# Talk:Tracheobronchial injury

This review is transcluded from Talk:Tracheobronchial injury/GA1. The edit link for this section can be used to add comments to the review.
I am currently reviewing "Tracheobronchial injury" as a "Good Article Candidate". It's another fine article by delldot; it clearly has his writing style stamped all over it. ;-) Axl (talk) 17:26, 31 August 2008 (UTC)
From "Classification" section, paragraph 1: "Another way to classify tracheal lesions is to divide them into complete and incomplete lacerations." What is the difference between complete and incomplete? Clinical significance? Axl (talk) 17:55, 31 August 2008 (UTC)

I assume this means 'torn all the way around' and 'not torn all the way around', but I'm still looking for an explicit source on this.  the emedicine article says "In 10% of affected patients, the tear is incomplete, with preservation of the peritracheal or peribronchial connective tissue sheath or sealing of the tear by fibrin." Would it be accurate to say something like "incomplete, in which some tissue at the site remains intact, and complete, in which the airway is transected"? I currently have "The laceration may completely transect the airway or it may go only part of the way around."  Is this too 'duh'?  Added a little about clinical significance.  delldot talk 03:15, 1 September 2008 (UTC)
I think I've straightened this out a bit, I found another source explaining about the surrounding tissues remaining intact in incomplete lacs.  delldot talk 04:57, 1 September 2008 (UTC)
Thanks, that's clearer. Axl (talk) 06:41, 1 September 2008 (UTC)
How about a "Prevention" section? Seat belts and air bags? Endotracheal tube design? [Reminds me of "Pulmonary contusion". :-) ] Axl (talk) 18:01, 31 August 2008 (UTC)

I'll work on this.  It's probably doable, but as with PC, you see a lot of "how to prevent chest trauma" and not a whole lot of "how to prevent tracheobronchial injury".  I'll work on it in my userspace till I have something presentable to add. delldot talk 03:15, 1 September 2008 (UTC)
From "Mechanism", paragraph 5: "When airways are damaged, air can escape from them and be trapped in the surrounding tissues; if it builds up to high enough pressures there, it can compress the airways." Is this pneumomediastinum? Subcutaneous emphysema? Pneumothorax? Axl (talk) 18:15, 31 August 2008 (UTC)

According to the source,  PMID 12002920, "the airway can be compressed by the mediastinal and cervical emphysema caused by the TBI." Added 'in the neck and mediastinum' to the sentence (mediastinum is defined above it). Is this enough?  delldot talk 03:15, 1 September 2008 (UTC)
Ah, so it's pneumomediastinum and subcutaneous emphysema. Axl (talk) 06:41, 1 September 2008 (UTC)
Not that it's especially important, but my preferred pronoun is 'her'. :P Thanks a ton for reviewing this Axl, I didn't even have to wait!  It's good to have your knowledge and careful reviewing.  delldot talk 03:15, 1 September 2008 (UTC)

My progress over the next few days might be slow, sorry!  delldot talk 04:57, 1 September 2008 (UTC)


### GA pass
This is an excellent article. It comprehensively describes the subject. It complies with WP:MEDMOS, although with the additional section "Anatomy". I particularly like the "Anatomy" section. It provides a succinct introduction for unfamiliar readers to the relevant features. The article is well-illustrated. The referencing is good.
Perhaps there is some room to expand the "Prevention" section, although I appreciate the difficulty in finding reliable sources. Axl (talk) 07:10, 2 September 2008 (UTC)

Thanks a ton Axl!  Sorry for being a slacker with the Prevention section, I can keep working on that.  Once again, your hard work in reviewing and improving the article yourself are much appreciated. delldot talk 22:44, 2 September 2008 (UTC)

This article indicates five possible mechanisms. Although admittedly the article is rather old (1983). Axl (talk) 11:34, 1 September 2008 (UTC)
Actually Shields' General Thoracic Surgery, sixth edition (2005) indicates three mechanisms, very similar to those currently described in the article. Axl (talk) 17:05, 1 September 2008 (UTC)

I have seen the crushing mechanism mentioned, and gave it a brief mention in the article (the dashboard thing).  In every review I've read that mentions mechanisms, the three are presented together as the "big three", being responsible for most TBIs, although other types (e.g. penetrating, crushing against the vertebrae) are sometimes mentioned too.  This is the first mention I've seen of a torsion mechanism.  delldot talk 02:22, 2 September 2008 (UTC)

I'm having difficulty finding reliable sources to describe preventive measures. I'll keep looking. Axl (talk) 20:08, 1 September 2008 (UTC)

Thanks a ton Axl, I will too.  delldot talk 02:22, 2 September 2008 (UTC)

This picture is not an accurate representation of the bronchial tree. The "primary bronchi" are incorrectly labelled. The right upper lobe bronchus and right middle lobe bronchus are not correct. The left main bronchus is not correct. There seems to be some bizarre bronchiectasis going on in the lower lobe bronchi. Axl ¤ [Talk] 09:10, 22 July 2009 (UTC)

The diagram here is much better. Axl ¤ [Talk] 09:16, 22 July 2009 (UTC)
Yipes, thanks for catching this Axl.  I just removed the image for now until I can get a better free one. I don't see any indication on the Encyclopedia of Science that it's GFDL, did I miss it?  Maybe we should mention this problem over at commons, I think it's part of a featured image.  delldot ∇. 01:10, 26 July 2009 (UTC)
Unfortunately the Encyclopedia of Science is copywritten: "Material appearing in The Internet Encyclopedia of Science may be copied only for the purposes of reading it or keeping it for personal reference by a single individual. Any other reproduction or distribution of the material in The Internet Encyclopedia of Science, including commercial use, is not permitted without written consent." Axl ¤ [Talk] 10:13, 27 July 2009 (UTC)
This is a nice picture:-

It looks suspiciously like the picture on the Encyclopedia of Science.... Axl ¤ [Talk] 10:16, 27 July 2009 (UTC)

(Actually the secondary bronchus is not correctly labelled. It is pointing to the right bronchus intermedius.) Axl ¤ [Talk] 10:22, 27 July 2009 (UTC)
Hm, in that case I'll leave this one out for now.  If it was an svg I could fix it but I don't really know how to do it cleanly with a jpg.  delldot ∇. 19:03, 27 July 2009 (UTC)
Would a link to the main anatomy article or at least using the image be in order for the anatomy section?

Jmwallach (talk)   — Preceding undated comment added 05:03, 21 October 2014 (UTC) 

Thank you for pointing out this image. I have added it to the article. Axl ¤ [Talk] 09:56, 21 October 2014 (UTC)

This image needs some arrows draw on it to make it more descriptive.Doc James (talk · contribs · email) 20:23, 18 December 2009 (UTC)

Done. delldot ∇. 20:41, 18 December 2009 (UTC)
And what does the star indicate? Doc James (talk · contribs · email) 21:10, 18 December 2009 (UTC)
According to the caption in the article it came from, "partial visualization of segmental branches of the right-lower-lobe bronchus (*)."  I guess I should black out the star and upload a new version.  delldot ∇. 21:56, 18 December 2009 (UTC)

This picture, in the "Classification" section, is referenced to Riley et al., "Injury to the esophagus, trachea and bronchus", pages 544–547. I would like to know the anatomical names of where the labels are going; I suspect that the lower ones are incorrectly placed. Axl ¤ [Talk] 09:50, 9 May 2011 (UTC)
In the absence of any other comments, I have removed the picture from the article. Axl ¤ [Talk] 08:27, 14 May 2011 (UTC)