OEC Chapter 23 Test
A skier collides chest first with a tree at a high rate of speed. Based on this mechanism of injury alone, the OECT should be suspicious of all of the following injuries EXCEPT:
A. A lacerated liver or ruptured spleen. B. A triple A. (answer B is correct) C. Hemo, pneumo, or hemopneumothorax. D. Pericardial tamponade.
All of the following statements about thoracic trauma are true EXCEPT:
A. Ongoing assessment is vital for patients with either major or minor traumatic chest injuries. B. 10-30% of all chest trauma requires surgical intervention. C. Skiers outnumber snowboarders almost 2:1 for incidences of traumatic chest injuries. (answer C is correct) D. Patients with chest trauma may initially appear very stable.
All of the following are true about the anatomy and physiology of the chest EXCEPT:
A. The thoracic cage encompasses the heart, lungs, and mediastinum. B. The mediastinum consists of the heart, aorta, vena cava, trachea, esophagus, thymus gland, and nerves. C. The thorax is enclosed by the bony rib cage, sternum, thoracic spine, and diaphragm. D. The thorax includes the area from the mandible to the costal margin. (Answer D is Correct)
A patient has sustained an injury to his mediastinum. Based on the anatomy of his chest, which of the following structures may have been injured?
A.The esophagus B. A bronchus C. The lungs (answer C is correct) D. The diaphragm
An OEC candidate asks you to explain a pneumothorax. Your response should be that it occurs when:
Air accumulates between the inner chest wall and the outside of the lung, causing the lung to collapse.
You have applied a nonporous dressing to a puncture wound on a patient's chest. An OEC candidate asks you why the dressing was taped only on three sides. Your best response is that taping the dressing on three sides:
Allows trapped air to escape upon exhalation.
A 39-year-old man has been stabbed once in the anterior chest. When notifying the patrol aid room by radio, you inform them that the patient has suffered what possible type of injury?
An open chest injury
You are following the L.A.P. method to examine the chest of a 38-year-old trauma patient. To assess for thoracic cage instability, you would apply moderate downward pressure on the sternum while asking the patient to take a deep breath, and then you would:
Apply moderate inward pressure on the lateral walls of the rib cage and ask the patient to take a deep breath.
You are listening to two patrollers discuss the accident to which they just responded. Which of the following injuries would lead you to believe that one of the patients had suffered from traumatic asphyxia?
Bluish discoloration of the neck and face
Injuries at which level of the spinal cord can affect the phrenic nerves and therefore respiration?
C3-C5
The diaphragm plays a major role in respiration. During inhalation, the diaphragm:
Contracts and creates a negative pressure in the thorax, which draws air into the lungs.
During inhalation, the diaphragm:
Contracts and descends into the abdomen.
You are at the scene of a shooting. Your assessment reveals a 23-year-old man who has been shot twice. The first wound is to the left lower quadrant of the abdomen and is bleeding. The second wound is to the left lateral chest and makes a sucking sound every time the patient takes a breath. The initial action of an OEC Technician should be which of the following actions?
Cover the chest wound with a gloved hand.
When assessing a patient, which of the following signs or symptoms is most indicative that the patient is suffering from a tension pneumothorax?
Decreased breath sounds in the right lung
Beck's triad consists of which three significant clinical findings?
Distended neck veins, muffled heart sounds, and pulsus paradox
Which of the following actions occurs when the diaphragm and the intercostal muscles relax?
Exhalation
You are managing a patient with a large flail segment in the right lateral chest. The immediate threat to this patient's life is:
Hypoxia
You treated a 19 year old with a puncture wound to the chest by covering the wound with an impermeable dressing. Now, as you perform your ongoing assessment, you note that the patient is tachypneic and is complaining of difficulty breathing. Breath sounds on the side of the injury are also diminished. Which of the following actions should you take immediately?
Lift a corner of the dressing from the wound for a few seconds; then reapply and check his breath sounds.
Your patient was involved in a serious motor vehicle collision. Which of the following assessment findings best helps to determine that the patient has a flail chest segment?
Paradoxical chest wall movement
Your 35-year-old patient has received major chest trauma. He complains of shortness of breath and pain. Your assessment reveals distended neck veins and pulsus paradoxus. Based on these signs and symptoms, you believe the patient to be suffering from:
Pericardial tamponade
You suspect that a trauma patient is suffering from a hemothorax to the left lung. Which of the following assessment findings would reinforce your suspicion?
Respiratory distress and the signs and symptoms of shock
You have placed an occlusive dressing on a puncture wound on the right side of the chest of a 33-year-old woman. During your ongoing assessment your primary concern is monitoring the injury for:
Tension pneumothorax
You are treating a 26-year-old man with a pneumothorax. The patient's breathing has been inadequate, and you have been assisting his ventilations with a bag valve mask. The patient's condition seems to be worsening. Because you understand the pathology involved in a pneumothorax, you are most concerned that:
The pressure from the BVM is causing more air to enter the pleural space and is causing a tension pneumothorax.
The heart and lungs are located in the:
Thoracic cavity
The diaphragm separates the:
Thoracic cavity from the abdominal cavity
Which of the following phrases best describes a flail chest segment?
Two or more adjacent ribs that have been broken in two or more places.
You are assisting at an accident scene and are asked to apply a dressing over a sucking chest wound on the patient's left anterior chest wall. Which of the following items would you use?
Vaseline gauze
You are following the L.A.P. method to examine the chest of a 38-year-old trauma patient. To assess for thoracic cage instability, you would apply moderate downward pressure on the sternum while asking the patient to take a deep breath, and then you would:
apply moderate inward pressure on the lateral walls of the rib cage and ask the patient to take a deep breath.
You are treating a 26-year-old man who fell about 20 feet while rock climbing. He is complaining of right sided chest discomfort and dyspnea. You note that his respiratory rate is 28 and shallow. Based on this assessment, the best emergency care would be:
performing a rapid body survey and assisting ventilations with BVM and high-flow oxygen.
You are treating a 26-year-old man with a pneumothorax. The patient's breathing has been inadequate, and you have been assisting his ventilations with a bag valve mask. The patient's condition seems to be worsening. Because you understand the physiology involved in a pneumothorax, you are most concerned that:
the pressure from the BVM is causing more air to enter the pleural space and is causing a tension pneumothorax.
An OEC candidate indicates that she understands the difference between a pneumothorax and a tension pneumothorax when she makes which of the following statements?
"A tension pneumothorax can cause cardiac output to decrease; a pneumothorax does not."
Which of the following statements indicates that the speaker understands chest trauma?
"Internal chest injuries are more difficult to assess and manage than are the more obvious external chest injuries."
You are instructing a class in Outdoor Emergency Care when a student asks you to explain the L.A.P. method of examining the thorax. Your best reply to this question would be which of the following statements?
"The L.A.P. method directs you to look, auscultate, and palpate the chest."
You are treating a 16-year-old male who was skiing out of control and ran off the trail and into the woods. When you arrive, he is alert and complaining of pain in his right lower chest. Upon examination you note that he has impaled himself with a tree branch. He tells you he will feel better if you just remove the branch. Based on your training as an OEC technician, you would respond by making which of the following statements?
"We need to leave the branch in place until we get you to a hospital."
The thorax is enclosed by the:
Ribs, sternum, thoracic spine, and diaphragm.