Q) Not a frontline treatment of flail chest ( Trauma Questions - 9)
a) Mechanical ventilation to internally splint the chest
b) Physiotherapy
c ) oxygen
d) Opiate
Trauma
Trauma
Q) a 50 year old man with road side accident and injuries on right chest and femoral fracture, He is conscious, BP is 80/60 , Pulse 104/min, and chest expansion is reduced. JVP is not raised and heart sounds are normal. Respiratory rate is 22/min
What does he have
a) Left heart failure
b) Fat Embolism
c) Pneumothorax
d) Fluid loss
Denver Criteria
Q) DENVER CRITERIA is used in
a. Blunt cerebrovascular trauma
b. Chest trauma
c. Blunt trauma abdomen
d) Penetrating abdominal injury
High speed injury
Q) A young 18 years old unrestrained car driver has an head on collision with a truck and becomes unconscious. He is intubated on the site of accident and resuscitated with IV fluids. He is brought to the emergency in a state of shock,( BP 90/60 and pulse 120/min) but opens eyes on commands. On examination he does not have pallor but neck veins are distended.
There are no signs suggestive of head or spine injury. Xray chest reveals normal cardiac chambers, no free gas and mild pleural effusion on left with no evidence of fracture ribs.
What will be the next step of management
a) Resuscitation and simultaneous CT thorax
b) Resuscitation and simultaneous Echo cardiography
c) Exploratory laparotomy
d) Chest tube drainage left side
Aortic rupture
Q) Most common site for traumatic aortic rupture is
a) Distal to the origin of left subclavian artery
b) Point of entry of aorta above the diaphragm
c) Root of aorta
d) Point distal to Left carotid artery
Answer
a) Distal to origin of subclavian artery
Traumatic aortic rupture leads to sudden death after high impact automobile accident or fall from height. Aorta is relatively fixed distal to ligament arteriosum just distal to the origin of subclavian artery and this is the most common site of traumatic rupture especially partial rupture in which adventitia is intact.
Specific clinical findings are
- Asymmetry of BP in upper limbs or upper and lower limbs
- Widened pulse pressure
- Chest wall contusions
Bailey page 355
http://www.msdmanuals.com/professional/injuries-poisoning/thoracic-trauma/aortic-disruption-traumatic
Penetrating Neck trauma
Q) In penetrating neck trauma, to help in the management, neck has been divided into zones. Great vessels of thoracic inlet are seen in (#Gen Surgery Trauma)
a) Zone 1
b) Zone II
c) Zone III
d) None