Chapter 29- Chest Injuries

Question 1

The thin membrane that covered each of the lungs and the thoracic cavity.

Answer 1

Pleura

Question 2

The muscle that separates the thoracic cavity from the abdominal cavity.

Answer 2

The diaphragm

Question 3

The nerve that supplies the diaphragm

Answer 3

Phrenic nerve

Question 4

Where does the phrenic nerve exit the spinal cord?

Answer 4

C3, C4, and C5

Question 5

Patients with spinal cord injuries at C3, or above can lose their ability to…

Answer 5

Breathe entirely.

Question 6

Minute volume

Answer 6

The amount of air that enters the lungs within a minute.

Question 7

Closed chest injury

Answer 7

Injury in which the skin is not broken

Question 8

If the heart is damaged by contusions it can cause

Answer 8

Cardiogenic shock

Question 9

Bruising in the lungs can lead to

Answer 9

Less surface area for oxygen and carbon dioxide exchange, leading to hypoxia and/or hypercarbia

Question 10

Open chest injury

Answer 10

Something that penetrates the chest wall itself.

Question 11

Signs and symptoms of chest injury

Answer 11

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

Question 12

Tachypnea

Answer 12

Rapid respirations

Question 13

Patients with chest injuries often have tachypnea and shallow respirations because…

Answer 13

It hurts to take a deep breath.

Question 14

Paradoxical potion

Answer 14

The motion of the portion of the chest wall that s detached in a flail chest

Basically the opposite of normal chest wall movements

Question 15

Occlusive dressing

Answer 15

An airtight dressing that protects a wound from air and bacteria

Question 16

Questions about the event surrounding the incident should focus on the…

Answer 16

MOI

Question 17

Pneumothorax

Answer 17

Commonly called a collapsed lung

Condition where air entered through a hole in the chest wall or the surface of the lung as the patient attempts to breathe, causing the lung on that side to collapse.

Question 18

Absent breathe sounds in chest trauma can indicate

Answer 18

A pneumothorax or a tension pneumothorax.

Question 19

Open pneumothorax/ sucking chest wound

Answer 19

An open penetrating wound to the chest wall

Question 20

The purpose of dressing a chest wound is too…

Answer 20

Seal the wound and prevent air from being sucked into the chest through the wound.

Question 21

Flutter valve

Answer 21

Part of vented occlusive dressing, allows air to leave the chest cavity but not return.

Question 22

Simple pneumothorax

Answer 22

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

Question 23

Tension pneumothorax

Answer 23

A pneumothorax that has progressively increased pressure in the chest that interferes with cardiac function with potentially fatal results.

Question 24

Patients with a tension pneumothorax will exhibit:

Answer 24

• chest pain
• tachycardia
• respiratory distress
• absent lung sounds
• JDV
• tracheal deviation

Question 25

Hemothorax

Answer 25

Where blood collects in the pleural space from bleeding around the rib cage or from a lug or great vessel.

Question 26

Suspect a hemothorax when;

Answer 26

The patient has signs and symptoms of shock without any obvious external bleeding or apparent reason for the shock state

Or decreased breath sounds on the affected side

Question 27

The presence of air and blood in the pleural space:

Answer 27

Hemopneumothorax

Question 28

Cardiac tamponade

Answer 28

Occurs when the protective membrane around the heart fills with blood or fluid, compressing the heart and dramatically affecting its ability to pump blood throughout the body.

Question 29

A condition in which three or more ribs are fractured in two or more places or in association with a fracture of the sternum so that a segment of the chest wall is effectively detached from the rest of the thoracic cage

Answer 29

Flail chest

Question 30

Pulmonary contusion

Answer 30

Injury or bruising of lung tissue that results in hemorrhage

Always expect this with patients who have a flail chest

Question 31

A pattern of injuries seen after a severe force is applied to the chest, forcing blood from the great vessels back into the head and neck

Answer 31

Traumatic asphyxia

Question 32

Myocardial contusion

Answer 32

Bruising of the heart muscle

Question 33

Commotio cordis

Answer 33

A blunt chest injury caused by a sudden, direct blow to the chest (over the heart) that occurs only during a critical portion of a person’s heartbeat