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58 Cards in this Set
- Front
- Back
- 3rd side (hint)
Thorax
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A bony cage consisting of the following structures:
-12 pairs of ribs -Scapula -Clavicle -Sternum -Thoracic |
Notes
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Intercostal space
Where is the budle of arteries, veins, and nerves? |
Area located between the ribs. Be aware that the neurovascular bundle of arteries, veins, and nerves are located in the intercostal space right below each rib.
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Notes
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Pericardium
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The sac containing the heart, consist of two layers, visera (inner) , and parietal (outer).
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Notes
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What is the principle muscle of respiration?
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The diaphragm
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Notes
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When the muscles contract the thoracic cavity __________ in size.
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increase
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Notes
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Flail chest
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When two or more adjacent ribs fractured in two or more places, creating "free-floating" segment that impairs chest wall motion. Usually cause from major blunt forces.
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Notes
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Large pneumothorax present with
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-Absent breath sounds
-Hypoxia -AMS -Tachycardia -Cyanosis |
Notes
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Tension Pneumothorax
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Life-threatening condition that results from continued air accumulation within the intrapleural space. May occur from open thoracic injury, blunt trauma, barotrauma, or shearing forces.
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Notes
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List the classic signs of Tension Pneumothrorax
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-Increased dyspnea
-Absent breath sounds on affected sound -Tachycardia -JVD (late sign) -Trachea deviation to the good size (late sign) |
Notes
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Each lung can hold up to ______ of blood
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3,000 mL
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Notes
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hemoptysis
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Cough up blood.
Sign of possible hemothorax. |
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Pericardial Tamponade
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Excessive fluid in the pericardial sac causing compression of the heart. May be caused by blunt or penetrating trauma, or medical conditions (inflammation).
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Notes
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Pericardial Tamponade affect of preload
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As the percardium fills, the atria and vena cavae become compressed. Preload is therefore reduced, which reduces stoke volume.
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Notes
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Beck's triad
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Classic trio pointing to pericardial tamponade. The signs are muffled heart tones, hypotension, JVD.
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Notes
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What is myocardial contusion?
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Blunt cardiac injury caused by heart colliding with the sternum. Leads to local tissue contusion, hemorrhage, edema, cellular damage, and may lead to dysrhythmias.
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Notes
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Assessment finding for myocardial contusion
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-Pt may complain of sharp, retrosternal chest pain.
-Soft-tissue injury may be present. -Lung sounds may reveal crackles. -ECG changes may occur. |
Notes
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What is myocardial rupture?
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Acute perforation of the ventricles, atria, septum, chordae, muscles, or valves caused by sever blunt force compression. Life threat that accounts for 15% of fatal cx injuries.
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Notes
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What is Commotio Cordis?
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Immediate cardiac arrest caused by blunt trauma caused by the heart's repolarization period. Pt appears in v-fib, responding well to defibrillation if performed quickly.
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Notes
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Aorta injury is caused by:
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Transection or dissection sheared at its fixed points.
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Notes
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What is the most serious diaphragmatic injury?
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Diaphragmatic herniation-Abdominal organs enter the thoracic cavity, causing a tension gastrothorax. Listen for bowels in lungs or absence of breath sounds on affect side.
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Notes
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subcutaneous emphysema
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Air underneath skin.
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Notes
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Assessment of JVD
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JVD is normal in supine pts, lack suggest hypovolemia. Proper assessment must be measure at a 45 degree angle.
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Notes
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Muffled heart sounds may indicate:
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tension pneumothorax or pericardial tamponade.
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Notes
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What happens with a simple pneumothorax with too much ventilation force?
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It may convert it into a tension pneumothorax.
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Notes
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Flail cx management
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Know s/s: paradoxical motion, dyspnea, and/or chest pain.
Life threatening emergency. Control airway and assist ventilations as needed. Stabilize area with bulky dressing during exhalation, ie hand. |
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Management of fx rib
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Know s/s hypoxia, hypercarbia, and pain. Tx with supportive care as external stabilization is no longer recommended.
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Notes
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Sternal fx management
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Supportive tx only
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notes
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Simple pneumothorax management
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ABCs, high flow O2, most critical intervention is ongoing assessment to ensure tension pneumothorax is not developing.
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Notes
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What kind of pain may a pt with tension pneumothorax experience?
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Pt complains of pleuritic pain and dyspnea.
Pleuritic is pain cause by irritation of the pleural surfactant brough on by coughing, breathing, and movement of lungs. |
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Massive Hemothorax Management
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Know s/s: Lack of JVD, Lack of tracheal deviation, hemopysis, and dull to percussion. Supportive care, including shock care.
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Notes
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Pulmonary Contusion Management
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Pt may experience hemoptysis, provide ABC, supportive care. Edema may exacerbate the injury.
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Notes
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Pericardial Tamponade Management
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Know s/s Beck's traid, ABC give IV fluids, trauma center trans, surgery is a definitive care.
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Notes
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When ventilating tracheobronchial injuries what should you be sure to do?
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Be sure to bag gently and slowly.
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Notes
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thoracic inlet
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The superior aspect of the thoracic cavity, this ring like opening is created by the first vertebral vertebra, the first rib, the clavicles, and the manubrium.
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23.28
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The thoracic cavity extends to the 12th rib posteriorly, the diaphragm inserts into the anterior thoracic cage just below the ________________ rib.
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fourth or fifth
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23.3
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List the bony structure of the thorax
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Sternum, clavicle, scapula, thoracic vertebrae, and the 12 pair of ribs.
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23.4
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What are the three portions of the sternum from top to bottom?
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The superior manubrium, the central sternal body, and the inferior xyphoid process.
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23.4
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suprasternal notch
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The space superior to the manubrium of the sternum.
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23.4
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Angle of Louis
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The junction of the manubrium and sternal body.
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23.4
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The first ____ pair of ribs are attach directly to the sternum via the costal cartilage.
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7
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23.5
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"Floating ribs"
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The eleventh and twelfth ribs which have no anterior connection.
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23.5
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What are the intercostal spaces number according to?
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The rib superior to the space.
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23.5
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Average cardiac output
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HRxSV
70x70=4,900 mL/min varies on pt size |
23.5
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Where does the brain stimulate a person to breathe?
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Via chemoreceptors that are located in the carotid sinus and aortic arch. The act as little "chemist" that analyze arterial blood.
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23.6
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When receptors sense CO2 is too high they...
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send a message to the brain, which responds by increasing respiarations in an effort to "blow off the CO2." COPD pts may go into hypoxic drive with too high of O2.
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23.6
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________ pressure pulls air into the thoracic cavity, and ________ pressure air is exhaled.
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Negative
positive |
23.8
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With a fx to the 4th through 9th rib what should you be suspicious for?
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Associated aortic injury, tracheobronchial injury, pneumothorax, vascular injury, or other more serious injury.
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23.8
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With a fx to the lower ribs 9th through 11th what should you be suspicious of?
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An associated intra-abdominal injury.
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23.8
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pneumothorax
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The accumulation of air or gas in the pleural cavity.
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23.8
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hemothorax
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The accumulation of blood in the pleural cavity.
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23.10
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commotio cordis
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When the thorax receives a direct blow during the critical portion of the heart's replarization period, resulting in immediate cardiac arrest. They may go into V-fib reason being for early defiberation being critical.
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23.11-12
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What are the three layers of the aorta from outer in inner?
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Adventita, Media, and Intima
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23.12
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what type of injuries cause great vessel injuries
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More likely with penetrating trauma.
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23.12
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know causes and s/s of diaphragm injuries
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May result from direct penetrating injury or blunt force trauma. Most occur on the left side due to protection on the rt by the liver.
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23.12
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why is the JVD in lung injuries, pneumo, hemo, tension
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Suggest increased intravenous pressure.
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23.15
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Correct placement for decompression:
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The bottom of the second intercostal space, between second and third rib at the bottom to avoid veins, nerves, and arteries.
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23.23
figure 23-17 |
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Classic findings in pericardial tamponade include:
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bradycardia, diaphoresis, cherry red lips, dyspnea
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23.23
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Which of the following is the most immediate life threatening
A: pneumothorax B: hemothorax C: tension pneumothorax D: flail chest |
C: tension pneumothorax
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23.9
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