Chapter 29-chest Injuries

Question 1

Signs and symptoms of chest injury

Answer 1

• pain at the site of the injury
• pain localized at the site of the injury that is increased by or aggravated by breathing
• bruising to the chest wall
• crepitus with palpation of the chest
• any penetrating injury to the chest
• dyspnea
• hemoptysis (coughing up blood)
• failure of one or both sides of the chest to expand normally with inspiration
• rapid week pulse and low blood pressure
• cyanosis around the lips or fingernails

Question 2

What does the heart need to have the ability to pump?

Answer 2

A functional pump, in adequate volume of blood to be pumped, and an appropriate amount of resistance to the pumping mechanism

Question 3

What is cardiac output?

Answer 3

The volume of blood delivered to the body in one minute

Question 4

Tachpnea

Answer 4

Rapid respirations

Question 5

What is the sharp pain with breathing due to irritation of the plural surfaces called?

Answer 5

Pleuritic pain or pleurisy

Question 6

What can result from extensive bleeding from lacerated structures within the chest cavity where the great vessels and heart are located?

Answer 6

Hypovolemic shock

Question 7

Paradoxical motion

Answer 7

An abnormality associated with multiple fractured ribs, in which one segment of the chest wall moves opposite of the other one

Question 8

Deadly dozen chest injuries

Answer 8

1. Airway obstruction
2. Bronchial disruption
3. Diaphragmatic tear
4. Open pneumothorax
5. Tension pneumothorax
6. Massive hemothorax
7. Flail chest
   8

Question 9

Pneumothorax (or a collapsed lung)

Answer 9

An accumulation of air in the plural space. Air enters through a hole in the chest wall or the surface of the lungs as the patient attempts to breathe, causing that long on that side to collapse.

Question 10

Open pneumothorax or sucking chest wound

Answer 10

When a hole is in the chest wall, you can hear a sucking sound as the patient inhales and the sound of rushing air as he or she exhales. Happens with opening or penetrating wounds to the chest wall

Question 11

Flutter valve

Answer 11

Found in vented occlusive dressing’s, a one-way valve that allows air to leave the chest cavity but not return

Question 12

Simple pneumothorax

Answer 12

Any pneumothorax that does not result in major changes in the patient’s cardiac physiology

Question 13

Tension pneumothorax

Answer 13

This can occur when there is significant ongoing air accumulation in the plural space. The air gradually increases the pressure in the chest, first causing the complete collapse of the affected lung and then pushing the central part of the chest containing the heart and great vessels into the opposite plural cavity

Question 14

Hemothorax

Answer 14

When blood collects in the plural space from bleeding around the rib cage or from a lung or great vessel. Suspect this if the patient has signs and symptoms of shock without any obvious external bleeding or apparent reason for the shock

Question 15

Hemopneumothorax

Answer 15

Presence of blood and air in the plural space

Question 16

Cardiac tamponade

Answer 16

Occurs when blood or fluid builds up within the pericardial sac, causing compression of the hearts chambers and dramatically impairing his ability to pump blood

Question 17

Flail chest

Answer 17

If three or more ribs are fractured and two or more places or if the sternum is fractured along with several ribs, a segment of the chest wall maybe detached from the rest of the thoracic cage

Question 18

Traumatic asphyxia

Answer 18

Severe compression of the chest, causing venous backup in the hearts right side. May experience distended neck veins, cyanosis in the face and neck, and hemorrhage in the sclera of the day signaling the burst of small blood vessels

Question 19

Myocardial contusion

Answer 19

Bruising of the heart muscle. Caused my Blunt chest trauma. Makes the heart unable to maintain adequate blood pressure

Question 20

Commotio cordis

Answer 20

A blunt chest injury caused by sudden direct blow to the chest over the heart. This result may be immediate cardiac arrest. It occurs only during a critical portion of a person’s heart beat. Can happen with bats, baseballs, softballs. Usually speeds of 35 to 40 miles an hour can do it