Question

What is worse a open or closed chest wound and why. What are the signs and symptoms of a concussion. What is the most prominent spinal cord injury in your opinion.

Answer 1

Open or Closed chest wound

A chest injury, also known as chest trauma, is any form of physical injury to the chest including the ribs, heart and lungs. Chest injuries account for 25% of all deaths from traumatic injury. Open chest injuries occur from a penetrating-type trauma, such as a gunshot wound or any type of object with the ability to make a hole in the chest. Keep in mind that any other vessel or organ in the pathway can also sustain injury. Gunshot wounds, especially guns with low calibers (such as a .22), can bounce all over the place and cause extensive damage. Bullets also cause cavitation-type injuries, a hollowing out of tissue along the path of the bullet that is much larger than the diameter of the bullet itself. When major vessels in the chest are injured, life-threatening hemorrhage occurs rapidly because of the large amount of blood in these vessels and the pressure in them. A hole in the chest can result in an open pneumothorax (An open wound to the chest that allows air to enter the pleural space and cause lung collapse.) This hole does not allow the lungs to inflate normally. An open chest wound can also produce a noticeable sucking sound when the patient breathes. This is called a “sucking chest wound.” (An open wound to the chest that permits air to enter the thoracic cavity.) When an open chest wound is identified, Immediately cover it with your gloved hand and place a onporous (occlusive) dressing over the wound and tape it on three sides. This prevents additional air from entering the pleural space, and traps any air already accumulated in this space.

An open pneumothorax can also result from a fractured rib resulting from blunt force trauma, without causing a visible hole in the chest. If too much air forms in this pleural space, it results in a tension pneumothorax (A condition in which the buildup of air and pressure in a hemothorax associated with an injured lung is so severe that it begins to shift to the uninjured side, resulting in compression of the heart, large vessels, and the uninjured lung.) This not only causes hypoxia but also decreases perfusion as pressure is exerted within the mediastinum, compressing the major blood vessels.

Closed chest injuries result from blunt force trauma such as a motor vehicle collision MVC during which the sternum strikes the steering wheel. Injuries to the esophagus, lung, heart, great vessels, and diaphragm occur as a result of closed chest injuries.

Signs and symptoms of a concussion
A concussion is a mild traumatic brain injury (TBI). It can occur after an impact to your head or after a whiplash-type injury that causes your head and brain to shake quickly back and forth. A concussion results in an altered mental state that may include becoming unconscious. Anyone can become injured during a fall, car accident, or any other daily activity. If you participate in impact sports such as football or boxing, you have an increased risk of getting a concussion. Concussions are usually not life-threatening, but they can cause serious symptoms that require medical treatment. A concussion is different from a contusion. A concussion specifically affects your brain, but contusions are bruises. Contusions can occur on your head, but they aren’t typically serious and tend to resolve within several days. Symptoms of a concussion vary depending on both the severity of the injury and the person injured. It’s not true that a loss of consciousness always occurs with a concussion. Some people do experience a loss of consciousness, but others don’t. It’s important to understand the symptoms you could go through yourself when you’re having a concussion, as well as the signs of someone else having a concussion.

Most prominent spinal cord injury
The spinal cord is a collection of nerves that travels from the bottom of the brain down your back. There are 31 pairs of nerves that leave the spinal cord and go to your arms, legs, chest and abdomen. These nerves allow your brain to give commands to your muscles and cause movements of your arms and legs. The nerves that control your arms exit from the upper portion of the spinal cord, while the nerves to your legs exit from the lower portion of the spinal cord. The nerves also control the function of your organs including your heart, lungs, bowels, and bladder. For example, signals from the spinal cord control how fast your heart beats and your rate of breathing. Other nerves travel from your arms and legs back to the spinal cord. These nerves bring back information from your body to your brain including the senses of touch, pain, temperature, and position. The spinal cord runs through the spinal canal. This canal is surrounded by the bones in your neck and back called vertebrae which make up your back bone. The vertebrae are divided into 7 neck (cervical) vertebrae, 12 chest (thoracic) vertebrae and 5 lower back (lumbar) vertebrae. The vertebrae help protect the spinal cord from injury.

The spinal cord is very sensitive to injury. Unlike other parts of your body, the spinal cord does not have the ability to repair itself if it is damaged. A spinal cord injury occurs when there is damage to the spinal cord either from trauma, loss of its normal blood supply, or compression from tumor or infection. There are approximately 12,000 new cases of spinal cord injury each year in the United States. They are most common in white males. Spinal cord injuries are described as either complete or incomplete. In a complete spinal cord injury there is complete loss of sensation and muscle function in the body below the level of the injury. In an incomplete spinal cord injury there is some remaining function below the level of the injury. In most cases both sides of the body are affected equally. An injury to the upper portion of the spinal cord in the neck can cause quadriplegia-paralysis of both arms and both legs. If the injury to the spinal cord occurs lower in the back it can cause paraplegia-paralysis of both legs only. The most common cause of spinal cord injury is trauma. Nearly half of the injuries are caused by motor vehicle accidents. Other types of trauma include:

• falls from heights,
• violence (stabbing or gunshot wounds to the spine), and
• sporting injuries (diving, football, rugby, equestrian, etc.).

Spinal cord injury can also be caused by compression of the cord by a tumor, infection, or inflammation. Some patients have a smaller than normal spinal canal (called spinal stenosis) and are at a higher risk of injury to the spinal cord. All tissues in your body including the spinal cord require a good blood supply to deliver oxygen and other nutrients. Failure of this blood supply to the spinal cord can cause spinal cord injury. This can be caused by an aneurysm (ballooning of a blood vessel), compression of a blood vessel or a prolonged drop in blood pressure.