Chest Trauma

Question 1

Definition of occult pneumothorax

Answer 1

only seen on CT

Question 2

4 Signs of pneumothorax on supine radiograph

Answer 2

1 - deep sulcus sign
2 - increased lucency at lung base
3 - double diaphragm sign
4 - increased definition of mediastinal contour

Question 3

Attenuation/Houndsfield units of blood in pleural space

Answer 3

35 - 70 HU

Question 4

What are patients with pulmonary contusion at risk to develop?

Answer 4

Pneumonia

ARDS

Question 5

Tracheobronchial injuries occur how from from the carina?

Answer 5

Within 2.5cm

Question 6

What is fallen lung sign?

Answer 6

When there is complete transection of bronchus and lung falls away from hilum. Posterior of supine and inferiorly if upright.

Question 7

What is Macklin effect?

Answer 7

Traumatic pneumomediastinum due to traumatic rupture of alveoli and air tracking along bronchovascular structures

Question 8

Where do esophageal ruptures occur and how?

Answer 8

1. distal and to the left - burst type like post-emetic due to less protection by pleural lining and the heart.
2. cervical due to direct blows to neck

Question 9

Where does the aorta rupture in trauma?

Answer 9

In order of frequency:
Proximal descending aorta
aortic arch
aortic root
distal descending aorta at aortic hiatus

Question 10

What is flail chest?

Answer 10

3 or more contiguous ribs with fractures in 2 or more places