42 Chest trauma Flashcards
What statement is true in regards to a clavicle fracture?
A.
A rare injury
B.
Seldom a significant injury
C.
Managed by reducing the fracture in the field
D.
Likely to heal poorly without surgical intervention
B
What are the most commonly fractured ribs? A. 1 and 2 C. 9 through 12 B. 3 through 8 D. 11 and 12
B
Which statement is true in regards to fractures to the first and second ribs?
A.
Occur commonly and have few complications
B.
Imply great force was exerted to cause the injury
C.
Are commonly complicated by spleen or liver injuries
D.
Most commonly occur in children
B
Paramedics are treating a 10-year-old girl who fell on her outstretched hand playing soccer. She complains of pain and tenderness in her right chest and arm. Based on the mechanism of injury, paramedics should suspect an injury to what location? A. Clavicle C. Rib B. Sternum D. Humerus
A
After a clavicle fracture, what vessel can be injured? A. Subclavian vein C. Aorta B. Intercostal artery D. Vena cava
A
Of the following, which ribs are the most likely to be fractured?
A.
Those of young children
B.
Those of patients with more resilient cartilage
C.
Those that are least protected by musculature
D.
Those of patients involved in sporting activities that include twisting
C
Because of the pain associated with rib fractures, in an attempt to splint the injury, the patient may not breathe deeply. This may result in which complications? A. COPD C. Atelectasis B. Adult onset asthma D. Bronchitis
C
A 17-year-old male is complaining of left-sided chest pain after being tackled in a football game. Examination reveals pain and crepitus around the tenth and eleventh ribs on the left side. Which is an underlying injury that may be present? A. Injury to the liver C. Diaphragmatic rupture B. Injury to the spleen D. Mesenteric injury
B
When three or more adjacent ribs are fractured in two or more places, what is a result? A. Traumatic asphyxia C. Open chest wound B. Flail segment D. Diaphragmatic rupture
B
A 35-year-old male unrestrained driver has been involved in a head-on motor vehicle collision. There is significant damage to the steering wheel. The patient is complaining of left-sided chest pain and difficulty breathing. Initial assessment reveals pain and crepitance around ribs 3 through 8 with diminished breath sounds on the left side.
En route to the hospital, the ongoing assessment reveals that the injured portion of the chest is moving in an opposite direction from the rest of the thorax during respiration. What term best describes that movement? A. Opposite directional shift C. Paradoxical movement B. Paradigm shift D. Antagonist movement
C
A 35-year-old male unrestrained driver has been involved in a head-on motor vehicle collision. There is significant damage to the steering wheel. The patient is complaining of left-sided chest pain and difficulty breathing. Initial assessment reveals pain and crepitance around ribs 3 through 8 with diminished breath sounds on the left side.
This patient has what type of injury of the thoracic wall? A. First rib fracture C. Flail segment B. Simple rib fracture D. Traumatic asphyxia
C
A 35-year-old male unrestrained driver has been involved in a head-on motor vehicle collision. There is significant damage to the steering wheel. The patient is complaining of left-sided chest pain and difficulty breathing. Initial assessment reveals pain and crepitance around ribs 3 through 8 with diminished breath sounds on the left side.
Why do patients with flail segments often develop hypoxia? A. Aortic rupture C. Pulmonary contusion B. Myocardial contusion D. Liver hematoma
C
A 35-year-old male unrestrained driver has been involved in a head-on motor vehicle collision. There is significant damage to the steering wheel. The patient is complaining of left-sided chest pain and difficulty breathing. Initial assessment reveals pain and crepitance around ribs 3 through 8 with diminished breath sounds on the left side.
What is the definitive treatment for a flail segment? A. Sandbags placed over the affected area B. Placement of an occlusive dressing C. Intubation with positive pressure ventilation D. PEEP at 30 cm H20
C
When treating a patient with crepitus to the sternum following a blow to the chest, what other injury should paramedics be concerned with? A. Diaphragmatic rupture C. Open pneumothorax B. Laceration of the spleen D. Myocardial contusion
D
Which signs/symptoms would be associated with a closed (simple) pneumothorax?
A.
Diminished breath sounds on the affected side
B.
Diminished breath sounds on the opposite side
C.
Hypotension
D.
Tracheal deviation
A
When does a simple pneumothorax occur?
A.
Most commonly in patients with blunt chest trauma
B.
Rarely in patients with penetrating chest trauma
C.
As a result of excessive pressure on the chest wall against a closed glottis
D.
As a result of rib fractures that penetrate the chest wall
C
Which statement about open pneumothorax is correct?
A.
Open pneumothorax is rarely a life-threatening injury.
B.
Very small injuries are more dangerous than larger injuries.
C.
The wound must be larger than the normal pathway for air to be able to enter the wound.
D.
Open pneumothorax rarely involves underlying lung injury.
C
What does the treatment of an open pneumothorax consist of?
A.
An occlusive dressing that is taped on three sides
B.
A sterile gauze that allows for measured air exchange
C.
Withholding fluids if the patient also presents with shock
D.
A large, bulky dressing that is taped in place
A
What is air trapped in the pleural space, under pressure, and compressing the vena cava known as? A. Simple pneumothorax C. Tension pneumothorax B. Complete pneumothorax D. Open pneumothorax
C
What will cause decreased cardiac output in a patient with a tension pneumothorax? A. Blood in the pleural space B. Pressure on the vena cava C. Pressure in the pericardial space D. Hypotension as a result of intercostal artery bleeding
B
