Surgical anatomy of chest trauma

Abstract

Introduction. Pathological changes that occur following thoracic trauma include the full spectrum of mechanical damage to thoracic tissues and organs - from bruises and bruises to the soft tissues of the thoracic wall to fractures of the ribs, sternum and thoracic vertebrae, pleura, lungs, bronchi, bronchi and the heart, large vessels, diaphragm, nerve trunks, esophagus and thoracic duct.These changes in tissues and organs refer both to direct injury occurring at the place of force application and to trauma to the ribs, lung tissue and master vessels.Aim of the study. The study of the clinical anatomy of chest trauma began to be regarded as an independent problem until the end of the 20th century, even though the interest for the surgical treatment of chest trauma is pursued throughout the history of medicine.The purpose of studying this field served the need to develop diagnostic methods, to discover different mechanisms of the pathophysiological disorders that arose from the trauma of the chest and certain vital organs, such as the heart and lungs.Also an extremely important aspect is the knowledge of the anatomical characteristics of the chest, mediastinal organs and lungs, because to a certain extent they determine the nature of the trauma, the diagnosis but also the therapeutic tactic.Materials and methods. Article: “What are the ten new commandments in severe polytrauma management?” - CW Kam,CH Lai,SK Lam,FL So,CL Lau,KH Cheung (World J Emerg Med,Vol I,No 2,2010); Article: “Damage control orthopedics –when and why” – James H.Carson,M.D; Основы топографической анатомии – Д.Н.ЛУБОЦКИЙ; Множественные и сочетанные травмы – В.А.СОКОЛОВ; Results. The functions of the internal thoracic organs are diverse, but the main ones are the breath and circulation of the blood.Cardiorespiratory disorders are the basis of all pathophysiological disorders in the case of chest trauma.These require emergency prevention and treatment.In the case of thoracic trauma, these conditions are most often interdependent and remain the main causes of death of each third victim with combined chest injuries, although 15% of the victims have no fatal injuries. Conclusions. The severity of the condition does not depend so much on the trauma of certain organs, but on the disorders of vital functions caused by general pathophysiological mechanisms. Examples may be: shock (shock lung), acute heart failure, acute respiratory failure, bronchodilatory syndrome (key moment - edema, dyskinesia, and sputum bronchiolysis).Regardless of the cause of the trauma, the victims of thoracic trauma form several typical syndromes that determine the diagnosis, the treatment tactic and the nature of the typical complications. The main syndromes are hemothorax, pneumothorax, subcutaneous emphysema and mediastinal emphysema.