MEDI7212 Lecture Notes - Lecture 63: Aortic Dissection, Pulsus Paradoxus, Intercostal Space
Document Summary
Blunt: acceleration-deceleration injuries (high velocity mechanism) usually affects solid structures (heart, great vessels, mechanism. Fall from height: 5m fall equals 36km/hr impact velocity vs 20m fall equals. 72km/hr impact velocity: heart strikes on impact causing widespread destruction to attached vasculature and other intrathoracic contents, road traffic accident, 40-50% unrestrained drivers have thoracic injuries, 25% drivers that die have a thoracic injury. Seat belt sign: contusions and abrasions on the abdomen of a restrained occupant involved. Seatbelt syndrome - find intraabdominal injury (small bowel, stomach, colon) and vertebral (chance fracture) using abdominal. Ct: three directions of injury, anterior-posterior, backwards motion of heart -> disruption of aorta below the subclavian artery or wishbone fracture of proximal bronchus, actual myocardial injury, disruption of valvular mechanisms. Lung 21: chest wall 70% - rib fractures are most common injury, diaphragm 7, oesophagus 7, aorta 5%
