Anatomy
Rapid identification of this landmark can identify the second intercostal space for needle decompression of tension pneumothorax.
What is the angle of Louis?
This named triad can indicate cardiac tamponade. What are its three components?
Hypotension, neck vein distention, and distant/absent heart sounds.
See slide 11 for image.
What is a large pleural effusion?
Name the steps to the lifesaving procedure that treats a tension pneumothorax.
Incision, dissection, chest cavity entry, finger sweep, tube insertion, suture fixation.
This condition caused by blunt chest trauma may seem innocuous but can lead to a severe inflammatory response and multisystem organ failure.
Pulmonary contusion
A horizontal mattress suture to exclude the coronary artery.
This is an anterior diaphragmatic hernia.
Morgagni hernia
See slide 12 for image.
What is a diaphragmatic hernia?
Injuries to the trachea, right bronchus, and proximal left mainstem bronchus are best accessed via what type of incision?
right thoracotomy incision
What is the ideal imaging tool for diagnosing rib fractures?
Chest CT is gold standard
What structure must you be mindful of when repairing the diaphragm?
the phrenic nerve
This condition/injury/trauma can result in laceration of the intercostal artery.
See slide 69 for image
pulmonary contusion
Name a hemorrhage control maneuver for the lung that can be performed without any equipment (except for a Bovie)?
Chronic diaphragmatic injuries are best repaired through the ??
Thorax/chest
What three nerves must you avoid injuring during a resuscitative thoracotomy?
Phrenic, vagus, and recurrent laryngeal nerves
Patient in extremis despite adequate management of a left hemothorax.
See image 70 for image.
Cardiac tamponade
Surgical fixation of rib fractures is ideally performed when in a patient's hospitalization?
Fixation is indicated within 72 hours of injury. If there are higher priority injuries, this can be delayed.
This well known American cardiothoracic surgeon underwent an aortic dissection repair at age 97, a technique he himself had pioneered.
Michael DeBakey, MD
What are the borders of the superior mediastinum?
Superior mediastinum is bounded superiorly by the innominate artery, inferiorly by the transverse aortic arch, laterally by the pleura, anteriorly by the manubrium, and posteriorly by the T4-T5 vertebrae.
Which famous survivor of chest trauma has been hit with a few shells but does not walk with a limp?
Curtis "50 cent" Jackson
What is the gold standard diagnostic tool for a patient in extremis with concern for chest trauma?
Cold steel.
abdomen
What is Dr. Horace Smithy's claim to fame?
He performed the first resuscitative thoracotomy.