七年制医学课件 专外 16Chest Injury.ppt

Chest Injury Yang Shuangqiang杨双强 Cardiothoracic Surgery The First Affiliated Hospital of Chongqing University of Medical Sciences General Introduction ⒈Reason for studying ① Susceptibility to injury: Chest constitutes a major portion of trunk, more exposed to injury. ② Serious result after injury: The two vital organs, heart and lung, essential to circulatory and respiratory functions are located in the chest. ③ High mortality rate: Traumatic injury ranks the third cause of death among mortalities of general population. 30%-50% of traumatic mortalities are due to chest injuries, ranking the first cause of death among traumatic mortalities. ④ Owing to the high mortality rate after chest injury, early diagnosis is very important and emergency treatment mandatory. ⑤ According to statistics, 80% of seriously injured patients may be saved if treated in time. ⑥ Emergency treatment is of particular importance for chest injuries. ⒉ Anatomical and Physiological  Characteristics of Chest Wall and Pleural Cavity ⑴ Chest wall……Bony framework of thoracic cage (thoracic vertebrae, sternum, and 12 pairs of rib)+ muscular and soft tissue. ⑵ Pleural cavity……A potential space formed by surrounding parietal and visceral pleurae. Characteristics of pleural cavity:① pleural cavity integrity . ② Persistent negativity of intrapleural pressure. Inspiratory phase -8~-10cm.H2O Expiratory phase -3~-5cm.H2O These characteristics of pleural cavity are important for the maintenance of normal respiratory and circulatory functions, especially for respiration. ⑶ Interrelationship among 3 pressure changes The 3 pressures: ① Atmospheric P. ② Intrapleural P. (intrathoracic P.) ③ Intrapulmonary P. (intraalveolas P.) ⒊ Classification and Causative Factors of Thoracic Trauma Classification in accordance with ⑴ whether the parietal pleura is perforated. ⑵ whether the thoracic cavity is in communication with atmosphe