Patients with pneumothorax, effusions, and diaphragmatic hernia tend to have a rapid, shallow pattern, whereas pulmonary injury generally results in slower, more labored (abdominal) respiration. The pattern of respiration can be diagnostic. Rib fractures can interfere with ventilation if the animal splints to reduce pain or occasionally, rib fractures may injure a major vessel. Crepitus may be an indication of SQ emphysema or isolated rib fractures. Subcutaneous emphysema may occur with trauma but in itself is usually of little significance. Thoracic injury reveals a variety of clinic aspects. Pulmonary contusions are seen in 55% of all thoracic injury. Death is due to associated neurologic injuries, cardiac injuries (such as aortic and pulmonary artery transection), and pulmonary disease complicated by brachial plexus injury and subclavian artery injury. Although first rib fractures are rare in dogs and cats due to anatomic differences (forelimb musculature being more protective), cranial rib fractures may cause a mortality rate as high as 36% in small animals. In humans, fractures of the first and second rib are the hallmark of severe thoracic trauma.

This starts with detailed evaluation of potential life-threatening injuries in the thorax. Once the initial survey is completed, and the animal stabilized, the secondary survey takes place. Encounters with automobiles, animal fights, traps, burns, weapons, and abuse are common traumatic injuries seen. The initial step in managing any traumatized animal is obtaining a history of the incident, with specific reference to the kinetics of the injury. Most treatable cardiovascular and respiratory injuries are seen in this period. Rapid and aggressive treatment determines survival. The next 2-4 hours are what we as clinicians recognize as the 'Golden period.' This is the most common presentation in the veterinary hospital. The first hour following trauma has classically been recognized in medicine as the 'survival hour.' It is within this time that most deaths occur as a result of major injury to the respiratory and cardiovascular system. Life-threatening problems are then treated immediately, according to their level of priority, utilizing a team-oriented approach. A primary survey involves triage of major body systems that follows the ABC's of emergency care. Blunt trauma can induce injury by three distinct mechanisms: a direct blow to the chest (e.g., rib fracture), deceleration injury (e.g., pulmonary or cardiac contusion and aortic tear), and compression injury (e.g., cardiac and diaphragm rupture).The 'Golden period' defines the time following injury wherein effective therapy ensures a good chance of survival. Penetrating thoracic injuries (e.g., stab wounds, gunshot wounds, impalement on a foreign body) primarily injure the peripheral lung, producing both a hemothorax and pneumothorax. Pathologic consequences of thoracic injury, either alone or in combination, are responsible for inadequate oxygen. The thorax is responsible for the vital cardiopulmonary physiology of delivering oxygenated blood to metabolically active tissues. The goal of this lecture will be to outline some basics of thoracic anatomy and physiology, pathophysiology of thoracic trauma, general trauma management, and the diagnosis and management of specific traumatic thoracic injuries. Thoracic trauma seldom occurs as an isolated injury patients are often in shock and may have other significant injuries: abdominal, spine-medullar and cranium-encephalic lesions. Thoracic injury is common in dogs and cats following trauma, mainly encounters with automobiles. Books & VINcyclopedia of Diseases (Formerly Associate).VINcyclopedia of Diseases (Formerly Associate).

Signs of head trauma in dogs