Chest Abd Flashcards
for an inj to be an open injury what must be present:
must have any break in skin above the injured site
proper management of a tibia/tibial fracture:
immobilization of distal femur to the foot
organ that, if fractured, would cause the most collateral damage
spleen (incorrect)
liver
pancreas
kidney
pancreas
pelvic ring fracture, bilateral closed femur fracture, how much bl predicted to have been lost:
2L is incorrect
3L
3L
ptnt sitting in pool of bl, deep wound to stomach. best position for suspected evisceration:
recovery position (incorrect)
supine w/knees flexed
high fowlers (incorrect)
supine w/knees flexed
thoracic fracture asw paradoxical movement:
flail chest
rib fracture
sternal dislocation
flail chest
device most appropriate for closed mid shaft femur fracture:
long board splints (incorrect)
pneumatic leg splint
traction splint
traction splint
10 mnth ptnt with severe burns on lower extremities. what % of surface area has burns:
18% (incorrect)
27%
27%
assessment findings for a hemothorax:
most expected assess w/a dislocated joint:
swelling (incorrect)
absent distal pulses (incorrect)
crepitus
fixed in place
fixed in place
ptnt w/fractured extremity, complains of parathesia what is the best reason why:
damage to sensory nerves
damage to motor nerves
damage to bl vessels (incorrect)
damage to periosteum
best way to stop flail segment paradoxical movement:
place ptnt onto flail segment
ventilate
tape a bulky dressing over the flail
ventilate the ptnt
massive hemothorax would not make enough pressure to make JVD - so that can be ruled out if there IS distended neck veins.
injury to the spleen can cause what symptoms:
Kehr’s sign is the occurrence of acute pain in the tip of the shoulder due to the presence of blood or other irritants in the peritoneal cavity when a person is lying down and the legs are elevated. Kehr’s sign in the left shoulder is considered a classic symptom of a ruptured spleen
pneumothorax vs hemothorax
and what symptoms help discern?
how would you perform an assessment to tell the diff? (using chest percussion).
Pneumothorax and hemothorax are conditions that affect the pleural space surrounding the lungs. When air leaks into this space, it’s called a pneumothorax; whereas when blood fills this space, it’s called a hemothorax.
Both conditions put pressure on the lungs and cause chest pain, labored breathing, and a rapid heart rate; both with symptoms such as dyspnea, hypoxia, decreased breath sounds, and chest pain. A key clinical finding that separates these two is that a pneumothorax will have hyper-resonance to percussion (air in the space - listen for hollow drum like sounds), but a hemothorax will have a hypo-resonance to percussion (absent or decreased breath sounds with stethoscope)
a CT scan is needed to fully diagnose.
likely injury for a ptnt with increasing BP and dropping heart rate.
head injury
The Cushing reflex results from the body’s response to increased intracranial pressure. Intracranial pressure is a blood pressure measurement in the brain.
The Cushing reflex is one of the body’s ways to try to keep pressure from getting too high in the skull. It signals receptors in the heart to slow the heart rate down to lower the intracranial pressure.
best way to stop paradoxical movement as seen with a flail segment on an (U) ptnt:
ventilate the ptnt
Ventricular tachycardia causes hypotension (low blood pressure) because when a person is experiences ventricular tachycardia, their left ventricle …
does not adequately fill with blood
A transient ischemic attack (TIA) occurs when: a small clot in a cerebral artery causes temporary symptoms
most indicative of a cardiovascular problem
JVD
ptnt with low pitched rattling sounds at bases of the lungs most likely is
aspiration pneumonia
acute MI occurs when:
heart muscle weakens and dysfunctions
coronary artery dilation decreases bl flow to heart (incorrect)
left ventricle is damaged and cannot pump bl
myocardial tissue dies secondary to an absence of o2
angina occurs when:
myocardial o2 demand exceeds supply
bl ejected from the rt ventricle:
flows into the pulm arteries
enters teh systemic circulation
was received directly fro m the aorta
has a high concentration of o2 (incorrect)
flows into the pulm arteries
cardiogenic shock following AMI:
caused by decreased pumping force of teh heart muscle
hypertensive emerg symptoms:
bounding pulse, headache, dizzy
An acute myocardial infarction (AMI) occurs when: myocardial tissue dies secondary to an absence of oxygen
signs of air embo:
(air or gas trapped in bl vessel)
can be caused when divers hold their breath when ascending or ascend too quickly
can also be caused by IVs, catheters, during surg procedures, trauma to lung , blast explosions (blast lung)
also air/gas in vessels can travel to the brain or lungs and cause heart attack, stroke, or resp failure
diff breathing
resp failure
chest pain
heart failure
muscle/joint pain
stroke
cyanosis/blue skin
mental status changes/loc
low bp
**
hemothorax signs/symptoms
diminished lung sounds
flat neck veins
dull to percussion
tension pneumothorax symptoms:
ABSENT lung sounds
distended neck veins
hyperresonant to percussion
