Special Surgery · MU Plovdiv

12. Blunt thoracic trauma

Inside: 58 sections · 10 labelled pictures · 2 tables · 14 flashcards · 17 min

Topic 12 of 74 in the MU Plovdiv syllabus for Special Surgery (Medicine, Year 4). The free AceMed note covers it in 43 sections, about 2,056 words (17 min of reading), with 14 flashcards.

In this note

  1. THEME III: THORACIC TRAUMA: Rib fractures. Sternal fractures. Scapular & Clavicular Fractures. Pneumothorax. Hemothorax. Pulmonary contusion.
  2. Which are the most common major thoracic injuries?
  3. Which is the classical mechanism of sternal fractures?
  4. For which thoracic injury associated with sternal fractures following motor vehicle crashes must be thought?
  5. What is the usual clinical presentation of sternal fracture?
  6. Which are the clinical signs of clavicular fracture?
  7. Fractures of the scapula are uncommon. Why?
  8. Which are the “lethal six” major injuries in thoracic trauma?
  9. Which are the “hidden six” major injuries in thoracic trauma?
  10. What is the definition of “Hemothorax”?
  11. What is the typical presentation in patients with Hemothorax?
  12. What is the definition of “massive Hemothorax”?
  13. There are 5 indications for performing an urgent thoracotomy. Which are they?
  14. What is the definition of “cardiac tamponade”?
  15. What is the definition of “beck’s triad”?
  16. What is the ultimate treatment of cardiac tamponade?
  17. What is the definition of “Myocardial contusion”?
  18. What is the most frequent scenario for myocardial contusion?
  19. What is the definition of “Pulmonary contusion”?
  20. Which is the most common potentially lethal chest injury?
  21. The management of patients who sustain pulmonary contusion is based on 3 factors. Which are they?
  22. Mediastinal and subcutaneous cervical emphysema is an evidence of what kind of injury in thoracic trauma?
  23. The mortality in esophageal injuries rises exponentially if treatment is delayed more than 12-24 hours. Why?
  24. Which signs can suggest “Cervical Tracheal injury”?
  25. In which thoracic trauma injuries tension pneumothorax and Murmured heart sounds are presented?
  26. Thoracic trauma - deadly dozen, penetrating/ blunt
  27. threatening conditions in thoracic trauma,
  28. what to do in emergency cardiac tamponade,
  29. what to do in airway obstruction,
  30. 6 lethal and 6 hidden caused by chest trauma
  31. Cardiac tamponade
  32. difference between cardiac tamponade and tension
  33. Hemothorax
  34. Definition
  35. Types
  36. Anatomy of Chest Wall
  37. CHEST TRAUMA. TRAUMATIC HEMOTHORAX
  38. Etiology
  39. Clinical Features
  40. Diagnosis
  41. Treatment
  42. CHEST TRAUMA. PULMONARY CONTUSION. TRACHEAL INJURY. ESOPHAGEAL INJURY. CARDIAC TAMPONADE
  43. Thoracic Trauma Deadly Dozen

Which are the most common major thoracic injuries?

  • Rib fractures are the most common major thoracic injuries. Up to 40% of all thoracic trauma patients present with rib fractures.

Which is the classical mechanism of sternal fractures?

The classic mechanism of sternal fractures is:

Direct impact of the sternum of an unrestrained driver against the steering column of an automobile in a deceleration crash.

For which thoracic injury associated with sternal fractures following motor vehicle crashes must be thought?

  • Myocardial contusion
  • It is the most important thoracic injury associated with sternal fractures following motor vehicle crashes.
  • A baseline ECG should be obtained especially in patients over age 40.
  • Many patients like this with significant anterior chest trauma will → have transient right ventricular dysfunction but the need for cardiac monitoring is based upon the associated injuries and underlying cardiac rather than the sternal fracture.

What is the usual clinical presentation of sternal fracture?

The clinical manifestations of sternal fractures include:

  1. Anterior chest pain
  2. Tenderness
  3. Ecchymosis
  4. Swelling
  5. A palpable deformity
  6. Motion of the fracture fragments upon respiration

Which are the clinical signs of clavicular fracture?

Clinical signs of clavicular fracture are:

  1. Tenderness
  2. Crepitus
  3. Palpable deformity

The ipsilateral shoulder may be positioned inferiorly and medially if the fracture is displaced.

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