Thoracic Injuries and Anatomy Review

Thoracic injuries are common and potentially serious, involving injuries that interfere with normal breathing and require immediate treatment.
Blood from lacerations of thoracic organs and major blood vessels can collect in the chest cavity, preventing lung expansion.
Prevention strategies include gun safety education, sports training, and seat belt use.

The thoracic cavity extends from the lower end of the neck to the diaphragm.
The mediastinum is the central region of the thorax, containing the heart, great vessels, esophagus, lymphatic channels, trachea, main stem bronchi, and phrenic nerves.
The thoracic cavity is partially protected by the ribs, connected to the 12 thoracic vertebrae in the back and to the sternum through costal cartilages in the front.
Intercostal muscles and the diaphragm are the primary muscles for breathing, while the sternal, clom, mastoid, trapezes, rhomboids, and latissimus dorsi muscles provide covering for the framework of the posterior thorax.
The pectoralis major surrounds the rib cage in the front.

Ventilation occurs through expansion and contraction of the thoracic cage, with intercostal muscles and the diaphragm contracting and descending for inspiration, and relaxing for expiration.
Oxygenation is the delivery of oxygen from the air to the blood, occurring in the pulmonary circulation.
Cardiac output is the volume of blood delivered to the body in 1 minute.
Chemical changes can influence the rate and depth of breathing, with chemo receptors responding to chemical fluctuations.

Categories of thoracic trauma include blunt and penetrating injuries, with blunt trauma causing force distribution over a large area, and penetrating injuries distributing forces over a smaller area.
Closed injuries are those where force is distributed over a large area, while open injuries are penetrating injuries that distribute forces over a smaller area.
Blunt trauma can cause fractured ribs, sternum, or chest wall, leading to bruised lungs and heart, and damage to the aorta.
Blast injuries occur when a shock wave compresses organs, similar to blunt trauma.
Any injury to the chest has the potential to be lethal, causing blood loss, pressure changes, vital organ damage, or any combination.

Pain at the site of the injury, aggravated by breathing
Visible bruising to the chest wall
Crepitus with palpation of the chest
Penetrating injury to the chest
Shortness of breath
Failure to expand the chest normally while breathing
Rapid weak pulse and low blood pressure
Signs of cyanosis (blue lips or fingernail beds)
Change in breathing (fewer than 12 or more than 20 breaths per minute)
Tachypnea or bradypnea
Dnia (airway obstruction, damage to the chest wall, improper lung expansion, or lung compression)
Absent radial pulses (severe hypotension)
Rapid weak pulse and hypotension (hypovolemic shock)
Narrow pulse pressure (increased pressure on the myocardium)

Thoracic injuries can interfere with normal breathing and require immediate treatment.
Blood from lacerations can collect in the chest cavity, preventing lung expansion.
Prevention strategies include gun safety education, sports training, and seat belt use.

The thoracic cavity extends from the lower end of the neck to the diaphragm.
The mediastinum contains the heart, great vessels, esophagus, lymphatic channels, trachea, main stem bronchi, and phrenic nerves.
The thoracic cavity is partially protected by the ribs, connected to the 12 thoracic vertebrae in the back and to the sternum through costal cartilages in the front.
Intercostal muscles and the diaphragm are the primary muscles for breathing.
The pectoralis major surrounds the rib cage in the front.

Ventilation occurs through expansion and contraction of the thoracic cage.
Inspiration occurs when intercostal muscles and the diaphragm contract and descend.
Oxygenation is the delivery of oxygen from the air to the blood, occurring in the pulmonary circulation.
Cardiac output is the volume of blood delivered to the body in 1 minute.
Chemical changes can influence the rate and depth of breathing.

Thoracic trauma can be categorized into blunt and penetrating injuries.
Blunt trauma causes force distribution over a large area, while penetrating injuries distribute forces over a smaller area.
Closed injuries are those where force is distributed over a large area, while open injuries are penetrating injuries that distribute forces over a smaller area.
Blunt trauma can cause fractured ribs, sternum, or chest wall, leading to bruised lungs and heart, and damage to the aorta.
Blast injuries occur when a shock wave compresses organs, similar to blunt trauma.

Pain at the site of the injury, aggravated by breathing.
Visible bruising to the chest wall.
Crepitus with palpation of the chest.
Penetrating injury to the chest.
Shortness of breath.
Failure to expand the chest normally while breathing.
Rapid weak pulse and low blood pressure.
Signs of cyanosis (blue lips or fingernail beds).
Change in breathing (fewer than 12 or more than 20 breaths per minute).
Tachypnea or bradypnea.
Dnia (airway obstruction, damage to the chest wall, improper lung expansion, or lung compression).
Absent radial pulses (severe hypotension).
Rapid weak pulse and hypotension (hypovolemic shock).
Narrow pulse pressure (increased pressure on the myocardium).