

Flail Chest

Two or more adjacent ribs are fractured in two or more locations or detachment of the sternum

12

Paradoxical chest movement

Free-floating segment of the chest

Doesn't follow breathing

13

Why aren't pulmonary contusions seen often in the ED

Develop over time

14

What is the visceral pleura

Adhering to the lung

15

Adhering to the chest wall is the

Pleural cavity

16

PAIN: Fluid

Fluid sinks
Low ache on side of fluid

17

PAIN: Air

Air rises
Higher up / radiate over shoulder

18

FREMITUS: Fluid

Absent
Sound is absorbed by fluid

19

FREMITUS: Air

Decreased

20

Hemothorax can be from

Venous - usually self limiting

Arterial - Pressures higher (1500 ml can get stuck in pleural space)

Autotransfusion

21

Arterial hemothorax and you chest tube...

Drain..just refills

22

Only tx for hemothorax

Thoracotomy
Autotransfusion - while you wait

23

Why can blood from the blood bank not be good?

Sitting for 30 days

Some of the RBC have died = hyperkalemia

Highly acidotic - breathing in a bag

24

How do you practice fremitus

Have pt say "99" while holding hands against the chest.

Vibrations will transmit through air NOT fluid

25

Egophony

"e" while holding a stethoscope near the top of the fluid line

"e" will sound like "a" through fluid

26

Simple Pneumo

Air enters the pleural space causing a negative intrapleural pressure

Inside out

27

Open Pneumo

Outside in

A penetrating wound

28

Tension Pneumo

Accumulation of air in the pleural space that can't get out

29

Needle thoracostomy

Place needle just above the 3rd rib at the midclavicular

14-16 gauge adult
18-20 gauge ped