Types of chest injuries
Chest injuries include fractures of the ribs, sternum, injuries of the soft tissues of the chest wall, lungs, large vessels and mediastinal organs. Trauma of the chest is often accompanied by acute respiratory failure, massive blood loss, and shock. Among those who died from trauma, chest injuries were found in 50% of the victims; in 25%, they were the main cause of death.
There are open and closed chest injuries. Among open injuries, there are non-penetrating and penetrating wounds in the thoracic cavity. Both open and closed chest injuries can cause fractures of bones, damages to the lungs and mediastinal organs, hemothorax and pneumothorax.
The severity of chest injury is largely determined by the severity of respiratory failure. If normal respiratory rate is 16 per 1 min, then with a mild degree of damage, shortness of breath is up to 25 per 1 min, moderate - 25-30 per 1 min, and severe - over 30 per 1 min.
Anatomical and physiological features
Rib is a narrow, curved plate consists of bone in the back part (longer) and cartilage at the front (wider) part. With posterior ends - the head and articular surface, the ribs are connected with the vertebrae, and with the tubercle on the rib body - with the glenoid fossa of the transverse processes of the vertebrae. The bend of the rib is located laterally to the tubercle, forming the angle of the rib. Seven upper ribs are connected with the front ends to the sternum through symphyses or flat joints. Ribs VII-IX-X (false) are attached not to the sternum but by the cartilaginous part to the cartilage of the previous rib. Ribs XI-XII (floating) are located freely.
With inhale, the ribs rotate in the posterior sections, while the front ends rise and diverge, the chest expands in the anteroposterior section. When the ribs are raised, the angular bends of the cartilage are straightened, and movements occur between the cartilage and the sternum. The cartilage is stretched and twisted. At the end of inhalation, the ribs descend.