TY - CHAP M1 - Book, Section TI - Heart and Thoracic Vascular Injuries A1 - Wall Jr, Matthew J. A1 - Tsai, Peter I. A1 - Mattox, Kenneth L. A2 - Moore, Ernest E. A2 - Feliciano, David V. A2 - Mattox, Kenneth L. PY - 2017 T2 - Trauma, 8e AB - The heart and its tributaries are encased in the thoracic skeleton composed of the manubrium, sternum, clavicles, rib cage, and vertebral bodies. This rigid chassis protects the heart, lungs, and great vessels. Trauma may result from penetrating or blunt mechanisms. The bony structures, interestingly, can also provide unique forms of injuries as they cause deflection of bullets, altering vectors of the original direction of penetration or by secondary fragments. Blunt forces can lead to crushing, traction, or torsion injuries to the heart from deceleration. Penetrating trauma to the great vessels usually leads to immediate exsanguination or, through a pattern of injury similar to blunt trauma including pseudoaneurysm, partial transection with intimal flap, thrombosis, and propagation. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/16 UR - accesssurgery.mhmedical.com/content.aspx?aid=1147416760 ER -