外科胸部外伤课件.pptVIP

THORACIC INJURY General consideration (1) Physiological basis: * Pleural cavities are the closed spaces * Lung ventilation is accomplished by the generation of negative pressure * Negative pressure: During the quiet respiration, it varies from -6 to -12 cmH2O with inspiration to -3 to -5 cmH2O during expiration General consideration (2) Anatomy basis: * Pleura is divided into two portions: Parietal: internal lining of the chest wall Visceral: covering the entire surface of the lung General consideration (3) Normal situation: * The pleural cavities are to be closed space * There are a little fluid accumulated not being seen Abnormal situation: Increased capillary hydro-pressure or great negative intra-pleural pressure, tends to increase transudation into the cavity, loss of intra-pleural negative pressure (pneumo-thorax) diminished transudation General consideration (4) Pleural cavity in summary: The vital important space for circulation and respiratory systems Special anatomic and physiological situation * negative pressure in the pleural cavities * thoraco-abdominal injury * mild traumatic injury may salvaged by relative minor procedure The treatment : simple straightly maneuver General consideration (5) Mechanisms of thoracic injury * blunt trauma (combined injury) * penetrating (local injury) Common causes * Peaceful time: Automobile, industrial accidents, violent injury * Wartime: missiles, gun shot General consideration (6) The classification of thoracic injury Closed thoracic injury: * rib fracture * pneumo-thorax * hemo-thorax * traumatic asphysia, et al. Open thoracic injury: * blind wound: triangle knife, stabbing injury. * penetrating injury: gun shot, gun fire General consideration (7) Thoraco-abdominal injury: Chest injury below the 4th intercostal space, diaphragm, spl