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Emergency Medical Technician > Chest Injuries > Flashcards

Chest Injuries Flashcards

1
Q

The body’s ability to move air in and out of the chest and lung tissue

A

Ventilation

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2
Q

The process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs

A

Oxygenation

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3
Q

Thoracic cage

A

Chest

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4
Q

The thoracic cage extends from ___ to the ___

A
  1. Where the neck and chest meet
  2. Diaphragm
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5
Q

In a person who is lying supine or who has just completed exhalation, the diaphragm may rise as high as ___. Thus a penetrating injury to the chest may also penetrate the ___

A
  1. The nipple line
  2. Lung and diaphragm and injure the liver, spleen, or stomach
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6
Q

Why do children belly breath?

A

The intercostal muscles are not yet developed, so breathing is done with the diaphragm

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7
Q

The intercostal muscles are innervated from?

A

The spinal nerves originating in the lower cervical or upper thoracic region

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8
Q

Lying on the inferior and slightly posterior part of each rib is the ___, composed of ___

A
  1. Neurovascular bundle
  2. A network of nerves, arteries, and veins
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9
Q

Side of the chest

A

Hemithorax

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10
Q

Left lobe formation of the lung allows space for the heart to reside

A

Cardiac notch

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11
Q

Thin membrane that covers each lung and the thoracic cavity

A

Pleura

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12
Q

The inner chest wall has a lining called the ___

A

Parietal pleura

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13
Q

The lining on the lungs is called the ___

A

Visceral pleura

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14
Q

Between the visceral and parietal pleura is ___

A

A small amount of pleural fluid that allows the lungs to move freely against the inner chest wall

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15
Q

Pleural fluid also creates ___ to allow the lungs to adhere to the rib cage

A

Surface tension

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16
Q

The trachea divides into the ___

A

Left and right mainstem bronchi

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17
Q

Effect of the intercostal muscles contracting

A

Elevates and expands the rib cage

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18
Q

Effect of the diaphragm contracting

A

Increases the inferior-superior diameter of the chest

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19
Q

The nerves supplying the diaphragm

A

Phrenic nerves

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20
Q

The phrenic nerves exit the spinal cord at ___

A

C3, C4, & C5

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21
Q

A patient whose spinal cord is injured below the ___ may lose the power to move the intercostal muscles

A

C5

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22
Q

Patients with spinal cord injuries at ___ can lose their ability to breath entirely

A

C3

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23
Q

Amount of air moved into or out of the lungs during a single breath

A

Tidal volume

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24
Q

Average tidal volume

A

500 mL

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25
Q

Minute volume

A

Tidal volume x number of breaths a minute

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26
Q

If the patient is only able to inhale small amounts of air, the patient will need to ___

A

Exceed the normal respiratory rate to make up the difference in minute volume

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27
Q

Overinflation of the lungs can cause ___

A
  1. Gastric distention
  2. Impair function of the lungs
  3. Increase intrathoracic pressure
  4. Reducing cardiac output
  5. Reducing venous return to the heart
  6. Worsen chest injuries
  7. Causing acid-base imbalance by blowing off too much carbon dioxide
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28
Q

Chest injury in which the skin is not broken

A

Closed chest injury

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29
Q

Closed chest injuries are generally caused by ___

A

Blunt trauma

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30
Q

Two types of contusions found in chest injuries

A
  1. Cardiac contusions
  2. Pulmonary contusions
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31
Q

Closed chest injuries often cause ___

A

Significant contusions

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32
Q

Chest injury generally caused by penetrating trauma

A

Open chest injury

33
Q

If the patient’s oxygen saturation was normal initially and begins to drop rapidly, suspect ___

A

Tension pneumothorax

34
Q

Signs and symptoms of chest injury

A
  1. Pain at the site of injury
  2. Pain localized at the site of injury that is aggravated by or increased with breathing
  3. Bruising to the chest wall
  4. Crepitus with palpation of the chest
  5. Any penetrating injury to the chest
  6. Dyspnea
  7. Hemoptysis
  8. Failure of one or both sides of the chest to expand normally with inspiration
  9. Rapid, weak pulse and low BP
  10. Cyanosis around the lips or fingernails
  11. Diminished breath sounds on one side
  12. Low oxygen saturation
35
Q

The sensation felt when broken bone ends grind together

A

Crepitus

36
Q

Coughing up blood

A

Hemoptysis

37
Q

Sharp or sticking pain when breathing from irritation or damage to pleural surfaces

A

Pleuritic pain

38
Q

Hemoptysis usually indicates that ___

A

The lung itself or the air passages have been damaged

39
Q

A rapid, weak pulse and low BP are the principal signs of ___

A

Hypovolemic shock

40
Q

Cyanosis in a patient with a chest injury is a sign of ___

A

Inadequate respiration

41
Q

Jugular vein distention may indicate ___

A
  1. Tension pneumothorax
  2. Pericardial tamponade
42
Q

Significant ongoing air accumulation in the pleural space

A

Tension pneumothorax

43
Q

Injury to the heart that results in blood accumulating in the pericardial sac

A

Pericardial tamponade

44
Q

One segment of the chest wall moves opposite the rest of the chest

A

Paradoxical motion

45
Q

The segment of the chest wall that moves the opposite during paradoxical motion

A

Flail segment

46
Q

Paradoxical motion is associated with ___

A

Multiple fractured ribs

47
Q

Use ___ for all penetrating injuries to the chest

A

Vented chest seal or an occlusive dressing

48
Q

If you believe a tension pneumothorax has developed in a patient with an open chest wound, the occlusive dressing should be ___

A

Burped and then placed back over the wound

49
Q

Deadly dozen chest injuries

A
  1. Airway obstruction
  2. Bronchial disruption
  3. Diaphragmatic tear
  4. Esophageal injury
  5. Open pneumothorax
  6. Tension pneumothorax
  7. Massive hemothorax
  8. Flail chest
  9. Cardiac tamponade
  10. Thoracic aortic dissection
  11. Myocardial contusion
  12. Pulmonary contusion
50
Q

Leakage from a traumatic aneurysm of the portion of the aorta that lies within the chest

A

Thoracic aortic dissection

51
Q

Pertinent negatives when examining the chest include ___

A
  1. No associated shortness of breath
  2. No rapid breathing
  3. No absent or abnormal breath sounds
  4. No areas of deformity or abnormal movement
52
Q

If you find an accelerated pulse rate or respiratory rate, the chest injury may be causing either ___

A

A decrease in available oxygen (hypoxia) or blood loss that results in a decreased number of red blood cells that can carry oxygen (hypoxemia)

53
Q

Collapsed lung

A

Pneumothorax

54
Q

If the lung is collapsed past ___, you may hear diminished breath sounds on that side of the chest

A

30% to 40%

55
Q

Open or penetrating wound to the chest wall

A

Open pneumothorax or a sucking chest wound

56
Q

One way valve in a vented chest seal

A

Flutter valve

57
Q

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

A

Simple pneumothorax

58
Q

Simple pneumothorax are commonly the result of ___

A

Blunt trauma that results in fractured ribs

59
Q

Can occur when there is significant ongoing air accumulation in the pleural space

A

Tension pneumothorax

60
Q

Tension pneumothorax occurs more commonly as a result of ___

A

Closed, blunt injury to the chest in which a fractured rib lacerates a lung or bronchus

61
Q

Signs of tension pneumothorax

A
  1. Chest pain
  2. Tachycardia
  3. Marked respiratory distress
  4. low or rapidly dropping oxygen saturation
  5. Absent or severely decreased lung sounds on the affected side
  6. Signs of shock such a hypotension or altered mental status

May also exhibit:
7. Jugular vein distention
8. Cyanosis
9. Tracheal deviation

62
Q

Jugular vein distention is best assessed for with the patient sitting at a ___

A

45 degree angle

63
Q

Relieving a tension pneumothorax that is the result of blunt trauma is often done by ___

A

Inserting a needle through the rib cage into the pleural space

64
Q

Inserting a needle through the rib cage into the pleural space

A

Needle thoracotomy

65
Q

Blood collects in the pleural space from bleeding around the rib cage or from a lung or great vessel

A

Hemothorax

66
Q

Suspect hemothorax if the patient has ___

A

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

67
Q

The presence of air and blood in the pleural space

A

Hemopneumothorax

68
Q

As the amount of blood or fluid in the pericardial sac increases, the heart is less able to ___

A

Fill with blood during each relaxation phase

69
Q

Signs and symptoms of cardiac tamponade are referred to as ___

A

The Beck triad

70
Q

Beck triad

A
  1. Distended or engorged jugular veins seen on both sides of the trachea
  2. Narrowing pulse pressure
  3. Muffled heart sounds
71
Q

___ should always be suspected in a patient with a flail chest

A

Severe pulmonary contusion

72
Q

Any suspected fracture of the sternum should increase your index of suspicion for ___

A

Injuries to the underlying organs

73
Q

The sudden increase in intrathoracic pressure results in a characteristic appearance including distended neck veins, cyanosis in the face and neck, and hemorrhage into the sclera of the eye, signaling the bursting of small blood vessels

A

Traumatic asphyxia

74
Q

Traumatic asphyxia findings suggest ___

A

An underlying injury to the heart and possible a pulmonary contusion

75
Q

Suspect myocardial contusion in all cases of ___

A

Severe blunt injury to the chest

76
Q

Myocardial contusion can mimic the signs and symptoms of a ___

A

Heart attack

77
Q

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

A

Commotio cordis

78
Q

The blunt force, at a single specific point in the cardiac cycle, causes a lethal abnormal heart rhythm called ___

A

Ventricular fibrillation

Emergency Medical Technician (100 decks)

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