CHEST TRAUMA CHEST TRAUMA

May 19, 2010

Outline:

Soft tissue injuryBoneLungMediastinumGreat vessels.

Normal chest

Subcutaneous emphysema: Soft tissue injury / fracture

Subcutaneous emphysema: could be from rib fracture, stab wound, larynx or tracheal injury

Blunt chest injury with fracture ribs, subcutaneous and mediastinal emphsyema, extend down to abdominal wall and retroperitoneum

Lung contusion: Seen as patchy / alveolar density

Unilateral lung contusion, DDx aspirated pneumonia

Pulmonary contusion, DDx pneumonia

Lung contusion

Air bronchograms:

Resulted from:Alveolar pathology eighter fluid (exudate, edema blood) or cell (alveolar cell ca) or alveolar atelectasis (surfactant def.)

Pulmonary contusion

Pulmonary edema / ARDS as a consequence of lung contusion with subpneumonic gas

What is your diagnosis?

Tension pneumothorax

Tension pneumothorax

RLL atelectasis, AP: right retrocardiac density

Lat: Ligh vertebral sign

RUL Atelectasis

Mediastinal emphysema: could be from rib fracture, trachea injury, esophageal injury

Pneumo-mediastinum:

Better seen in lateral view as lucent streak outline great vessel and heart

Rib fractures, subcutaneous emphsyema, mediastinal emphysema, pneumopericardium and lung contusion.

Pneumomediastinum and lung contusion: angle wing sign

LEFT DIAPHRAGMATIC RUPTURE

PLEURAL EFFUSION

What is your diagnosis?

What is your diagnosis?

Widened mediastinum

DDX:- mediastinal hematoma- aortic injury- aneurysm of aorta- from supine position.

- should be awared when interpret

Fracture rib with lung contusion and widening of mediastinum, from great vessel injury

Widening of mediastinum: hematoma

SPINE INJURYSPINE INJURY

CERVICAL SPINE ALIGNMENT

A= ANTERIOR VERTEBRAL BODY

B= POSTERIOR VERTEBRAL BODY

C= SPINOLAMINAR LINE

D = INTERSPINOUS LINE

1 = ANTERIOR LONGITUDINAL LIGAMENT

2 = INTERVERTEBRAL DISC

3 = POSTERIOR LONGITUDINAL LIGAMENT

4 = CAPSULAR LIGAMENT

5 = LIGAMENTUM FLAVUM

6 = INTERSPINOUS LIGAMENT

C1-2 ALIGNMENT C1-2 ALIGNMENT …then click the placeholders to add your own pictures and captions.

DEN FRACTURE IDEN FRACTURE I

DEN FRACTURE IIDEN FRACTURE II

DEN FRACTURE IIIDEN FRACTURE III

HANGMAN’S FRACTUREHANGMAN’S FRACTURE

BURST FRACTUREBURST FRACTURE

JEFFERSON FRACTUREJEFFERSON FRACTURE

ATLANTO-OCCIPITAL DISLOCATIONATLANTO-OCCIPITAL DISLOCATION

CLAY CLAY SHOVELLER SHOVELLER FRACTUREFRACTURE

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