Chapter 22 Phatho Flashcards
(42 cards)
1
Q
- What is flail chest?
A
double fractures of three or more adjacent ribs
2
Q
- What does flail chest produce?
A
- instability of the chest wall and paradoxic motion of the thorax.
- the lung also may be contused (bruised) under the fractured ribs
3
Q
- What happens to the affected flail ribs?
A
they cave in (flail) during inspiration as a result of the subatmospheric intrapleural pressure.
4
Q
- Flail chest can cause what type of lung disorder?
A
restrictive
5
Q
- The major pathologic or structural changes of the lungs associated with flail chest are?
A
- double fracture of numerous adjacent ribs
- rib instability
- lung volume restriction
- atelectasis
- lung collapse (pneumothorax)
- lung contusion
- secondary pneumonia
6
Q
- A blunt or crushing injury of the chest is usually the cause of?
A
Flail chest
7
Q
- What is used to stabilize a flail chest?
A
volume controlled ventilation, accompanied by (PEEP) positive end-expiratory pressure
8
Q
- For how many days is mechanical ventilation used on a patient with flail chest?
A
5 to 10 days
9
Q
- Flail oxygen therapy protocol is used to?
A
- treat hypoxemia
- decrease work of breathing
- decrease myocardial work
10
Q
- Hypoxemia that develops in flail chest is most commonly caused by?
A
alveolar atelectasis and capillary shunting
11
Q
- What is pendelluft
A
the shunting of air from one lung to another
12
Q
- Venous Admixture.
A
is admixture of oxygenated (ventilated alveolus) blood with unoxygenated (hypoventilated alveolus) blood.
13
Q
- Vital signs in flail chest include
A
- increased respiratory rate (tachypnea)
- paradoxic movement of the chest wall
- increased heart rate (pulse) or blood pressure
14
Q
- Increased ventilator rate can be caused by?
A
- stimulation of the chemoreceptors (hypoxemia)
- paradoxic movement of the chest wall
15
Q
- In flail chest trauma, during inspiration the fractured ribs are?
A
pushed inward by the atmospheric pressure surrounding the chest and negative intrapleural pressure
16
Q
- In flail chest trauma, during expansion the fractured ribs are?
A
the flail area bulges outward when the intrapleural pressure becomes greater than the atmospheric pressure
17
Q
- A person with flail chest will have abnormal chest and lung movement (paradoxic movement) that will cause airto?
A
will cause air to be shunted from one lung to another during a ventilator cycle.
18
Q
- During pendelluft the patient rebreathes?
A
dead space gas and hypoventilates
19
Q
- Pendelluft produces what type of ventilation?
A
hypovetilaion
20
Q
- During pendelluft, what my also decrease by the lung compression and atelectasis associated with the unstable chest wall?
A
alveolar ventilation
21
Q
- V/Q ratio decreases as a result of?
A
pendelluft, lung compression, and atelectasis
22
Q
- Because of venous admixture, the patient’s ?
A
PaO2 and CaO2 decrease
23
Q
Lung sounds in flail chest will be?
A
diminished on both the affected and the unaffected sides
24
Q
- Chest radiograph (x-ray) on a flail chest will show?
A
- increased opacity (whiter)
- the density of the lung of the affected side increases
25
25. Paradox movement of chest wall
during inspiration the fractured ribs are pushed inward by atmospheric pressure surrounding the chest and negative intrapleural pressure. during exhalation the flail area bulges outward when the intrapleural pressure becomes greater than the atmospheric pressure.
26
26. Pendelluft
the shunting of air from one lung to another
27
27. PEEP
positive end-expiratory pressure
28
28. In flail chest, the following will occur?
2. Atelectasis
| 3. Intrapulmonary shunting occurs
29
29. When the patient has a severe flail chest, the following will occur?
2. Cardiac output decreases
| 3. Central Venous pressure increases
30
30. A flail chest consists of a double fracture of at least?
three adjacent ribs
31
31. As a consequence of severe flail chest, the following will occur?
2. Vt decreases
| 4. FRC decreases
32
32. When mechanical ventilation is used to stabilize a flail chest, how much time generally is needed for adequate bone healing to occur?
5 to 10 days
33
33. A flail chest is defined as:
double fractures of 3 or more adjacent ribs
34
34. Overall, how would a flail chest affect lung function?
Restrictive lung disorder
35
35. Major pathologic and structural changes associated with a flail chest include:
Major pathologic and structural changes associated with a flail chest include:
36
36. A flail chest is usually caused by:
blunt or crushing chest injury
37
37. Your patient was in an automobile crash and has a mild flail chest injury. What is likely to be needed?
Pain medication
38
38. Treatment of a patient with a flail chest will normally include:
1. giving a medication to relieve pain
2. supplemental oxygen
3. mechanical ventilation with PEEP
39
39. Your patient with a flail chest has atelectasis on the affected side. What should be implemented to correct the problem?
Hyperinflation therapy protocol
40
40. Your patient with a flail chest has paradoxical chest movement. What would be seen with this?
During a cough the flail area bulges out
41
41. With paradoxical chest movement there can be the movement of air from one lung to another. This is called:
pendelluft
42
42. Which of the following pathophysiologic mechanisms may be activated as a result of a flail chest and increase the patient's respiratory rate?
3. Activation of the deflation reflex
| 4. Stimulation of the peripheral chemoreceptors
