Chapter 36 Flashcards
An open pneumothorax causes ventilatory inadequacy when:
• the heart stops perfusing the lung on the side of the open chest injury.
• the glottic opening is much larger than the open wound on the chest wall.
• negative pressure created by inspiration draws air into the pleural space.
• positive pressure created by expiration forces air into the pleural space.
negative pressure created by inspiration draws air into the pleural space.
With the exception of the aorta, great vessel injury is most likely to occur following:
• rotational injury.
• blunt trauma.
• penetrating trauma.
• shearing forces.
Penetrating trauma
Which of the following interventions would most likely convert a simple pneumothorax to a tension pneumothorax?
• Positive-pressure ventilation
• A 500-mL fluid bolus
• Needle thoracentesis
• A semi-sitting position
Positive-pressure ventilation.
Tracheobronchial injuries have a high mortality rate due to:
•massive internal hemorrhage.
• perforation of the esophagus.
• concomitant spinal cord injury.
• associated airway obstruction.
Associated airway obstruction.
Dysrhythmias following a myocardial contusion are usually secondary to:
• excess tachycardia that accompanies the injury.
•direct damage to the vasculature of the epicardium.
• aneurysm formation caused by vascular damage.
• damage to myocardial tissue at the cellular level.
Damage to myocardial tissue at the cellular level
Increased central venous pressure commonly manifests as:
• jugular venous distention.
• a widened pulse pressure.
• a pulsating abdominal mass.
• bounding peripheral pulses.
Jugular venous distention
Isolated rib fractures may result in inadequate ventilation because:
• the patient often purposely limits chest wall movement.
• most rib fractures cause paradoxical chest wall movement.
• preferential use of the intercostal muscles reduces tidal volume.
• the pain associated with the fracture causes hyperventilation.
the patient often purposely limits chest wall movement.
A pulmonary contusion following blunt chest trauma results in:
• pulmonary vasodilation as the body attempts to shunt blood to the injury.
• decreased pulmonary shunting with rupture of the alveolar sacs.
• alveolar and capillary damage with intraparenchymal lung hemorrhage.
• blood leakage from injured lung tissue into the pleural space.
alveolar and capillary damage with intraparenchymal lung hemorrhage.
A blood pressure of 110/68 mm Hg in the presence of clinical signs of a tension pneumothorax:
• indicates that prehospital needle decompression likely will not be required.
• is likely the result of systemic vasodilation in an attempt to reduce preload.
• should be treated with crystalloid fluid boluses to prevent hypotension.
• suggests adequate cardiac compensation for the diminished venous return.
suggests adequate cardiac compensation for the diminished venous return.
As air accumulates in the pleural space, the first thing to occur is:
• marked decrease in venous return.
• compression of the great vessels.
• jugular venous distension.
• decreased pulmonary function.
Decreased pulmonary function.
