Chest Trauma Quiz Part I

Question 1

Which of the following statements regarding the thorax is correct?

Select one:

a. The thoracic cavity extends to the ninth or tenth rib posteriorly.
b. The diaphragm inserts into the anterior thoracic cage below the fifth rib.
c. The dimensions of the thorax are defined inferiorly by the thoracic inlet.
d. The dimensions of the thorax are defined anteriorly by the thoracic vertebrae.

Answer 1

b. The diaphragm inserts into the anterior thoracic cage below the fifth rib.

Question 2

Bony structures of the thorax include all of the following, EXCEPT the:

Select one:

a. ribs.
b. scapulae.
c. clavicles.
d. acromion.

Answer 2

d. acromion.

Question 3

A flail chest is characterized by:

Select one:

a. a free-floating segment of fractured ribs.
b. bulging of fractured ribs during inspiration.
c. excessive negative intrathoracic pressure.
d. drawing in of fractured ribs during expiration.

Answer 3

a. a free-floating segment of fractured ribs.

Question 4

Isolated rib fractures may result in inadequate ventilation because:

Select one:

a. the patient often purposely limits chest wall movement.
b. most rib fractures cause paradoxical chest wall movement
c. the pain associated with the fracture causes hyperventilation.
d. preferential use of the intercostal muscles reduces tidal volume.

Answer 4

a. the patient often purposely limits chest wall movement.

Question 5

Ribs four through nine are the most commonly fractured because:

Select one:

a. they are not anteriorly attached to any portion of the sternum.
b. these particular ribs are inherently weak compared to other ribs.
c. the person’s height predisposes him or her to injury in this area.
d. they are less protected by other bony and muscular structures.

Answer 5

d. they are less protected by other bony and muscular structures.

Question 6

The self-splinting effect observed in patients with chest wall trauma:

Select one:

a. allows the body to compensate for the injury.
b. may cause atelectasis, hypoxemia, or pneumonia.
c. is often accompanied by subcutaneous emphysema.
d. is characterized by a markedly increased tidal volume.

Answer 6

b. may cause atelectasis, hypoxemia, or pneumonia.

Question 7

Pneumothorax is MOST accurately defined as:

Select one:

a. air or gas within the pleural cavity.
b. perforation of a lung by a broken rib.
c. injury to the visceral or parietal pleura.
d. partial or complete collapse of a lung.

Answer 7

a. air or gas within the pleural cavity.

Question 8

An open pneumothorax causes ventilatory inadequacy when:

Select one:

a. positive pressure created by expiration forces air into the pleural space.
b. the heart stops perfusing the lung on the side of the open chest injury.
c. negative pressure created by inspiration draws air into the pleural space.
d. the glottic opening is much larger than the open wound on the chest wall.

Answer 8

c. negative pressure created by inspiration draws air into the pleural space.

Question 9

Pneumothoraces create a ventilation-perfusion mismatch when:

Select one:

a. concomitant myocardial injury prevents adequate pulmonary perfusion and the lung collapses.
b. perfusion of the involved lung continues while the pneumothorax prevents adequate ventilation.
c. the vasculature of the affected lung is not intact and intrapulmonary gas exchange is impaired
d. the affected lung continues to expand adequately despite a decrease in pulmonary perfusion.

Answer 9

b. perfusion of the involved lung continues while the pneumothorax prevents adequate ventilation.

Question 10

What type of chest injury is characterized by air accumulation in the pleural space when a perforation in the lung parenchyma acts as a one-way valve?

Select one:

a. Tension pneumothorax
b. Simple pneumothorax
c. Massive hemothorax
d. Spontaneous pneumothorax

Answer 10

a. Tension pneumothorax