Anatomy and Physiology of the ThoraxMediastinumCentral space within thoracic cavityBoundariesLateral:LungsInferior:DiaphragmSuperior:Thoracicoutlet上级漏Structures胸骨粉Heart胸骨角GreatVessels前纸匾Esophagus中纵隔-21Trachea后纵隔下级隔NervesVagusPhrenicThoracicDuct6
6 Anatomy and Physiology of the Thorax ◼ Mediastinum ◼ Central space within thoracic cavity ◼ Boundaries ◼ Lateral: Lungs ◼ Inferior: Diaphragm ◼ Superior: Thoracic outlet ◼ Structures ◼ Heart ◼ Great Vessels ◼ Esophagus ◼ Trachea ◼ Nerves ◼ Vagus ◼ Phrenic ◼ Thoracic Duct
Thoracic Trauma Chest trauma (or thoracic trauma) is a serioussinjuryof the chest Thoracic trauma is a common cause of significantdisability and mortality, the leading cause of death fromphysical trauma after head and spinal cord injury.Blunt thoracic injuries are the primary or a contributingcause of about a quarter of all trauma-related deaths The mortality rate is about 10%
7 ◼ Chest trauma (or thoracic trauma) is a serious injury of the chest. ◼ Thoracic trauma is a common cause of significant disability and mortality, the leading cause of death from physical trauma after head and spinal cord injury. ◼ Blunt thoracic injuries are the primary or a contributing cause of about a quarter of all trauma-related deaths. ◼ The mortality rate is about 10%. Thoracic Trauma
ClassificationChest trauma can be classified as bluntt orpenetrating Blunt and penetrating injuries have differentpathophysiologies and clinical courses.Specific types of chest trauma include:(1)Injuries to the chest wall Chest wall contusions or hematomasRib fracturesFlail chestSternal fracturesFractures of the clavicle and sshoulder girdle8
8 Classification ◼ Chest trauma can be classified as blunt or penetrating. ◼ Blunt and penetrating injuries have different pathophysiologies and clinical courses. ◼ Specific types of chest trauma include: (1)Injuries to the chest wall ◼ Chest wall contusions or hematomas. ◼ Rib fractures ◼ Flail chest ◼ Sternal fractures ◼ Fractures of the clavicle and shoulder girdle
(2)Pulmonary injury (injury to the lung) and injuriesinvolving the pleural spacePulmonary contusionPulmonary lacerationPneumothoraxHemothoraxHemopneumothorax(3)Injury to the airwaysTracheobronchial tear9
9 (2)Pulmonary injury (injury to the lung) and injuries involving the pleural space ◼ Pulmonary contusion ◼ Pulmonary laceration ◼ Pneumothorax ◼ Hemothorax ◼ Hemopneumothorax (3)Injury to the airways ◼ Tracheobronchial tear
Most blunt injuries are managed with relatively simpleinterventions like intubation and mechanical ventilationand chest tube insertion.Diagnosis of blunt injuries may be more difficult andrequire additional investigations such as CT scanningPenetrating injuries often require surgery, and complexinvestigations are usually not needed to come to adiagnosis.10
10 ◼ Most blunt injuries are managed with relatively simple interventions like intubation and mechanical ventilation and chest tube insertion. ◼ Diagnosis of blunt injuries may be more difficult and require additional investigations such as CT scanning. ◼ Penetrating injuries often require surgery, and complex investigations are usually not needed to come to a diagnosis