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42 Cards in this Set
- Front
- Back
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What % of all Motor Vehicle deaths are due to thoracic trauma
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25%
p1031 |
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Pericardial tamponade is almost always associated w/ ___ thoracic trauma, while cardiac rupture is almost excusively caused by ____ thoracic trauma
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Penentrating trauma
Blunt trauma p1031-1032 |
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Name the 3 categories of penetrating trauma
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*Low-energy-injury occurs from direct path the object takes
*High-energy-cause extensive damage perpindicular to the track of theprojectile *Shotgun wounds- divided into 3 types. p1033 |
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Describe the 3 types of shotgun blasts and seriousness of injuries
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Type I- target greater that 7 meters, penetrate skin but not deep
Type II- target between 3-7 meters, internal organ injury possible Type III- target less than 3 meters, massive tissue destruction and life threatening p1033 |
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____ tissue is very resilient when impacted by high-energy projectiles
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Lung tissue
p1033 |
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Penetrating trauma ____ leads to pneumothorax
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frequently
p1034 |
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_____ injuries are by far the most common injuries in blunt chest trauma
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Chest wall
p1035 |
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Name the 4 different closed chest wall injuries
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Contusion
rib fracture sternal fracture/dislocation flail chest P1035 |
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Ribs __ to __ are the most commonly fractured ribs
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4-8
p1035 |
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Fracture or displacement of the lower ribs may injure the ___ on the right side and the ____ on the left.
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Liver on the right side
Spleen on the left side p1036 |
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____ is one of the most serious chest wall injuries due to reduced volume of respirations, increased effort to breathe, and it takes more energy to move less air
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Flail Chest
P1037 |
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______ ventilation of a flail chest will reverse paradoxical movement, restore tidal volume, and reduce pain. However this could lead to a pneumothorax.
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Positive-pressure ventilation
P1038 |
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Name the 5 different pulmonary injuries
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*Simple pneumothorax
*Open pneumothorax *tension pneumothorax *Hemothorax *Pulmonary Contusion P1038 |
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T or F
In a simple pneumo. the pressure does not exceed normal expiratory pressure and there is no mediastinal shift |
True
p1038 |
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The "sucking chest wound" is a common sign of a _____
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Open pneomo.
p1039 |
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For air to move into the chest wall the opening must be at least _____ the diameter of the trachea
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2/3rds
p1039 |
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Tension pneumo. generates and maintains pressure ____ than atmospheric pressure w/in the thorax.
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Greater
P1040 |
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Tracheal shift and medistinal structures move _____ from the increasing pressures.
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Away
p1040 |
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Each side of the thorax may hold up to ____mL of blood
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3000mL
p1041 |
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Name the 2 specific MOI's associated with Pulmonary Contusions
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*Deceleration
*Pressure wave w/ either high velocity bullet or explosion P1042 |
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Microhemorrhage into the alveolar tissue may result in up to ____ to ____ mL of blood loss
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1000-1500mL
p1043 |
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Small, flame shaped areas of disruption throughout the lung tissue membrane leading to microhemorage and edema
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Spalding effect
p1043 |
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Name the 4 major types of Cardiovascular injuries
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Myocardial Contusion
Pericardial tamponade Myocardial aneurysm/rupture Aortic aneurysm/rupture p1043 |
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Myocardial contusion will most likely affect the ___ atrium and ____ ventricle
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Right, Right\
P1043 |
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Cardiac monitoring most frequently reveals sinus tach, what are other dysrhythmias associated w/ cardiac contusions (7)
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*Atrial flutter/fib.
*premature atrial or ventricular contractions *tachydysrhythmias *bradydysrhythmias *bundle branch patterns *T wave inversions *ST segment elevations P1044 |
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A restricition to cardiac filling caused by blood or fluid w/in the pericardial sac, occurs less than 2% of all chest trauma pts
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Pericardial tamponade
P1044 |
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The pressure of pericardial tamponade affects which part of the heart first
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Right ventricle because it is where the pressure of filling is the lowest.
p1044 |
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It takes ___ to ___ mL of blood to induce frank tamponade, and removing as little as ___mL of blood may provide significant relief
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150-300mL of blood
20mL p1045 |
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What are the 3 signs of Beck's triad
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JVD
Distant heart tones hypotension p1045 |
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What is the most commonly injured part of the heart injured by blunt trauma and has a mortality rate of 85-95%
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Aorta
p1046 |
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Name the 3 parts wherer the aorta is fixed
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Aortic annulus- at the heart
Aortic isthmus- at the ligamentum arteriosum Diaphragm p1045 |
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_____ is the primary cause of injury to the pulmonary arteries and vena cava
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Penetrating trauma
p1047 |
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Diaphragmatic rupture presents with signs and symptoms similar to _____, including duspnea, hypoxia, hypotension, and JVD
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Tension pneumothorax
p1047 |
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The pt with disruption of the trachea or mainstem bronchi, intermittent positive pressure ventilation makes the condition _______.
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Worse
due to the fact that it drives air into the pleura or mediastinum p1048 |
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Is traumatic asphyxia a respiratory problem or a vascular problem?
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Vascular problem
P1048 |
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When percussing the chest during assessment what does a DULL sound mean VS. a hyperresonant sound
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Dull-collecting of blood or other fluid
Hyperresonant-suggests air or air under pressure p1049 |
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Suspect serious underlying injury if which ribs are fractured
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Upper ribs or ribs 9-12
p1051 |
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When auscultating lungs, contusions will usually present with what sounds?
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Progressively increasing Crackles
P1052 |
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Diminsihed breath sounds on the ipsilateral side is an indication of
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pneumothorax
p1052 |
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Pulsus paradoxus and jugular filling are indicative of
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pericardial tamponade
p1052 |
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If the minute volume is less than 6000mL consider _____ at a rate of _____ breaths/min
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overdrive ventilation at a rate of 12-16 BPM
p1054 |
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What is the drug of choice for a pt that is entrapped for a long period of time and is experiencing signs of traumatic asphyxia?
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Sodium Bicarbonate
p1058 |
