Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Advanced EMT > Chest Injuries > Flashcards

Chest Injuries Flashcards

You may prefer our related Brainscape-certified flashcards:
NREMT® EMT flashcards
1
Q

Any injury at the ______ should be considered both a thoracic injury and an abdominal injury.

A

Nipple line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Spinal cord injuries at ___ or above can completely lose their ability to breathe spontaneously.

A

C3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Spinal cord injuries at ___ level or below may lose the ability to move intercostal muscles, but the diaphragm will still contract.

A

C5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How can the diaphragm still contract if a spinal cord injury at C5 level occurs?

A

The phrenic nerve remains intact due to location of injury.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Central chemoreceptors are found in the ____.

A

Medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Peripheral chemoreceptors are located in the ____ and ____ bodies.

A

Carotid; aortic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which chemoreceptors are the main influence on CO2 levels?

A

Central

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Respiratory alkalosis

A

Result of hyperventilation

CO2 level fall causing a reduction in carbonic acid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Repspiratory acidosis

A

Always related to body’s inability to remove CO2
Chest trauma common cause
Buildup of CO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

s/s of chest injury

A 
Pain at site of injury
Pain exacerbated by breathing
Chest wall bruising
Crepitus
Penetrating injury
Dyspnea
Hemoptysis
Asymmetric movement
Rapid, weak pulse and hypotension
Cyanosis around lips or fingernails
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does hemoptysis usually indicate?

A

Damage to lung parenchyma or airway passages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does loos of peripheral pulses during inspiration suggest?

A

Pulsus paradoxus and cardiac tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pulsus paradoxus

A

Drop in systolic BP of 10 mmHG or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What would you expect in a patient w/ a spinal cord injury at C5?

A

Breathing by diaphragm only
Paralysis of all muscles below the shoulders
Loss of sensation from the shoulders down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are you looking for during a rapid exam in your primary survey?

A 
Obvious injuries
Presence of blood
Difficulty breathing
Cyanosis
Irregular breathing
Asymmetrical chest rise and fall
Accessory muscle use
JVD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Muffled heart tones is a clue of?

A

Tension pneumothorax or cardiac tampondae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hyperresonance of chest percussion is:

A

tympani, drum-like sound indicating present of air. Suggests air in pleural spar or pneumothorax.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hyporresonance of chest percussion is:

A

Dull sound indicating solid or fluid suggesting presence of blood or hemothorax,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

JVC suggests increased intravenous pressure resulting from :

A

Tension pneumo
Volume overload
R-sided heart failure
Cardiac tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Life-threatening chest injuries that should be detected and managed during the primary survery?

A 
Airway obstruction
Bronchial disruption
Diaphragmatic tear
Esophageal injury
Open pneumo
Tension pneumo
Hemothorax
Flail chest
Cardiac tamponade
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Life-threating chest injures that may be identified during secondary assessment?

A

Thoracic aortic dissection
Myocardial contusion
Pulmonary contusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What should you assess during the breathing portion of your primary survery?

A 
DCAP-BTLS
Breath sounds
Heart sounds
Paradoxical motion
Equal chest rise and fall
Percussion of chest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What should you assess during the circulation portion of your primary survey?

A

Pulse
Control external bleeding
Heart sounds
JVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What should you do in your secondary assessment?

A

Look for injuries w/ potential to compromise ABCs
Repeat rapid full-body scan
Vital signs - HR, BP, respirations, oxygen sat, mental status, skin condition, pupils, and capnography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Signs of impending cardiopulmonary arrest

A

Decrease in RR and HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

JVD is best assess in which position?

A

Semi-fowler at 45 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Why is a fracture to one of the upper four ribs a sign of a very severe MOI?

A

These four ribs are well protected by the bony girdle of the clavicle and scapula.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What injuries should you suspect with a fracture to the first and second ribs?

A

First and second : ruptured aorta, tracheobronchial tree injury or vascular injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Lower rib fractures are associated with injuries to ?

A

Spleen, kidneys, and liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Why is a fracture to the floating ribs a sign of s severe MOI?

A

These ribs are protected by the abdominal musculature which suggest a strong potential for life-threatening injuries.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Assessment of rib fractures

A

Located TTP, crepitus, pain w/ application of anteroposterior pressure
Exacerbated pain w/ inspiration, expiration, deep breathing, or coughing
Hold affected area of rib cage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Management of rib fractures

A

Focus on managing ABCs and evaluating pt for other, more lethal injuries.
Administer O2
Splint chest wall w/ pillow or blanket

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Assessment of flail chest

A 
DCAP-BTLS
Chest wall contusions
Respiratory distress
Accessory muscle use
Paradoxical motion
Pleuritic chest pain
Crepitus
Tacypnea
Tahycardi
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Management of flail chest

A

Assess the need for positive pressure ventilation
Administer oxygen
Provide positive pressure ventilation via BVM or CPAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What injuries should you have a high index of suspicion if a sternal fx is present?

A 
Pulmonary contusion
Myocardial contusion
Flail chest
Vascular disruption of thoracic vessel
Intra-abdominal injuries
Head injuries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Management of sternal fx

A

Positive pressure ventilations PRN
Establish IV
Administer isotonic crystalloid solution only to maintain systolic BP on 80-90
Elevate the head of long board to reduce pressure in thoracic cavity and facilitate lung expansion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How would you splint a clavicle fx?

A

Sling and swathe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Commotio cordis

A

Chest wall impact directly over the heart, especially over the left ventricle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Indicators of commotio cordis

A 
Unresponsiveness
Apnea
Absent pulse
Cyanosis
Tonic-clonic seziures
Chest wall contusions/localized bruising
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

V-fib in a patient w/ commotio cordis responds positively to ear defibrillation within the first _____ minutes.

A

3

41
Q

During which phase of the cardiac cycle can immediate cardiac arrest occur if the chest wall is struck directly over the heart?

A

Repolarization phase

42
Q

Pneumothorax

A

Accumulation of air in the pleural space

43
Q

Spontaneous pneumothorax

A

Weak area of the lung surface ruptures spontaneously

44
Q

s/s simple pneumothorax

A 
Tachypnea
Tachycardia
Hyperresonance w/ percussion
Dyspnea
Chest pain referred to shoulder or arm on affected side
Pleuritic chest pain
Subcutaneous emphysema
Hypovolemia
Cardiac dysrhythmias
Tracheal deviation (late sign)
45
Q

s/s of larger pneumothoraces

A 
Increasing dyspnea
Agitation
AMS
Tachycardia
Tachypnea
Cyanosis
Lower pulse ox readings
Pulsus paradoxus
Absent breath sounds on affected side
46
Q

Where does the air accumulate in a pneumothorax when the patient is standing? When the patient is supine?

A

Standing : apices

Supine : anterior portion of the chest

47
Q

Management of simple pneumothorax

A

Cover any open wounds w/ occlusive dressing
Maintain ABCs
Positive pressure ventilations sparingly

48
Q

Open pneumothorax

A

Accumulation of air or gas in the pleural space, resulting from penetrating trauma to the chest.

49
Q

s/s of open pneumothorax

A 
Tachycardia
Tachypnea
Subcutaneous emphysema
Decreased breathing sounds on affected side
Hypovolemia
Cardiac dysrhythmias
50
Q

Management of open pneumothorax

A

Cover sucking chest wounds with occlusive dressing
Maintain ABCs
Positive pressure ventilations sparingly

51
Q

Tension pneumothorax

A

Accumulation of air or gas in the pleural space that progressively collapses the lung, decreases cardioac output, and pushes the mediastinum to the opposite pleural cavity.

52
Q

Classic signs of tension pneumothorax

A 
Absence of breath sounds on affected side
Unequal chest rise
Pulsus paradoxus
Tachycardia
Dysrhythmias which progress to v-tach and v-fib
Narrow pulse pressure
JVD (late sign)
Tracheal deviation (very late sign)
53
Q

s/s of tension pneumothorax

A 
Pleuritic chest pain
Dyspnea
Hypoxia
Anxiety
Tachycardia
Tachypnea
Cyanosis
Hypotension (late sign)
54
Q

Management of tension pneumothorax

A

Cover any open wounds with occlusive dressing
Maintain ABCs
Call ALS for dart

55
Q

Hemothorax

A

Space between the parietal and visceral pleural is violated and blood accumulates w/in this space.

56
Q

Most common causes of hemothorax

A

Rib fractures and injuries to lung parenchyma

57
Q

Massive hemothorax

A

Accumulation of more than 1,500 mL of blood w/in the pleural space

58
Q

s/s of hemothorax

A 
Tachypnea
Tachycardia
Dyspnea
Respiratory distress
Hypotension
Hyporessonance on percussion
Pleuritic chest pain
Pale, cool, moist skin
Decreased or unequal chest sounds
Neck veins will be flat or distended
59
Q

How would you differentiate from a pneumothorax and a hemothrorax?

A

Signs of hypovolemia along with respiratory compromise

60
Q

Describe why hypoxia and hypotension occurs with hemothorax.

A

Hypoxia results from decreased gas exchange and hypotension and inadequate profusion result from blood loss.

61
Q

Hemopneumothorax

A

Pneumothorax w/ air and bleeding in the pleural space

62
Q

Management of hemothorax and hemopneumothorax

A

Manage ABCs
Administer oxygen and provided positive ventilations as needed.
Establish IV access
Fluid bolus to maintain systolic BP of 80-90 mmHG only if signs of hypovolemia
Transport rapidly

63
Q

Three physical mechanisms for creating pulmonary contusion

A

Implosion effect
Inertial effect
Spalding effect

64
Q

Implosion effect

A

Overexpansion of air in the lungs secondary to a pressure wave causes blunt trauma and results in rapid, excessive stretching and tearing of the alveoli.

65
Q

Inertial effect

A

Alveoli are stripped from the heavier bronchial structures when the alveoli are pulled at varying rates by a pressure wave.

66
Q

Spalding effect

A

Liquid-gas exchange is disrupted by a shock wave.

67
Q

How does the body compensate for a large pulmonary contusion?

A

Vasoconstricting pulmonary blood flow and increasing cardiac output.

68
Q

s/s of pulmonary contusion

A 
Hemoptysis
Contusion
Tenderness
Crepitus
Paradoxical motion
Wheezes, rhonchi, rales or diminished breath sounds in the affected area
Cyanosis and low o2 stats
69
Q

Management of pulmonary contusion

A

Maintain ABCs
Establish IV access
Small amount of fluid only to improve CO as needed, titrating to a systolic BP of 80-90

70
Q

Cardiac tamponade

A

Blood or other fluid collects in pericardium preventing the heart from filling during the diastolic phase, lower BP

71
Q

Function of the pericardium

A

Anchor the heart, restricting excess movement and preventing kinking of the great vessels.

72
Q

Why does hypotension occur with cardiac tampondae?

A

Pressure w/in pericardial sac reduces the prefusion leading to hypotension.

73
Q

Classic signs of cardiac tamponade

A

Beck triad - narrowing pulse pressure, JVD, and muffled heart tones

Only occurs in advance stages

74
Q

s/s cardiac tamponade

A 
Weak or absent peripheral pulses
Diaphoresis
Dyspnea
Cyanosis
AMS
Tachycardia
Tachypnea
Agitation
Beck triad
75
Q

Physical findings in a patient w/ cardiac tampondae

A 
Hypotension
JVD
Tachycardia
AMS
Signs of hypoperfusion
Trachea midline
Equal breath sounds
Normal chest percussion
Muffled heart sounds
76
Q

Management of cardiac tamponade

A

Manage ABCs
Administer oxygen and positive ventilation as needed
Establish IV access
Rapid fluid bolus to maintain systolic BP at 80-90

77
Q

Myocardial contusion

A

Bruising of the heart muscles

78
Q

Myocardial contusions result in the following :

A

Hemorrhage w/ edema
Fragmented myocardial fibers
Cellular injury

79
Q

Injuries associated w/ myocardial contusion

A 
1-3 rib fx and/or sternal fx
Sharp, retrosternal chest pain
Bruising
Crackles or rales
Irregular pulse rate
80
Q

Management of myocardial contusion

A

Supportive care
Administer oxygen
Establish IV access
Call ALS early for tx of life-threatening dysrhythmias

81
Q

Myocardial rupture

A

Acute perforation of the ventricles, atria, intraventricular septum, intra-atrial septum, chordae tendineae, papillary muscles, or valves.

82
Q

Traumatic aortic disruption

A

dissection or rupture of aorta

83
Q

Assessment findings of traumatic aortic disruption

A

Restrosternal or interscapular “tearing” pain
Dyspnea
Dysphagia
Hoarseness or stridor
Ischemic pain of the extremities
UE hypertension w/ absent or decreased strength of femoral pulses
Hypotension and signs of shock

84
Q

Management of traumatic aortic disruption

A

Maintain ABCs
Establish IV access
Small bolus to maintain adequate perfusion
Immediate transport

85
Q

Management of potential injuries to great vessels

A

Maintaining ABCs
Establish IV line
Consider air transport if transport to Level I trauma center is delayed due to distance

86
Q

Injuries to the great vessels are accompanied by :

A

Massive hemorrhage
Hypovolemic shock
Cardiac tamponade
Enlarging hematomas

87
Q

Physical findings in the acute phase of a diaphragmatic injury

A

Begins at the time of injury and ends w/ recover from other injuries. Other injuries may overshadow diaphragmatic injury.

88
Q

Physical findings in the latent phase of diaphragmatic injury.

A

Intermittent abdominal pain due to periodic herniation or entrapment of abdominal contents in the defect.

89
Q

Physical findings in the obstructive phase of diaphragmatic injury.

A

Abdominal contents herniate through the defect, cutting off their blood supply.

90
Q

s/s of diaphragmatic injury

A 
Tachypnea
Tachycardia
Respiratory distress
Hyporessonance to persuccions
Scaphoid abdomen
Bowel sounds in affected hemithorax
Decreased breath sounds
91
Q

Management of diaphragmatic injuries

A

Elevate head of backboard or stretcher

Positive pressure ventilation

92
Q

s/s esophageal injury

A 
Pleuritic chest pain
Exacerbation of pain w/ swallowing
Hoarseness
Dysphagia
Respiratory distress
Shock

Cervical esophageal perforation : local tenderness and subcutaneous emphysema

93
Q

s/s intrathroacic esophageal injury

A 
Mediastinal emphysema
Mediastinitis
Subcutaneous emphysema
Mediastinal crunch
Splinting of chest wall
94
Q

Management of esophageal injuries

A

Support

Manage ABCs and sxs

95
Q

Findings of tracheobronchial injuires

A 
Hoarseness
Tachypnea
Tachycardia
Massive subcutaneous emphysema
Dyspnea
Respiratory distress
Hemoptysis
Signs of tension pneumo w/o improvement from needle decompression
96
Q

Management of tracheobronchial injuries

A

Earl recognition and rapid transport.
Treat symptoms
Position appropriately
Ventilate as needed

97
Q

Traumatic asphyxia

A

Sudden, severe compression injury of the chest, which produces a rapid increase in intrathoracic pressure

98
Q

Signs of traumatic asphyxia

A 
JVD
Cyanosis in face, upper neck, UE, and torso
Swelling and cyanosis of tongue and lips
Subconjunctival hematoma
Exophthalmos
99
Q

Management of traumatic asphyxia

A 
Early recognition and rapid transport.
Treat sxs, position patient appropriately, and ventilate as needed.
C-spine and spinal immobilization
Establish two large-bore IV lines
Transport to nearest trauma center

Advanced EMT (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions