Injuries Associated with PenetratingThoracic TraumaTracheobronchial treeClosed pneumothoraxlacerationsOpen pneumothoraxEsophageal lacerations(including sucking chestPenetrating cardiacwound)injuriesTension pneumothoraxPericardial tamponade PneumomediastinumSpinal cord injuriesHemothoraxDiaphragm traumaHemopneumothoraxIntra-abdominalLaceration of vascularpenetration withassociated organ injurystructures16
16 Injuries Associated with Penetrating Thoracic Trauma ◼ Closed pneumothorax ◼ Open pneumothorax (including sucking chest wound) ◼ Tension pneumothorax ◼ Pneumomediastinum ◼ Hemothorax ◼ Hemopneumothorax ◼ Laceration of vascular structures ◼ Tracheobronchial tree lacerations ◼ Esophageal lacerations ◼ Penetrating cardiac injuries ◼ Pericardial tamponade ◼ Spinal cord injuries ◼ Diaphragm trauma ◼ Intra-abdominal penetration with associated organ injury
Pathophysiology of Thoracic TraumaChestWallInjuriesRib Fractures>50% of significant chest trauma cases due toblunt traumaCompressional forces flex and fracture ribs atweakest points Ribs 1-3 requires great force to fracture. Possible underlying lung injuryRibs 4-7 are most commonly fracturedRibs 8-12 less likely to be fracturedTransmit energy of trauma to internal organsIf fractured,suspect liver and spleen injuryHypoventilation is COMMON due to PAIN17
17 Pathophysiology of Thoracic Trauma Chest Wall Injuries ◼ Rib Fractures ◼ >50% of significant chest trauma cases due to blunt trauma ◼ Compressional forces flex and fracture ribs at weakest points ◼ Ribs 1-3 requires great force to fracture ◼ Possible underlying lung injury ◼ Ribs 4-7 are most commonly fractured ◼ Ribs 8-12 less likely to be fractured ◼ Transmit energy of trauma to internal organs ◼ If fractured, suspect liver and spleen injury ◼ Hypoventilation is COMMON due to PAIN