#rib fractures | Explore Tumblr Posts and Blogs

mcatmemoranda · 4 months

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Mechanisms of injury – Rib fractures are common injuries that occur most often following direct blunt thoracic trauma but can also result from severe coughing, athletic activities (eg, rowing, swinging golf clubs), child abuse, and bone metastases.

●Clinical features – Patients with rib fractures typically describe a history of a minor to moderate chest wall injury. Frequently, they can localize the pain to one or two ribs. Examination reveals point tenderness on a specific rib or focal tenderness caused by compression of the ribcage distant from the site of pain. A deep breath typically elicits pain at the fracture site. Rib stress fractures present with a gradual onset of activity-related chest wall pain.

●Diagnosis and diagnostic imaging – Rib fractures in victims of blunt trauma are generally identified clinically or by chest radiograph (CXR). A definitive diagnosis of rib fractures is not always necessary. The presence of isolated rib fractures does not have to be radiologically confirmed in all patients once associated injury has been adequately excluded, typically with a CXR, which is obtained primarily to identify pneumothorax, hemothorax, and other signs of intrathoracic injury.

•In most cases when CXR is not sufficient for the identification of rib fractures, chest computed tomography (CT) should be performed. Chest CT demonstrates greater sensitivity and specificity for rib fractures compared with plain radiographs but should not be performed for the sole purpose of assessing potential rib fractures since the clinical significance of these additionally discovered fractures is generally minimal. When expertise and technology is available, emergency physician-performed bedside ultrasound is an emerging modality with test characteristics comparable to CT for identifying rib fractures. Rib radiographs have very limited utility when CT is available.

•In patients with concern for stress fracture in whom definitive diagnosis will change management, magnetic resonance imaging (MRI) has become the modality of choice. Both bone scintigraphy and MRI have traditionally had better sensitivity for fracture than CT but are limited by resource availability. Bone scintigraphy requires large doses of ionizing radiation and has poor specificity.

•A skeletal survey should be obtained in infants with rib fractures, especially multiple fractures in various stages of healing, since this raises suspicion for abuse.

●Fracture patterns associated with internal injuries – Liver or spleen lacerations, mediastinal injury, pneumothorax, hemothorax, flail chest, and pulmonary contusion may occur but are uncommon with isolated rib injuries. An increasing number of rib fractures correlates with serious intrathoracic and intra-abdominal injuries. Displaced fractures increase the risk of internal injury and delayed bleeding.

•First rib fractures are associated with greater overall injury severity and life-threatening internal injury (including injuries to the brain, spine, lungs, and pelvis).

•Fractures of superior ribs (numbers 1 to 3) reflect trauma involving significant force and the potential for injury to mediastinal structures, major blood vessels (eg, aorta), and lung parenchyma.

•Fractures of ribs 9 through 12 may be associated with intra-abdominal injury. Right lower rib fractures may be associated with hepatic injury and left lower rib fractures with splenic injury. Fractures of the posterior portion of the lower ribs can be associated with renal injury.

•Three or more adjacent ribs each fractured in two places (ie, flail chest) (figure 4) is often associated with significant morbidity from pulmonary contusion as well as injuries elsewhere.

●Management – Treatment of rib fractures should be focused on early and adequate pain relief to avoid complications (eg, pneumonia) from splinting and atelectasis. Analgesia for isolated rib fractures includes nonsteroidal antiinflammatory drugs (NSAIDs) with or without opioids. Encourage incentive spirometry to prevent atelectasis.

For more severe injuries, intercostal nerve blocks are an effective approach but typically require admission.

Rib stress fractures are treated similarly to other low-risk stress fractures. Treatment begins with restriction of the inciting activity for four to six weeks followed by a gradual return to the activity as tolerated.

●Disposition – We typically hospitalize patients with three or more rib fractures and use a more conservative threshold for admission in older or frail adults and those at increased risk for pulmonary complications. An algorithm to assist clinicians with the disposition of patients with isolated rib fractures is provided (algorithm 1).

●Follow-up care – A follow-up evaluation six to eight weeks after the injury is reasonable, especially if the patient has persistent pain or any questions regarding ability to return to sports or work. Virtually all rib fractures heal well within six weeks. Follow-up chest radiographs are unnecessary unless indicated by clinical symptoms (eg, new shortness of breath, new or severe pain). (See 'Follow-up care' above.)

●Return to sports and work – Some patients are able to return to work within a few days, depending on their occupation, while some patients may experience prolonged pain and disability. (See 'Return to sports and work' above.)

#rib fractures #rib fracture

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that-girl-in-the-corner101 · 5 months

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I am in love with being friends with Ana but she's caused me to have at least 9 rip fractures and they way they are healing is not cute. Ana??? Why can't you fix this problem?

#ana #anoreic #anoreixic #anarex14 #starving #starve #starvat10n #b0nspo #d3pr3ssion #fractures #rib fractures

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the-magpie-archives · 2 years

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Like many of you, I am fascinated with the state of Jonathan Sims head archivist of the magnus institute London... In particular, his ribs! Many focus only on his missing two, but there are many more things to consider!

Jon's a fragile guy, I mean it's pretty much his whole canon appearance! For a man like him to be thrown around like a ragdoll for pretty much his entire time as archivist, he'd certainly have suffered more than a few broken ribs!

To contribute even more to the damage, after the unknowing, Jon was found with no pulse and not breathing, meaning he would have undergone CPR for at least 20 minutes. And trust me, THAT BREAKS RIBS.

Aside from bones, I can't imagine Jon's lungs are in the best state either. He's a long time smoker, was exposed to dangerous amounts of CO2, and survived a massive explosion followed by a collapsing building. Needless to say, these sort of things make it hard to keep lungs healthy!

Despite all the pain and horror, I like to think that Jon managed to stay looking at least relatively put together, so picture this:

A polite, slightly awkward office worker comes into your clinic. You decide that to diagnose properly, you'll need to do a chest X-ray! He's distracted, but readily agrees. After the brief wait, you get the images back, and see THE MOST FUCKED UP CHEST YOU HAVE EVER SEEN. A horrifying amount of healed fractures, warped and re-broken; two ribs are just straight up gone, both lungs scarred beyond survivability, and somehow this guy is just sitting there. Alive, as far as you can tell.

The man remains composed, and smiles politely as you stare at the X-rays, and you begin to think that maybe those aren't acne scars across his face.

#Overall I would just love to do a full medical examination on him... God it'd be fascinating.#Man's using otherworldly life support to keep his corpse up and walking #But seriously Google 'healed rib fractures' if you don't already know what they look like‚ shits interesting.#tma #the magnus archives #the magnus institute #Jonathan Sims #the archivist #The unknowing #jared hopworth #tma the flesh #tw injury #tw doctors #tw graphic description

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whumpypepsigal · 1 month

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Fire Country s02e04: “[Bode] is concussed. Eve said that debris fell on him inside.”

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weirdstrangeandawful · 2 months

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TW: fracture

Rib fracture reveal!

“Stop! Stop! Stop making me laugh. Ow. Let me catch my breath”

“Why are you all hunched over like that?”

“No, don’t hug me!”

“Just take a deep breath.” “I can’t. It hurts too much”

*with their head stuck inside their shirt* “help…!”

“This blanket’s too heavy. It hurts.”

"No nononononono, not that side!"

#whump #whump prompt #rib fracture #fracture

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bug-slappy · 3 months

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what do u think reigen smells like. i think he smells like mens deodorant and tobacco

i think that at work he has a really nice mens cologne that he wears, (not too expensive but not cheap) after all first impressions are very important. he feels professional when he wears it, like someone to be respected. like someone,, serizawa likes it and also feels a little intimidated when reigen walks by and he smells his nice cologne

i think the new office smells a little scentless and bright like spring flowers, and the old office smelled like tobacco and tiger-balm

i think naturally his home and casual clothes smell like a mix of different incense scents. he sort of smells like tiger balm, sea salt and hot pavement on a summer day (sweaty). if you stand near the balcony, it still smells faintly of cigarettes but its not as strong as it was since hes quit (and also scrubbed it clean when 10 year old mob said something "rude to say to grown ups, especially his mentor").

#anon you got a big storm comin.#i think about the way things smell Very hard #my autism super powers #reigen arakata #mp100 #i do think he quit smoking #but he had 1 dart he hid in his underwear drawer that he smoked half of after the events of mob asking tsubomi out #that serizawa gave him a stern talking to about #he let the rest of it burn out on its own after that but not before showing serizawa his cool smoke trick #and then spending an extra day in recovery from coughing too hard with a fractured rib

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swordmaid · 11 months

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thinking abt jaime having to cuddle with a wounded brienne because it’s cold and she’s shivering and having nightmares …

#like the whole concept of jaime having to take care of brienne the same way she did for him back in asos #but this time he has to be GENTLE bc she’s literally bruised and broken all over. arm fractured ribs broken big ass wound on her cheek.#and he’s never been gentle before. he has to learn how to be gentle so he doesn’t hurt her even more ….#bc he thinks the reason why she’s in that state is bc of him..!!! like jaime learning that she DID hang for him …#having to grapple his anger over the knowledge that she did that FOR him (why?????) but also being gentle and kind to her bc that’s the #least that he can do for her…..!!!!!!! he’s mad at her but he will still care for her. his feelings does not negate the care that he will #give. and then cue the introspection bc she’s sleeping in his arms and he’s just like why would you even do this you fool…#then also like WHY is he so upset about it. and then when he sees the bruises on her throat it’s like why does he feel guilty ….#it’s such a rich moment I love any instances where that concept is explored #but I think what I love the most is the role reversal from asos bc jaime considered her as his protector #now HE’S the one who’s going to have to take up that mantle …. 💆‍♀️💆‍♀️💆‍♀️💆‍♀️💆‍♀️

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somedaytakethetime · 7 months

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Here:

You can see a fractured rib, geriatric sexy king 🙂🫠🫠🫠

#WHY ARE YOU PLAYING WITH A FRACTURED RIB LAD???#i mean... do you i guess...#*whispers* and do me too 🥺👉🏻👈🏻#i need him CARNALLY your honour 😩😩#Kasper Schmeichel #king thicccness #Big DADDY 🥺#paizinho papi papà far tudo 😩😩😩

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crepuscularpete · 8 months

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When your workmate knows you're in pain so comes for cuddles. ❤️🐾

#boxer #dog #dog life #cute #its a dogs life #dog day care #dog groomer #long hair dont care #beat friend #fractured ribs are not fun

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varibean · 1 year

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Still thinking about the body swap idea but about both of them roasting his shitty the other’s body is

Hugo: oh my god whyyyyyy do you hurt so much? You have the body of an old man

Varian: hey quick question are there any vitamins your body ISNT deficient in, just curious

Hugo: i feel like your muscles are about to snap like over tightened violin strings

Varian: I am self diagnosing you with fucking scurvy oh my gods the sun fucking hurts

Hugo: yeah well you-OUCH HEY DO YOU HAVE A??? FRACTURED FUCKING RIB YOU FORGOT TO MENTION TO ME??? HONEY????

#varian #varigo #vat7k #Hugo wins bc Varian does in fact have a fractured rib he just didn’t mention #‘I hardly even noticed it didn’t think I had to mention it!’#Hugo: oh my sun and moon you are going to be the end of me

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blueberry-gills · 3 months

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I.

am going to start crying

#tf you mean she fractured her ribs??? and shes NOT resting?????#tf you mean someones poisoned and their posting about it on rotomblr????#???? is that last one real???#wha huh????#dash commentary #pkmn irl #pokeblr #pokemon irl #pokeblogging #rotomblr

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maburp · 11 months

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Rewatching one piece from the beginning is so enlightening like I finally understand how each crew member survived each arc!

Zoro - bro trains everyday and lives on motivation which is why he survives no matter what like a cockroach. Literally buried under a building? Not a problem with his three sword style building slasher move!

Sanji - his family has unnatural strength… which is why he’s able to survive being hit by literally 1000 volts in skypeia arc!!! Or fight Arlong with a fractured rib cage???…. to avoid spoilers that’s all I’ll say,,, watch whole cake arc

Ussop, Nami, Chopper - crazy lucky. can dodge good and use their brains on adrenaline bc of previous circumstances and makes them really good at beating enemies without having to actually use fists. And they always have friends who have their back!

Luffy - same breed as Zoro. also is made of rubber so when things like rocks bury him he’s like “wow! That was funky and fun! Do it again!”

Robin - five billion hands. Enough said.

#I forgot a lot of character arcs so I’m currently rewatching #this is just what I’ve observed so far #robin is invincible to me #this realization is more to do with sanji bc he’s crazy and in the beginning arcs keeps jumping in front of things??? or getting hurt??#and everyone is like omg how tf is he going to survive that!#and then he just does survive it #like the arc where he meet him he fractures his ribs then immediately proceeds to beat arlongs ass #ig also anime logic #talks maburp #one piece #roronoa zoro #nico robin #monkey d luffy #tony tony chopper #nami #ussop

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bewitched-bullet · 6 months

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I thought I was doing so well today, went to the gallery, worked on some jewelry, nsfw drawings, cleaned, got groceries, vacuumed….

And I pushed myself too damn far.

I wanna cry I hurt so bad

Please send the best DnD moments you’ve had, best fanfiction, comics, memes, jokes, everything please.

I’m going out of my mind without my routine, shame for not being able to physically do what I need to do, and anxiety through the roof (because, hell, why not)