BED SITE TEACHING

TRAUMA
PEMBIMBING :
D R . B E K T I S A FA R I N I , S P. R A D ( K )

VERERI KARINA
30101206738
KEPALA
EPIDURAL HEMORRHAGE
 CLINICAL PRESENTATION
Extradural haemorrhages usually are precipitated by clearly defined
head trauma.
A typical presentation is of a young patient involved in a head strike
(either during sport or a result of a motor vehicle accident) who
may or may not lose consciousness transiently. Following the injury,
they regain a normal level of consciousness (lucid interval), but
usually have an ongoing and often severe headache. Over the next
few hours, they gradually lose consciousness.
Due to the long cisternal course of the sixth cranial nerve (
abducens nerve,CN VI), it is often involved as downward herniation
begins, usually on the side of the haemorrhage and can, in an
emergency, guide exploratory burrholes.
hematoma epidural
menunjukkan konfigurasi
lenticular klasik di lateral
lobus temporal kiri. Area
dengan densitas rendah di
hematoma yang
menunjukan perdarahan
sedang berlangsung
Hematoma epidural

ditunjukkan meluas ke
superior di lateral lobus
frontal kiri dengan
sulcus yang datar,
serta pergeseran garis
tengah ke kanan
 Massive biconvex
extradural
hematoma form a
fracture of the skull
hematoma epidural

Epidural Hemorrhage di lobus

frontal kanan. Atasnya
terdapat soft-tissue swelling
pada bagian frontal kanan
scalp
Biconvex
(lenticellular)
epidural hematoma
(arrowheads),
deep to the parietal
skull fracture (arrow)
SUBARACHNOID HEMORRHAGE
CLINICAL FINDING
Headache is most common symptom
Frequently reported as severe (worst headache of
life"), of abrupt onset, reaches maximum intensity
within seconds (thunderclap headache)
Nausea
Vomiting
Change in mental status -- confusion
Decreased level of consciousness including coma
Spinal fluid may be bloody
 There is high-attenuation blood
in the Sylvian fissures (blue
arrows) and the
interhemispheric fissure (red
arrow) seen on this non-contrast
enhanced CT of the brain. Do
not confuse normal, physiologic
calcifications (white and black
arrows) for blood
SUBDURAL HEMORRHAGE
CLINICAL FINDING

Acute subdural usually present in the setting of head trauma.

This is especially the case in young patients, where they
commonly co-exist withcerebral contusions.
Most patients (65-80%) present with severely depressed
conscious state, and pupillary abnormalities may be seen in
~40% (range 30-50%) of cases.
Clinical presentation of subacute/chronic subdural in the elderly
is often vague and is one of the classic causes of a pseudo-
dementia. A history of head trauma is often absent or very
minor.
 Perdarahan subdural
Akut
A large acute on chronic
subdural haemorrhage is
seen on the
leftexertingmarked mass
effect on the underlying
left hemisphere with
midline shift, subfalcine
and uncal herniation. The
right lateral ventricle is
dilated. Blood is also seen
layering on the tentorium
High density blood
(arrowheads) fills the
sulci over theright
cerebral convexity in
this subarachnoid
hemorrhage
Subdural
haemorrhage,
crossing a suture
thus distinguishing
it from an
extradural
haematoma.
 CONTUSSION
HEMORRHAGE
Cerebral haemorrhagic contusionsare a type of
intracerebral haemorrhageand are common in the setting
of significant head injury.
They are usually characterised on CT as hyperdense foci in
the frontal lobes adjacent to the floor of the anterior cranial
fossa and in the temporal poles
CONTUSSION HEMORRHAGE
Multiple foci of high
density corresponding
to
hemorrhage (arrows) in
an area of low density
(arrowheads) in the left
frontal lobe due to
cerebral contusion.
THORAKS
PNEUMOTHORAKS
Bayangan radiolusen
dengan batas paru
berupa garis
radioopak tipis
Menekan jaringan
paru kearah hilus atau
paru menjadi
kuncup/kolaps
didaerah hilus
Mediastinum
terdorong kearah
kontralateral
Sela iga menjadi
semakin lebar
PNEUMOTHORAKS

PNEUMOTHORAX PLEURAL LINE

HEMATOTHORAKS

Manifestasi Klinis Hematothoraks :

- Adanya tanda- tanda syok
- suara nafas menghilang
- Perkusi pekak pada sisi dada yang
mengalami trauma
HEMATOTHORAKS
KONTUSIO PARU

Sekitar 50%pasien dengan kontusio paru mengalami

hemoptisis.
Tanda-tanda trauma dinding dada seperti memar,
patah tulang rusuk atauflail chest.
Kontusio ini dapat terjadi dengan atau tanpa fraktur
iga
KONTUSIO PARU
Bayangan bercak
di paru
Opasifikasi
abnormal
parenkim paru
PNEUMOMEDIASTINUM
Blue arrow points to
"continuous diaphragm
sign." The entire diaphragm
is visualized from one side
to the other because air in
the mediastinum outlines
the central portion which is
usually obscured by the
heart and mediastinal soft
tissue structures that are in
contact with the
diaphragm. The red arrow
points to the air beneath
and posterior to the heart.
 This chest radiograph
(posteroanterior and lateral
view) is from a 3-year-old girl
with a history of prematurity,
chronic lung disease, and
asthma who presented with a
viral pneumonitis and
persistent cough. On the
posteroanterior view, a
pneumomediastinum (arrow)
is noted. Also, extensive
subcutaneous air is observed.
PNEUMOPERICARDIUM
Air density within the
pericardium (arrows) after
aspiration of a large
pericardial effusion.
The lucent stripe on
the inferior border of
the heart is
indicative of
pneumopericardium.
ABDOMEN
KLASIFIKASI
Trauma penetrasi (trauma perut dengan penetrasi ke dalam rongga
peritonium)
Trauma tembak
Trauma tusuk

Trauma non penetrasi/trauma tumpul (trauma perut tanpa

penetrasi ke dalam rongga peritonium)
Kompresi
Hancur akibat kecelakaan
Sabuk pengaman
Cedera akselerasi
FAST kuadran kiri atas normal dan abnormal
FAST kuadran kanan atas
FAST Suprapubik view normal dan abnormal