Chest Trauma

Question 1

What are the three portions of the sternum?

Answer 1

• Manubrium
• Sternal body
• Xiphoid process

Question 2

How many ribs are present in a human body?

Answer 2

12

Question 3

What is the junction between the sternal body and the manubrium?

Answer 3

Angle of Louis

Question 4

Fill in the blank.

The muscle between each rib is called the ________ space.

Answer 4

intercostal

Question 5

What runs on the bottom of each rib?

Answer 5

• nerves
• veins
• arteries

Question 6

What organs/tissues are contained within the mediastinum?

Answer 6

• Heart
• Great Vessels
• Esophagus
• Trachea
• Mainstem bronchi
• Vagus and phrenic Nerve

Question 6

Assessment:

palpating the chest

Answer 6

• Crepitus
• Subcutaneous emphysema
• Edema
• Tracheal position
• Tenderness
• Deformities
• Bony instability

Question 7

What does Jugular Venous Distention suggest clinically?

Answer 7

Increased intravenous pressure.

Question 8

What are the causes of Jugular Venous Distention?

Answer 8

• Tension pneumothorax
• Volume overload
• Right-sided heart failure
• Cardiac tamponade

Question 9

Describe:

flail chest

Answer 9

Two or more adjacent ribs fractured.

Question 10

What type of chest movement is found in a flail chest?

Answer 10

paradoxical movement

Question 11

Treatment:

flail chest

Answer 11

positive pressure ventilation

Question 12

Define:

tension pneumothorax

Answer 12

Accumulation of air within the pleural cavity, causing a decrease in preload and intrathoracic pressure.

Question 13

What are the signs/symptoms of pneumothorax?

Answer 13

• pulsus paradoxus
• JVD
• progressive respiratory distress
• unequal chest wall movement
• decreased unilateral lung sounds

Question 14

Treatment:

tension pneumothorax

Answer 14

• Perform needle chest decompression using a 14-gauge needle.
• Cover the wound with a dressing secured on three sides.
• Administer oxygen.
• Repeat needle decompressions if necessary.

Question 15

What are the locations for needle decompression?

Answer 15

• 2nd ICS, mid-clavicular line
• 4th or 5th ICS, mid-axillary line

Question 16

Define:

hemothorax

Answer 16

Accumulation of blood within the pleural cavity.

Question 17

Define:

cardiac tamponade

Answer 17

Fluid accumulation within the pericardial sac.

Question 18

What are the signs/symptoms of pericardial tamponade?

Answer 18

• Beck’s triad
• Electrical alternans
• AMS

Question 19

What are the components of Beck’s Triad?

Answer 19

• Hypotension
• Muffled heart tones
• JVD

Question 20

Treatment:

cardiac tamponade

Answer 20

Pericardiocentesis

Question 21

Define:

Commotio Cordis

Answer 21

Direct blow to the chest during the heart’s absolute repolarization period.

Question 22

Define:

Aortic Dissection

Answer 22

Rupture of the aorta.

Question 23

What types of traumas are likely to cause aortic dissection?

Answer 23

• high speed collision
• falls

Question 24

What are the signs/symptoms of aortic dissection?

Answer 24

• altering BP in each arm
• hypotension
• shock

Question 25

What happens during a diaphragmatic injury?

Answer 25

Rupture of bowels into the thoracic cavity.

Question 26

Treatment:

impaled object in the chest

Answer 26

Leave it in place unless it impedes CPR.