Trunk Trauma

Question 1

Aortic dissection s/s

Answer 1

• new onset murmur
• widened mediastinum
• obscured aortic knob on XR

Question 2

Open Pneumothorax (air-leak syndrome) s/s

Answer 2

• sucking chest wound on inhalation

- bubbling blood on exhalation

Question 3

Tension Pneumothorax s/s

Answer 3

• respiratory distress
• JVD
• hypotension increased inspiration
• absent or reduces breath sounds on affected side
• tracheal deviation to unaffected side

Question 4

Pericardial tamponade (obstructive shock) - Becks Triad

Answer 4

Becks Triad:

• JVD
• hypotension
• muffled (distant) heart sounds
• pulsus paradoxus (fall in BP >10)

Question 5

REBOA- where is zone 1 and 3?

Answer 5

zone 1- abdominal hemorrhage

zone 3- pelvic trauma

Question 6

Ruptured diaphragm s/s

Answer 6

• penatrating trauma below 4th ICS
• peristaltic gurgling in left chest
• progressively scaphoid abdomen (concaves in)
• Kehr’s sign (left shoulder pain) worsening when supine

Question 7

Liver injury s/s

Answer 7

• Cullen’s sign (ecchymosis/ bruising around umbilicus)

Question 8

Pancreatic injury s/s

Answer 8

• *commonly missed initially
• sits retroperitoneal (Grey-Turner’s sign)
• epigastric pain radiating to back

Question 9

Abdominal Compartment Syndrome

Answer 9

• level transducer at symphysis pubis with patient in supine

- normal reading 12-15 mmHg, >20 may require decompression