Chest injuries

Question 1

Define

Cardiac tamponade

Answer 1

Compression of the heart as the result of buildup of blood or other fluid in the pericardial sac, leading to decreased cardiac output.

Question 2

Define

Closed chest injury

Answer 2

An injury to the chest in which the skin is not broken, usually caused by blunt trauma

Question 3

Define

Commotio cordis

Answer 3

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

Question 4

Define

Crepitus

Answer 4

A grating or grinding sensation caused by fractured bone ends or joints rubbing together.

Question 5

Define

Flail chest

Answer 5

A condition in which two or more adjacent 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.

Question 6

Define

Hemopneumothorax

Answer 6

The accumulation of blood and air in the pleural space of the chest.

Question 7

Define

Hemothorax

Answer 7

A collection of blood in the pleural cavity.

Question 8

Define

Myocardial contusion

Answer 8

Bruising of the heart muscle.

Question 9

Define

Open chest injury

Answer 9

An injury to the chest in which the chest wall itself is penetrated by a fractured rib or, more frequently, by an external object such as a bullet or knife.

Question 10

Define

Open pneumothorax

Answer 10

An open or penetrating chest wall wound through which air passes during inspiration and expiration, creating a sucking sound; also referred to as a sucking chest wound.

Question 11

Define

Paradoxical motion

Answer 11

The motion of the portion of the chest wall that is detached in a flail chest; the motion—in during inhalation, out during exhalation—is exactly the opposite of normal chest wall motion during breathing.

Question 12

Define

Pulmonary contusion

Answer 12

njury or bruising of lung tissue that results in hemorrhage.

Question 13

Define

Sucking chest wound

Answer 13

An open or penetrating chest wall woundthrough which air passes during inspiration and expiration, creating a sucking sound

Question 14

Define

Traumatic asphyxia

Answer 14

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.

Question 15

How does a penetrating chest injury potentially cause harm?

Answer 15

It has the potential to penetrate the lung and diaphragm and injure the heart and great vessels.

Question 16

What are the two main classifications of chest injuries?

Answer 16

Closed or open

Question 17

How are closed chest injuries typically caused?

Answer 17

Often the result of blunt force trauma.

Question 18

How are open chest injuries typically caused?

Answer 18

The result of an object penetrating the skin and/or chest wall.

Question 19

What type of injuries can blunt trauma potentially cause to the ribs and sternum?

Answer 19

Fractures

Question 20

What is a life-threatening external hemorrhage associated with chest injuries?

Answer 20

Massive bleeding from a chest injury.

Question 21

When assessing a patient with a chest injury, what should be addressed immediately, even before airway or breathing concerns, if present?

Answer 21

Life-threatening external hemorrhage.

Question 22

What is the primary assessment focused on when a chest injury is encountered that interferes with the body’s ability to perfuse or oxygenate effectively?

Answer 22

Identifying and addressing the injury quickly.

Question 23

What can any open wound in the chest wall potentially allow to enter the pleural space and cause a pneumothorax?

Answer 23

Air

Question 24

What is a pneumothorax where air enters the chest cavity through the chest wall called?

Answer 24

A vented chest wound or an open pneumothorax.

Question 25

What is the term for the hole created in the chest wall by a penetrating injury, through which air is heard to move in and out as the patient breathes?

Answer 25

An open pneumothorax.

Question 26

What type of trauma is typically the cause of a simple pneumothorax?

Answer 26

Blunt trauma, such as fractured ribs.

Question 27

What is a spontaneous pneumothorax?

Answer 27

It may be the result of rupture of a bleb (a weakened area on the lung surface) that allows air to leak into the pleural space and accumulate.

Question 28

Is a spontaneous pneumothorax always related to trauma?

Answer 28

No, it often results from non-traumatic injuries or conditions and can occur during normal activity or even exercise

Question 29

What serious condition can a pneumothorax potentially progress to?

Answer 29

A tension pneumothorax, which can potentially cause cardiac arrest.

Question 30

What happens in a tension pneumothorax?

Answer 30

Air accumulates in the pleural space after a traumatic injury, which progressively collapses the injured lung and shifts the mediastinum (heart and great vessels) to the opposite side.

Question 31

What is a flail chest segment?

Answer 31

Two or more adjacent ribs broken in two or more places, creating a segment of the chest wall that moves independently.

Question 32

Why is identifying and managing a flail chest particularly important for a patient with a chest injury?

Answer 32

Because it indicates significant force of injury and can impair breathing.

Question 33

How should all patients with chest injuries who require high-flow oxygen be ventilated?

Answer 33

Using positive pressure ventilation if needed and tolerated.

Question 34

What is pulmonary contusion?

Answer 34

Bruising of the lung tissue.

Question 35

What does pulmonary contusion interfere with?

Answer 35

Gas exchange in the lung

Question 36

What is myocardial contusion?

Answer 36

Bruising of the heart muscle after traumatic injury

Question 37

What are the potential signs and symptoms of myocardial contusion?

Answer 37

They may have the same signs and symptoms as a heart attack, including an irregular pulse

Question 38

Is myocardial contusion the same as a heart attack?

Answer 38

No, it is an injury to the heart muscle from trauma, not from a heart attack.

Question 39

What is commotio cordis?

Answer 39

Commotio cordis occurs from a direct blow to the chest during a critical portion of the patient's heartbeat.

Question 40

What can commotio cordis result in?

Answer 40

Immediate cardiac arrest.

Question 41

What is cardiac tamponade?

Answer 41

Cardiac tamponade is when blood collects in the space between the pericardial sac and the heart.

Question 42

How does cardiac tamponade affect the heart?

Answer 42

This condition results in pressure building up inside the pericardial sac until the heart cannot pump effectively.

Question 43

Where are the great vessels of the body located?

Answer 43

In the mediastinum.

Question 44

What type of injury can the great vessels sustain after traumatic injury?

Answer 44

Lacerated or torn

Question 45

What can injury to the great vessels cause inside the patient's chest cavity?

Answer 45

Heavy, unseen bleeding

Question 46

What should you suspect in any patient who has signs of shock with a chest injury, even without visible bleeding?

Answer 46

Suspicion of unseen, life-threatening bleeding inside the chest