Based on Nancy Caroline's Emergency Care in the streets chapters 23,24
The thoracic cavity extends to the ninth or tenth rib posteriorly
The diaphragm inserts into the anterior thoracic cage below the fifth rib
The dimensions of the thorax are defined inferiorly by the thoracic inlet
The dimensions of the thorax are defined anteriorly by the thoracic vertebrae
Manubrium
Angle of louis
Costal cartilage
Suprasternal notch
Third intercostal space
Intrathoracic margin
Second intercostal space
Second subcostal margin
Comprises the pericadial sac itself
Is attached directly to the diaphragm
Is the outermost layer of the pericardium
Adheres to the heart and forms the epicardium
Less than the pressure within the right atrium
One fourth of the pressure within the left ventricle
Nearly equal to the pressure within the left ventricle
Three times greater than the pressure in the left ventricle
4,800
5,200
6,000
6,400
Anulus
Coronary sinus
Aortic hiatus
Ligamentum arteriosum
Is an accessory muscle used during respiratory distress
Works in conjunction with the sternum during inspiration
Forms a barrier between the thoracic and abdominal cavities
Creates positive intrathoracic pressure when it increases in size
The patient often purposely limits chest wall movement
Most rib fractures cause paradoxical chest wall movement
The pain associated with the fracture causes hyperventilation
Preferential use of the intercostal muscles reduces tidal volume
Allows the body to compensate for the injury
May cause atelectasis, hypoxemia, or pneumonia
Is often accompanied by subcutaneous emphysema
Is characterized by a markedly increased tidal volume
Positive pressure created by expiration forces air into the pleural space
The heart stops perfusing the lung on the side of an open chest injury
Negative pressure created by inspiration draws air into the pleural space
The glottic opening is much larger than the open wound on the chest wall
Decreased pulmonary function
Contralateral tracheal deviation
Compression of the great vessels
Marked decrease in venous return
Pulmonary injury with secondary myocardial injury
10% of circulating blood volume in the pleural space
Cardiac arrest secondary to severe intrapleural bleeding
More than 1,500 mL of blood within the pleural space
Excess tachycardia that accompanies the injury
Damage to myocardial tissue at the cellular level
Aneurysm formation caused by vascular damage
Direct damage to the vasculature of the epicardium
Shearing forces
Rear-end collisions
Penetrating trauma
Motorcycle crashes
Fifth rib to the pelvis
Umbilicus to the pelvis
Diaphragm to the pelvis
Nipple line to the diaphragm
Recognizing the need for rapid transport
Initiating fluid resuscitation in the field
Contracting medical control immediately
Performing a careful abdominal assessment
Space behind the navel
External umbilical orifice
Areas lateral to the umbilicus
Area around the umbilicus
Panceas
Stomach
Small bowel
Gallbladder
The liver is the largest hollow organ in the abdomen and is responsible for producing and storing bile
The liver is a relatively avascular organ that is uncommonly injured during blunt abdominal trauma
The liver is a solid organ that lies in the right upper abdominal quadrant and detoxifies the blood
The liver is partially protected by the left lower ribcage and serves the function of filtering bacteria from the blood
Pylorus
Duodenum
Gallbladder
Cardiac sphincter
The intraabdominal cavity can accommodate large amounts of blood
Blood in the peritoneum can compress the aorta and maintain perfusion
It takes approximately 4 liters of blood loss before signs of shock manifest
The abdominal muscular can sustain massive blunt force without bruising
Massive internal hemorrhage and profound shock
Peritonitis caused by rupture and spillage of toxins
Immediate death secondary to a massive infection
Delayed treatment due to the absence of external signs
Hollow abdominal organs rupture upon impact
The persons abdomen collides with the steering wheel
Rapid deceleration propels an unrestrained person forward
Abdominal organs shear from their points of attachment
Size of the patient
Profile of the bullet
Trajectory of the bullet
Distance the bullet traveled