acute pulm pt 2

Question 1

flail chest

Answer 1

2+ fractures per rib in at least 2 contiguous ribs

Question 1

rib fx mgmt

Answer 1

consult trauma surgery

pain management

pulm hygiene

Question 2

when to suspect flail chest

Answer 2

ecchymosis, seat belt sign, graze abrasions

crepitus

paradoxical movement

Question 3

rib fracture complications

Answer 3

resp failure - hypoventilation, atelectasis, hypercapnia, atelectasis, pneumonia

Question 4

pulmonary contusion

Answer 4

injury to lung parenchyma as a consequence of blunt chest trauma

typically along w rib fx

develop over 24 h

can lead to ARDS, resp failure, atelectasis, pneumonia

Question 5

pulm contusion diagnostics

Answer 5

CXR - blossoming

chest CT

Question 6

pulm contusion s/s

Answer 6

s/s of resp failure

tenderness to palpation

paradoxical chest wall excursion

retractions, accessory muscle use

Question 7

tension pneumo exam findings

Answer 7

hypotension
hypoxia
JVD
tracheal deviation
high peak pressures

asymmetric lung expansion
absent breath sounds
hyper resonance to percussion
decreased tactile fremitus
adventitious lung sounds - crackles, wheeze ipsilateral

Question 8

hemothorax exam findings

Answer 8

decreased breath sounds
dullness to percussion
decreased chest expansion

Question 9

transudative vs exudative pleural effusion

Answer 9

transudative - imbalance btw hydrostatic/oncotic

exudative - inflammatory condition