Ch. 30 Flashcards
(31 cards)
A flail chest occurs when:
-A segment of the chest wall is detached from the thoracic cage
-More than three ribs are fractured on the same side of the chest
-A segment of fractured ribs bulges during the inhalation phase
-Multiple ribs are fractured on both sides of the thoracic cage
A segment of the chest wall is detached from the thoracic cage
A patient who presents with profound cyanosis following a chest injury:
-Is most likely experiencing severe blood loss
-Has most likely experienced a ruptured aorta
-Requires prompt ventilation and oxygenation
-Should be placed in Trendelenburg’s position
Requires prompt ventilation and oxygenation
A simple pneumothorax:
-Often has a non-traumatic cause
-Is caused by penetration chest trauma
-Heals on its own without any treatment
-Is commonly caused by blunt chest trauma
Is commonly caused by blunt chest trauma
Hemoptysis is defined as:
-Blood in the pleural space
-Abnormal blood clotting
-Coughing up blood
-Vomiting blood
Coughing up blood
Irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation is called:
-Dyspnea
-Pneumonitis
-Pneumothorax
-Pleurisy
Pleurisy
Patients with rib fractures will commonly:
-Develop a sucking chest wound
-Breathe rapidly and shallowly
-Take a series of deep breaths
-Prefer to lie in a supine position
Breathe rapidly and shallowly
Signs and symptoms of a tension pneumothorax include all of the following except:
-Unilaterally absent breath sounds
-Altered mental status
-Collapsed juglar veins
-Profound cyanosis
Collapsed juglar veins
Subcutaneous emphysema is an indication that:
-Your patient is experiencing a pericardial tamponade
-Air is escaping into the chest wall from a damaged lung
-Blood is slowly accumulation within the tissue of the lung
-At least half of one lung has completely collapsed
Air is escaping into the chest wall from a damaged lung
The thoracic cavity is separated from the abdominal cavity by the:
-Intercostal margin
-Diaphragm
-Anterior rib cage
-Costovertebral angle
Diaphragm
Which of the following organs or structures does not reside within the mediastinum?
-Lungs
-Vena cavae
-Trachea
-Esophagus
Lungs
When the chest impacts the steering wheel during a motor vehicle crash with rapid deceleration, the resulting injury that kills almost one third of patients, usually within seconds, is:
-A hemothorax
-Aortic shearing
-A pneumothorax
-A ruptured myocardium
Aortic shearing
Signs and symptoms of a chest injury include all of the following, except:
-Hemoptysis
-Hematemesis
-Asymmetrical chest movement
-Increase pain with breathing
Hematemesis
During your assessment of a patient who was stabbed, you see an open wound to the left anterior chest. Your most immediate action should be to:
-Position that patient on the affected side
-Transport immediately
-Assess the patient for a tension pneumothorax
-Cover the wound with an occlusive dressing
Cover the wound with an occlusive dressing
When caring for a patient with signs of a pneumothorax, your most immediate concern should be:
-Hypovolemia
-Intrathoracic bleeding
-Ventilatory inadequacy
-Associated myocardial injury
Ventilatory inadequacy
What purpose does a one-way “flutter valve” serve when used on a patient with an open pneumothorax?
-It prevent air escape from within the chest cavity
-It allows the release of air trapped in the pleural space
-It only prevents air from entering an open chest wound
-It allows air to freely move in and out of the chest cavity
It allows the release of air trapped in the pleural space
Signs of a cardiac tamponade include all of the following, except:
-Muffled heart tones
-A weak, rapid pulse
-Collapsed juglar veins
-Narrowing pulse pressure
Collapsed juglar veins
A patient experienced a severe compression to the chest when trapped between a vehicle and a brick wall. You suspect traumatic asphyxia due to the hemorrhage into the sclera of his eyes and which other sign?
-Flak neck veins
-Cyanosis in the face and neck
-Asymmetrical chest movement
-Irregular heart rate
Cyanosis in the face and neck
A 14-year-old baseball player was hit in the chest with a line drive. He is in cardiac arrest. Which of the following is the most likely explanation?
-Myocardial contusion
-Traumatic asphyxia
-Commotio cordis
-Hemothorax
Commotio cordis
Paradoxical chest movements is typically seen in patients with:
-A flail chest
-A pneumothorax
-Isloated rib fractures
-A ruptured diaphragm
A flail chest
A 40-year-old man, who was the unrestrained driver of a car that hit a tree at a high rate of speed, struck the steering wheel with his chest. He has a large bruise over the sternum and an irregular pulse rate of 120 beats/min. You should be MOST concerned that he:
-Has inured his myocardium
-Has a collapsed lung and severe hypoxia
-Has extensive bleeding ton the pericardial sac
-Is at extremely high risk for ventricular fibrillation
Has inured his myocardium
Pneumothorax
Commonly called a collapsed lung
Accumulation of air in the pleural space: Blood passing through the collapsed portion of the lung is not oxygenated.
You may hear diminished, absent, or abnormal breath sounds.
Simple pneumothorax
Does not result in major changes in the patient’s cardiac physiology
Commonly due to blunt trauma that results in fractured ribs
Can often worsen, deteriorate into tension pneumothorax, or develop complications
Tension pneumothorax
Results from ongoing air accumulation in the pleural space
Increased pressure in the chest: Causes complete collapse of the unaffected lung. Mediastinum is pushed into the opposite pleural cavity
Commonly caused by a blunt injury where a fractured rib lacerates a lung or bronchus
Hemothorax
Blood collects in the pleural space from bleeding around the rib cage or from a lung or great vessel
