CHAPTER 30, 31, 32 REVIEW, Ch 30: Chest Injuries mergeee, Chapter 31 Abdominal and Genitourinary Injuries mergee

The messengers is:

A membranous fold that attaches the intestines to the walls of the body

Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of:

A poorly placed lap belt

An unresponsive trauma patient has a large open abdominal wound with massive external bleeding. You should:

Apply direct pressure to the wound

54-year-old male experience an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain in the division is bleeding moderately. The most appropriate treatment for this patient includes:

Applying direct pressure with a dry, sterile dressing

When documenting a call involving a female patient who was sexually assaulted, the EMT should:

Avoid speculation and document only factual data

The phrenic nerves control the diaphragm and exit the spinal cord at:

C3, C4, C5

You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at th hospital is less than 10 minutes. After treating the patient appropriately, you should:

Closely monitor him and reassess him frequently

Your presence is requested by law-enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you were talking to her, you know impressive amount of blood are in clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/minute, and her respirations are 24 breaths/minute. You should:

Control any external bleeding, administer oxygen, and transport at once

A man has a large laceration across his lower abdominal wall and a loop of bowel is protruding from the wound. He is conscious and alert and there is minimal bleeding from the wound. You should:

Cover the exposed bowl with a moist sterile dressing and then secure it in place with a dry bandage

Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured:

Diaphragm

Accumulation of blood in the abdominal cavity will most likely cause:

Distention

Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade?

Engorged jugular veins

A four-year-old male presents with severe abdominal pain after blunt trauma. He is a diaphoretic, intensely Thursday, and has a week in rapid pulse. Appropriate dreamer for this patient includes all the following, except:

Giving him small sips of plain water

Contraction or tensing of the abdominal muscles in an effort to ease pain is called:

Guarding

You are transporting for Turo, male who experience blunt a domino trauma. He is receiving oxygen at 12 L/minute via a nonrebreather mask, I'm full, spinal precautions have been applied. During a reassessment, you know his level consiousness has decreased his respirations have become shallow. You should:

Insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag valve mask

During your assessment of a patient who experience blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of:

Intra-abdominal bleeding

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should:

Lift the airbag and look for deformity to the steering wheel

Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the:

Liver

Which of the following organs would most likely bleed profusely when injured?

Liver

Placing a pregnant patient in a supine position during the third trimester of pregnancy:

Might decrease the amount of blood that returns to the heart

A rapid, irregular pulse following blunt trauma to the chest is MOST suggestive of a:

Myocardial contusion

When a hollow organ is punctured during a penetrating injury to the abdomen:

Peritonitis might not develop for several hours

A 28-year old male was struck in the chest with a baseball bat during an altercation. He is conscious and alert and complains of severe chest pain. Your assessment reveals a large area of ecchymosis over the sternum and a rapid irregular pulse. In addition to providing supplemental oxygen, you should:

Prepare for immediate transport

Because the depth of an open abdominal wound is often difficult to determine:

Prompt transport to the hospital essential

Early bruising following abdominal trauma often manifests as:

Red areas of skin

The presence of tachycardia following a significant abdominal injury:

Should be assumed to be a sign of shock

All of the following are hollow abdominal organs, except the:

Spleen

Which of the following statements regarding abdominal trauma is correct?

The bad sense of abdominal pain does not rule out intra-abdominal bleeding

CHAPTER 31: Which of the following statements regarding abdominal eviscerations is correct?

The protruding organs should be kept warm and moist.

A 22-year-old male was kicked in the Abdomin several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His blood pressure is 142/82 mm Hg, his pulse rate is 110 beat/minute and strong, and his respirations are 22 breaths/minute and regular. In addition to administering high flow oxygen, you should:

Transport him in the position in which you found him

Which of the following organs is at most risk for injury as the result of a pelvic fracture:

Urinary bladder

A flail chest occurs when:

a segment of the chest wall is detached from the thoracic cage.

Pneumothorax is defined as:

accumulation of air in the pleural space

While jogging, a 19-year-old male experienced an acute onset of shortness of breath and pleuritic chest pain. He is conscious and alert with stable vital signs. Your assessment reveals that he has diminished breath sounds over the left side of the chest. You should:

administer oxygen and transport to the hospital.

A 37-year-old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should:

aggressively manage his airway.

An open pneumothorax occurs when:

air enters the pleural space from outside the body.

Subcutaneous emphysema is an indication that:

air is escaping into the chest wall from a damaged lung

Patients with rib fractures will commonly:

breathe rapidly and shallowly.

Signs and symptoms of a tension pneumothorax include all of the following, EXCEPT:

collapsed jugular veins.

You are transporting a stable patient with a possible pneumothorax. The patient is receiving 100% oxygen and has an oxygen saturation of 95%. During your reassessment, you find that the patient is now confused, hypotensive, and profusely diaphoretic. What is MOST likely causing this patient's deterioration?

compression of the aorta and vena cava

Hemoptysis is defined as:

coughing up blood

The thoracic cavity is separated from the abdominal cavity by the:

diaphragm

A spontaneous pneumothorax would MOST likely occur as the result of:

exertion of a person with a congenital lung defect.

Common signs and symptoms of a chest injury include all of the following, EXCEPT:

hematemesis

A sign of kidney damage after blunt trauma is:

hematuria

Peritonitis usually occurs when:

hollow abdominal organs are damaged and spill their contents into the peritoneal cavity.

You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, you should:

immediately request ALS support

The MOST critical treatment for a tension pneumothorax involves:

inserting a needle through the rib cage into the pleural space.

You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The patient is unconscious, tachycardic, and diaphoretic. Your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. You should be MOST suspicious that this patient has experienced a:

laceration of the aorta.

Which of the following organs or structures does NOT reside within the mediastinum?

lungs

When a person is lying supine at the end of exhalation, the diaphragm:

may rise as high as the nipple line.

If a person's tidal volume decreases, but his or her respiratory rate remains unchanged:

minute volume will decrease.

If a patient with a chest injury is only able to inhale small amounts of air per breath, he or she:

must increase his or her respiratory rate to maintain adequate minute volume.

A spinal cord injury at the level of C7 would MOST likely result in:

paralysis of the intercostal muscles.

You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:

partially remove the dressing.

The ________ nerves control the diaphragm.

phrenic

Irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation is called:

pleurisy

In order to avoid exacerbating a patient's injury, it is especially important to use extreme caution when providing positive-pressure ventilation to patients with a:

pneumothorax

28-year-old male was struck in the chest with a baseball bat during an altercation. He is conscious and alert and complains of severe chest pain. Your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. In addition to applying 100% oxygen, you should:

prepare for immediate transport.

Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, reduced tidal volume, and cyanosis. Her blood pressure is 80/50 mm Hg and her pulse is 130 beats/min and thready. You should:

provide some form of positive-pressure ventilation

A patient who presents with profound cyanosis following a chest injury:

requires prompt ventilation and oxygenation.

When assessing a patient with a hemothorax, you will MOST likely find:

signs and symptoms of shock

During your assessment of a patient with blunt chest trauma, you note paradoxical movement of the left chest wall. As your partner is administering oxygen to the patient, you should:

stabilize the chest wall with a bulky dressing.

Elevation of the rib cage during inhalation occurs when:

the intercostal muscles contract.

Very young children tend to breathe predominantly with their diaphragm because:

their intercostal muscles are not fully developed.

Immediate death from blunt chest trauma following a motor vehicle crash is MOST often the result of:

traumatic aortic rupture

A 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what MOST likely occurred?

ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle

Pleural fluid is contained between the:

visceral and parietal pleurae.

A 54-year-old male experience an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveal that he is in severe pain and that the avulsion is bleeding moderately the most appropriate treatment for this patient includes:

Applying direct pressure with a dry, sterile dressing.

Which of the following statements regarding rebound tenderness is correct?

It is often discovered when the patient is jarred or moved suddenly

You are dispatched to a residence for a young female who was kicked in the abdomen. While en route to the scene, you should ask the dispatcher if:

Law enforcement is at the scene