Trauma Part 2 chest Flashcards Preview

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Flashcards in Trauma Part 2 chest Deck (15):
1

Diagnostic tools for evaluation of cardiac trauma

Gold standard is subxiphoid pericardial window, which can be enlarged to median sternotomy if needed. Also can use echo, US in FAST survey, thorascopy

2

What valve is most likely to be injured by blunt cardiac trauma?

Aortic valve

3

Where does the neurovascular bundle run relative to the rib?

Along the INFERIOR margin of the rib

4

Where is chest tube placed for PTX.?

Fourth intercostal space at the mid axillary line

Incision is made over the rib

5

Size of chest tube for PTX

Adult hemothorax, use 36-40 French. For adult pneumothorax, use 24 French or pigtail catheter. For peds, use 4x the appropriate ETT size

6

What is the danger of tension pneumothorax?

Mediastinal shift impairs venous return by compressing pulmonary veins, decreasing preload to heart

7

Thoracic great vessel injury possible mechanisms

Deceleration shear force, compression between bones, intraluminal hypertension

8

Signs and sx of thoracic great vessel injury

Hypotension or hypertension, retrosternal chest pain, dyspnea, new systolic murmur (aortic valve), unequal blood pressures in extremities. CXR showing widened mediastinum, tracheal deviation, hemothorax, indistinct aortic knob

9

What injury could cause absent or decreased upper extremity pulses with increased lower extremity pulses?

Injury to brachiocephalic or subclavian arteries

10

What type of aortic dissection can be managed medically?

Type B, descending aorta only

11

What is a communicating pneumothorax?

Known as a sucking chest wound, this occurs when there is a traumatic hole in the chest that has a diameter > 2/3 that of the trachea, so that air preferentially enters the hole.

12

What's the treatment of a communicating pneumothorax?

Seal it off on only three sides. This converts it into a closed pneumothorax.

13

Pulmonary contusion appears as what on chest X-ray?

A consolidation

14

Where is the entrance for an emergent thoracotomy?

Left anterolateral incision at fourth or fifth intercostal space

15

Becks triad for tamponade

Muffled heart sounds, elevated JVD, hypotension