A Lesson From Einstein : Energy cannot be created or destroyed Force has to go somewhere Energy is transmitted through human tissue Newton’s Law of Physics Force= Change in Velocity x Mass

Introduction : Trauma or injury = damage to the body caused by an exchange with environmental energy  Most common cause of death for all individuals between the ages of 1 and 44 years.  Third most common cause of death regardless of age (after cancers & cardiovascular diseases).

Anatomic Regions

Quadrant system describes location in abdomen −Four regions Periumbilical area: around the navel

Anatomic Regions

Abdominal Organs and Vital Vessels

Organs of the Genitourinary System The abdomen contains organs of the reproductive system. The female reproductive system

Organs of the Genitourinary System The male reproductive system

Physiology Some abdominal trauma can cause shock due to blood loss. −Bleeding may produce few signs and symptoms.

Evisceration

Impaled Objects © Custom Medical Stock Photo

Kidney Injuries Generally caused by large forces Suspect injury with: −Fractures of the 11th and 12th ribs −Flank tenderness

Anatomy Review (cont.) Internal thoracic organs and major blood vessels: Heart & pericardium. Lungs & pleura. Thoracic aorta. Pulmonary artery & veins. Vena cava. Trachea & esophagus. Thymus gland. Lymph nodes.

Anatomy Review Abdominal quadrants −Right Upper −Left Upper −Right Lower −Left Lower

Common Sports Injuries Fractures can occur to ribs, sternum, clavicle, or thoracic vertebrae. −Injuries must be treated immediately to avoid pneumothorax or hemothorax. Joint dislocations and subluxations of thoracic skeletal joints can occur. Costochondral separations involve disunion of sternum and ribs.

Blunt Trauma :

Blunt Abdominal Trauma :

Wound Ballistics : High Velocity Shot to Abdomen Entrance Wound Large Bowel pulled through by Bullet

Grey Turner’s sign Cullen’s sign Fox’s sign

Splenic Laceration :

Retroperitoneal Hemorrhage : Cullen’s Sign Commonly Seen with Pancreatic Injury

Gray Turner Sign :

Grey Turner’s sign Cullen’s sign Fox’s sign

Diaphragm Rupture

Tension Pneumothorax :

Hemothorax Is this patient lying or upright?

Portable CXR What’s wrong with this x-ray??

Portable Pelvic X-Ray What’s next?

Before What’s next?? After Wrapping the pelvis with a sheet

36 Penetrating Chest Trauma Injury Tension Pnuemothorax −Life Threatening −Lung collapses −Severe respiratory distress −Distended neck veins −Hypotension −Tracheal deviation −Cyanosis

37 Penetrating Chest Trauma Injury Cardiac Tamponade