chest trauma

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Author:
Anonymous
ID:
50546
Filename:
chest trauma
Updated:
2010-11-19 01:18:59
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chest trauma
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chest trauma
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  1. blunt or penatrating injuries OR a combination of blunt and penetrating injuries to chest wall and lung parenchyma
    chest trauma
  2. associated w/ deceleration, acceleration, or compression injuries (nothing went through the chest wall)
    blunt trauma
  3. deceleration =
    • MVA
    • falls
  4. acceleration =
    • blast injuring from explosion
    • struck w/ blunt object (bat, pipe)
  5. low- speed penetrating trauma
    knife wounds
  6. high-speed penetrating trauma
    velocity most imp factor in predicting severity (gun shot)
  7. abnormal accumulation of air in the subcutaneous or soft tissues seen on chest xray
    subcutaneous emphysema
  8. affted area of the chest wall moves inward w/ inspiration or outward w/ expiration is termed
    paradoxical chest movement
  9. worsened w/ positive pressure ventilation. persistent leakage of air into the pleural space despite proper chest tube placement and suction.

    rare. treatment includes rapid repair of the underlying injury.
    bronchopleural fistula
  10. compression of the heart due to a build-up of blood in the pericardium.

    treatment includes surgery/ emergent needle thoracotomy
    cardiac tamponade
  11. defined as an abnormal dilatation of the aorta

    blood makes its way btwn the laters of a blood vessel wall, seperating them.

    treatment is surgical repair
    aneurysm
  12. simple rib fractures usually involves ribs
    4-10
  13. simple rib fractures may result in (4)
    • v/q mismatch
    • hypoxemia
    • atelectasis
    • pneumonia
  14. treatment of simple rib fracture includes
    analgesia
  15. two or more fractures on each affected rib that result in a free floating portion of the rib cage
    flail chest
  16. flail chest causes
    paradoxical chest movement
  17. flail chest trauma usually includes pulm contusion which results in the alveoli and may result in (3)
    • intrapulm shunting
    • v/q mismatch due to hypoxemia
    • inc WOB
  18. treatment of flail chest includes
    • stabilize the chest wall w/ positive pressure vent
    • surgical stabilization
    • -placement of rib plates
    • -wiring of ribs
  19. associated w/ penetrating chest trauma, but also seen with severe blunt trauma from explosive blasts
    open pneumothorax
  20. associated w/ penetrating trauma, air enters the pleural space during inspiration, but cannot exit the plueral space bc the parietal pleura acts as a one way valve
    closed or tension pneumothorax
  21. in closed or tension pneumothorax the mediastinum shifts _____ from the affected area
    AWAY
  22. when mediastinum shifts away from the affected area, it causes (3)
    • dec in venous return to the heart
    • hypotension
    • shock
  23. presence of blood in the pleural space. can be associated with blunt or penetrating trauma is termed
    hemothorax
  24. presence of air and blood in the pleural space is termed
    hemopneumothorax
  25. bronchopleural fistula worsens with what type of ventilation
    positive pressure ventilation
  26. flail chest treatment
    • positive pressure vent
    • surgical
    • -rib plates
    • -wiring of ribs
  27. general trauma treatment (7)
    • o2 therapy
    • hyperinflation
    • mech vent
    • airway management/sucction/broncho hygiene
    • chest tube placement
    • iv fluids or blood
    • pain management
  28. associated w/ blunt chest trauma when lung impacts against the chest wall. alveolar microvascular damage allows blood to enter alveoli is termed as
    pulm contusion
  29. results from a penetrating injury. result in a sliding motion and the tearing of the lung parenchyma.

    often seen in association w/ pulm contusion.

    usually resolves spontaneously
    pulm hematoma

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