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54 Cards in this Set

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TRAUMA TO THE CHEST AND ABDOMEN CAN INVOLVE WHAT SYSTEMS
CARDIO,RESPIRITORY, DIGESTIVE, URINARY
HOW MANY PAIRS OF RIBS ARE THERE
12, UPPER 7 ATTACH TO STERNUM (TRUE RIBS), 8-10 ATTACH INDIRECTLY, 11-12 DO NOT ATTACH ANTERIOR(FLOATING RIBS)
WHAT ARE THE THREE SECTIONS OF THE STERNUM
MANIBRIUM (TOP), BODY, XIPHOID PROCESS (BOTTOM)
WHERE DO CLAVICALS ARTICULATE
STERNUM MEDIALLY, HUMERUS AND SCAPULA LATERALLY
WHAT % OF WORK DOES THE DIAPHRAGM DO
70%
WHAT IS IN THE MEDIASTINUM
HEART, GREAT VESSELS, TRACHEA, ESOPHAGUS, THYMUS GLAND
WHAT NERVE ROOTS INNERVATE THE DIAPHRAGM
PHRENIC NERVES, ORIGINATE FROM C-3,4,5
WHAT NERVE ROOTS INNERVATE THE INTERCOSTAL MUSCLES
INTERCOSTAL NERVES, ORIGINATE FROM T-2-12
WHERE DOES LYMPH EMPTY TO
RIGHT LYMPHATIC DUCT (DRAIN FROM R ARM, SIDE OF HEAD, SIDE OF THORAX), THORACIC DUCT (IN L THORAX, RECIEVES LYMPH FROM REST OF BODY), BOTH DUCTS DRAIN TO R/L SUBCLAVIAN VEINS
PEDIATRIC THORAX =
MORE CARTILAGE=ABSORBS FORCES= MINOR SIGNS OF INJURY, FEW RIB FRACTURES, GREATER INCIDENCE OF INTERNAL INJURY
GERIATRIC THORAX
CALSIFICATION & OSTEOPOROSIS=MORE RIB FRACTURES, PREEXISTING DISEASE AND PROGRESSIVE REDUCTION OF RESPIRATORY AND CARDIAC RESERVES= GREATER MORBIDITY/MORTALITY FROM SERIOUS CHEST TRAUMA
WHAT THREE WAYS DO CHEST INJURIES DAMAGE BELLOWS SYSTEM
1.PAIN RESTRICTS EXCURSION, 2.AIR CAN ENTER PLEURA SPACE-GAS EXCHANGE DISRUPTED, 3.CHEST WALL DOESN'T MOVE IN UNISON
RIB FRACTURES
FOUND IN >50% W/ BLUNT TRAUMA, USUALY IN LATERAL ASPECT OF RIBS 4-8, FRACTURES OF 9-12=ASSOCIATED AB INJURY
WHAT INJURIES ARE ASSOCIATED WITH FRACTURE OF RIB 1,2,3
MYOCARDIAL CONTUSION, BRONCHIAL TEARS, AORTIC RUPTURE, VASCULAR INJURY(MORBILITY OF UP TO 30%)
STERNAL FRACTURE:
INCIDENCE:5-8%, MORTALITY RATE OF 25-45% DUE TO OTHER INTERNAL INJURIES
FLAIL CHEST
THREE OR MORE RIBS FRACTURED IN TWO OR MORE PLACES, MAY NOT BE SEEN FOR UP TO TWO HOURS DUE TO MUSCLE SPASMS WITH INJURY
CLOSED (SIMPLE) PNEUMOTHORAX
PLEURA SPACE EXPANDS DUE TO INTERIOR WOUND OR DISEASE PROCESS
OPEN PNEUMO THORAX
PLEURA SPACE EXPANDS DUE TO EXTERNAL WOUND, OPENING MUST BE 2/3 SIZE OF TRACHEA
TENSION PNEUMOTHORAX
PNEUMOTHORAX THAT PUSHES MEDIASTINUM TO OPOSITE SIDE, S/S INCLUDE JVD, TRACHEAL DEVIATION
HEMO THORAX
ACCUMULATION OF BLOOD IN PLEURA SPACE, INTERCOSTAL ARTERY CAN BLEED 50ML MIN., EACH SIDE CAN HOLD 3000CC OF BLOOD
PULMONARY CONTUSION
BRUIS TO LUNGS, RESP. FAILURE CAN DEVOLOPE IN 8-24HR, BLOOD IS IRRITATING SO THE INFLAMITORY RESPONSE IS INITIATED=MORE FLUID TO AREA
MYOCARDIAL CONTUSION
BRIUSE TO HEART, SYSTOLIC PRESSURE RISES TO 800=ACUTE OR DELAYED RUPTURE OF HEART, 1.BRUISE-FULL OR PARTIAL THICKNESS, 2.DAMAGE TO CONDUCTION SYSTEM-MOST COMMON, 3.RUPTURE OF MYOCARDIAL WALL
PERICARDIAL TAMPONADE
FLUID IN PARICARDIAL SAC, PERICARDIAL SAC DOES NOT STRETCH, W/ 200-300CC S/S DEVOLOPE, 20CC REMOVED=SIGNIFICANT RELIEF, BLOOD NEEDS TO BE EVACUATED IN 10 MIN.
WHAT ARE S/S OF PARICARDIAL TAMPONADE
JVD, MUFFLED HEART SOUNDS, NARROWING PULSE PRESSURE, PUSLUS PARADOXUS, KUSSMAULS SIGN, ELECTRICAL ALTERATIONS
KUSSMAULS SIGN
DECREASE OR ABSENSE OF JVD DURRING INSPIRATION
PULSUS PARADOXUS
DROP IN BP OR PERIPHERAL PULSE DURRING INSPIRATION
TRAUMATIC AORTIC ANURYSM/RUPTURE
85-95% MORTALITY, 80-90% DIE IN 1ST HOUR
WHAT THREE POSITIONS IS AORTA FIXED
WHERE AORTA JOINS HEART(AORTIC ANNULUS), LIGAMENTUM ARTERIOSUM(AORTIC ISTHMUS, AT DIAPHRAGM, TEARS USUALY OCCUR ON DESCENDING SECTION AND AT THE LIGAMENTUM ARTERIOSUM
LOCATION OF DIAPHRAGM
4TH INTERCOSTAL SPACE ANTERIORLY, 6TH INTERCOSTAL SPACE POSTERIORLY
WHAT IS LIFE THREAT OF ESOPHAGEAL RUPTURE
STOMACH CONTENSE OR AIR IN MEDIASTINUM
TRACHEOBRONCHIAL INJURY
HAPPENS LESS THAN 3% OF TIME, 30% MORTALITY, 50% DIE W/I ONE HOUR, USUALYW/I 2.5 CM OF CARINA
TRAUMATIC ASPHYXIA
RESULTS FROM SEVERE CRUSH INJURY, INTRATHORASIC PRESSURE INCREASES, BLOOD RETURNING TO R SIDE OF HEART IS DISPERSEDINTO VEINS OF UPPER THORAX AND HEAD
S/S OF TRAUMATIC ASPHYXIA
BLOOD SHOT EYE, BULGING BLUE TONCUE, JVD, CYANOTIC UPPER BODY
WHAT ARE THE ABDOMINAL SECTIONS
1.RETROPERITONEAL-KIDNEY, AORTA, VENA CAVA, PART OF DUODENUM AND PANCREAS(NO PROTECTION) 2.PELVIC SPACE-BLADDER, RECTUM, OVARIES, FALLOPIAN TUBES 3.ABDOMINAL SPACE-4 QUADS
UPPER RIGHT QUADRANT
LIVER, R KIDNEY, GAL BLADDER, DUODENUM, HEAD OF PANCREAS, PART OF TRANSVERSE COLON
UPPER LEFT QUADRANT
SPLEEN, TAIL OF PANCREAS, STOMACH, L KIDNEY, PART OF TRANSVERSE COLON
RIGHT LOWER QUADRANT
APPENDIX, ASCENDING COLON, SMALL INTESTINE, R OVARY & FALLOPIAN TUBE
LEFT LOWER QUADRANT
SMALL INTESTINE, DESCENDING COLON, LEFT OVARY & FALLOPIAN TUBE
RETROPERITONEAL STRUCTURES
KIDNEYS, DUODENUM, PANCREAS, URINARY BLADDER, POSTERIOR PORTIONS OF COLON, RECTUM, MAJOR VASCULAR STRUCTURES
PERITONEUM
SEROUS MEMBRANE, FLUID BETWEEN LAYERS, SENSITIVE, STERAL SPACE, EASILY INFLAMED, COMPRISED OF MESENTARY AND OMENTUM
LIVER
2ND IN AMOUNT OF FUNCTIONS TO BRAIN, PERFORMS OVER 200 FUNCTIONS, RECEIVES 25% OF CO, HOLDS GREATEST BLOOD RESERVE OF ALL ORGANS, 2.5% OF TOTAL BODY WEIGHT, PAIN REFERED TO RIGHT SHOULDER
GALLBLADDER
3-4 IN LONG, STORES UP TO 40-70 CC OF BILE BRODUCED BY LIVER, BILE HELPS DIGESTION OF FAT-CHOLESTEROL-PHOSPHOLIPIDS-LIPOPROTEINS
PANCREAS
ACINI CELLS (99% OF CELLS IN PANCREAS) PRODUCE ENZYMES INVOLVED IN THE DIGESTION OF STARCHES-EMULSIFIED FATS-PROTEINS, PRODUCS BICARBONATE TO BUFFER ACID FROM STOMACH
PANCREAS
ISLETS OF LANGERHANS CONTAIN BETA CELLS (75%) THAT SECRETE INSULIN, ALPHA CELLS THAT SECRETE GLUCAGON, DELTA CELLS THAT SECRETE SOMATOSTATIN(HELPS INSULIN LOWER BLOOD SUGAR), PAIN RADIATE TO BACK
SPLEEN
STORES AND RELEASES BLOOD WHEN NEEDED, CONTAINES PLASMA CELLS THAT PRODUCE ANTIBODIES, CONTAIN MACROPHAGES THAT KILL PATHOGENS, OLD RBC, PLATELETS, PAIN REFERED TO LEFT SHOULDER
KIDNEYS
FORMS URIN FROM BLOOD PLASMA, WASTE PRODUCTS EXCRETED, ORGAN MOST RESPONSIBLE FOR ACID BASE BALANCE, PAIN RADIATED FROM FLANK TO GROIN
WHAT WILL HAPEN IF ABDOMIN CONTENTS ARE SPILLED INTO PERITONEUM
INFLAMATION WITH IN 12-24 HOURS, BLOOD WILL NOT CAUSE PERITONITIS
LOCATION OF UTERUS DURRING PREGNANCY
1ST TRIMESTER-JUST ABOVE PUBIC BONE, 5TH MONTH-AT UMBILICUS, 7TH MONTH-AT XYPHOID PROCESS
CARDIAC OUTPUT FOR PREGNANT WEMON
CO INCREASES 20-40% IN FIRST 10 WEEKS, PEAKS AT 6-7L PER MIN, HEART INCREASES 10-15 BPM, 45-50% INCREAES IN BLOOD VOLUME, CAN LOOSE 30-35% BEFORE HYPOTENSION
WHAT IS CARE FOR FLAIL CHEST
APPLY GENTLE PRESSURE WITH BULKY TRAUMA PAD OR PILLOW
WHAT IS CARE FOR PNEUMOTHORAX
SEAL WITH OCCLUSIVE ON THREE SIDES, SHOULD EXTEND 2" AROUND SITE, IF SIGNS OF TENSION DEVOLOPE-UNSEAL OCCLUSIVE
WHAT IS CARE FOR TENSION PNEUMOTHORAX
DECOMPRESS-MIDCLAVICULAR:2ND-3RD INTERCOSTAL SPACE, MIDAXILLARY:AROUND 5TH INTERCOSTAL SPACE(NIPPLE LINE) ABOVE RIB @ 90deg. WITH LARGE BORE FILLED WITH WATER
WHAT MAY CAUSE STRESS ON AN ANEURYSM
BP TAKEN ON LEFT ARM
WHAT IS CARE FOR EVISCERATION
WET STERAL DRESSING, OCCLUSIVE DRESSING, DRY STERILE LINT FREE BULKY DRESSING