Chest Injuries Chapter: 29
Ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle
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?
prepare for immediate transport
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:
The phrenic nerves control the diaphragm and exit the spinal cord at:
C3, C4, and C5.
Mediastinum
Center cavity of thorax
Thoracic Cage
Chest
Exhalation
Chest falls
Inhalation
Chest rises
blunt trauma
Closed chest injuries are typically caused by _______.
Hemoptysis
Coughing up blood
Beck's triad
Distended jugular veins, narrowing pulse pressure, and muffled heart tones are collectively known as _______.
must increase his or her respiratory rate to maintain adequate minute volume
If a patient with a chest injury is only able to inhale small amounts of air per breath, he or she:
traumatic aortic rupture
Immediate death from blunt chest trauma following a motor vehicle crash is MOST often the result of:
Aorta
Major artery in the chest
sponatenous pneumothorax
May be the result of rupture of a weak spot on the lung, allowing air to enter the pleural space and accumalate. this often results from nontraumatic injuries and may occur during times of physical activity such as excerise
flail chest
Paradoxical motion is a sign of a _______.
tachypnea
Patients with chest injuries will often present with _______.
Open chest injury
Penetrating wound
Pericadium
Sac around the heart
Diaphragm
Separates chest from abdomen
collapsed jugular veins
Signs and symptoms of a tension pneumothorax include all of the following, EXCEPT:
Closed chest injury
Usually blunt trauma
may rise as high as the nipple line.
When a person is lying supine at the end of exhalation, the diaphragm:
high-flow oxygen or ventilation with BVM
all patients with chest injuries should recieve
air enters the pleural space from outside the body
an open pneumothorax occurs when:
pneumothorax Occusive dressing
any penetrating injury to the chest may result in air entering the pleural space and may cause what type of dressing should be used
open injuries
are the result of an object penetrating the skin and/or chest wall
open or closed
chest injuries are classifed as
Signs and symptoms of a tension pneumothorax include all of the following, EXCEPT:
collapsed jugular veins.
The thoracic cavity is separated from the abdominal cavity by the
diaphragm.
Common signs and symptoms of a chest injury include all of the following, EXCEPT:
hematemesis.
lungs
hemoptysis indicates damage to the
pleurisy
irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation is called:
hemothorax
is the result of blood accumulating in the plueral space after a traumatic injury when the vessels of the lung are lacerated and leak blood
simple pneumothorax
is the result of blunt trauma, such as fractured ribs
Which of the following organs or structures does NOT reside within the mediastinum?
lungs
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.
breathe rapidly and shallowly
patients with rib fractures will commonly
The ________ nerves control the diaphragm.
phrenic
accumulation of air in the pleural space
pneumothorax is defined as:
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 applying 100% oxygen, you should:
prepare for immediate transport.
Tachypnea
rapid respirations
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.
ventilation
the body's ability to move air in and out of the lungs is called
mediastinum
the esophagus, trachea, and great vessels of the body are located in the
Pleural fluid is contained between the:
visceral and parietal pleurae.
pulmonary contusion-bruising of or injury to lung tissue after traumatic injury
what may interfere with oxygen exchange in the lung tissue
open pneumothorax
when a penetrating injury creates a hole in the chest wall, you may hear a sucking sound as the patient inhales this is called
signs and symptons of shock
when assessing a patinet with a hemothorax, you will MOST likely find
cardiac tamponade
when blood collects in the space between the pericardial sac and the heart. this condition results in pressure building up inside the pericardial sac until the heart cannot pump effectively; cardiac arrest may occur quickly
pulmonary contusion
A man called EMS 12 hours after injuring his chest. Your assessment reveals a flail segment to the right side of the chest. The patient is experiencing respiratory distress and his oxygen saturation is 78%. His breath sounds are equal bilaterally and his jugular veins are normal. You should suspect:
their intercostal muscles are not developed
Children are often "belly breathers" because _______.
hematemesis
Common signs and symptoms of a chest injury include all of the following, EXCEPT:
engorged jugular veins
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?
provide ventilation assistance with a BVM
Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, shallow breathing, and cyanosis. Her blood pressure is 80/50 mm Hg and her pulse is 130 beats/min and thready. You should:
primary assessment
Immediately life-threatening chest injuries must be found and managed during the _______.
pneumothorax
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:
diaphragm
The thoracic cavity is separated from the abdominal cavity by the:
Air is supplied to the lungs via the:
Trachea
immediately request ALS support.
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:
a segment of the chest wall is detached from the thoracic cage
a flail chest occurs when:
penetrate the lung and diaphragm and injure the liver or stomach
a penetrating chest injury has the potential to
myocardial contusion
a rapid, irregular pulse following blunt trauma to the chest is MOST suggestive of a
A flail chest occurs when:
a segment of the chest wall is detached from the thoracic cage.
is commonly caused by blunt chest trauma.
a simple pneumothorax
paralysis of the intercoastal muscles
a spinal cord injury at the level of C7 would MOST likely result in:
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.
Hemoptysis is defined as:
coughing up blood.
The thoracic cavity is separated from the abdominal cavity by the:
diaphragm.
The MOST critical treatment for a tension pneumothorax involves:
inserting a needle through the rib cage into the pleural space.
When a person is lying supine at the end of exhalation, the diaphragm
may rise as high as the nipple line.
A rapid, irregular pulse following blunt trauma to the chest is MOST suggestive of a:
myocardial contusion.
commotio cordis
occurs from direct blows to the chest during a critical portion of the patient's heartbeat. it may result in immediate cardiac arrest
closed injuries
often the result of blunt force trauma
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.
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.
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.
increases the risk of internal injury
the pliability of the pediatric rib cage
inserting a needle through the rib cage into the pleural space
the treatment for relieving a tension pneumothorax involves
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
repeats BP of 92/68 mmHg
A patient with a chest injury has a blood pressure of 100/60 mm Hg and a pulse rate of 120 beats/min. Which of the following additional findings should make you suspect a pericardial tamponade?
aortic rupture
Which of the following is most likely to cause immediate death?
administer oxygen and transport to the hospita
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:
compression of the aorta and vena cava
You are transporting a stable patient with a possible pneumothorax. The patient is receiving high-flow 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?
laceration of the aorta
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 unresponsive, 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:
partially remove the dressing
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:
minute volume will decrease
if a person's tidal volume decreases, but his or her respiratory rate remains unchanged
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
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.
If a person's tidal volume decreases, but his or her respiratory rate remains unchanged:
minute volume will decrease.
life-threatening hemorrage
must be addressed immediately during the primary assessment even before airway or breathing concerns
Irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation is called
pleurisy.
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 applying 100% oxygen, you should
prepare for immediate transport.
Elevation of the rib cage during inhalation occurs when
the intercostal muscles contract.
Elevation of the rib cage during inhalation occurs when:
the intercostal muscles contract.
myocardial contusion -bruising of the heart muscle after traumatic injury
this condition may have the same signs and symptons as a heart attack, including an irregular pulse, this injuryis an injury to the heart muscle from trauma not from a heart attack
flail chest segment postive-pressure ventilation
three or more ribs broken in two or more places what ventilation may be particularly important for a patient with a flail chest that compromises ventilation
Immediate death from blunt chest trauma following a motor vehicle crash is MOST often the result of:
traumatic aortic rupture
Immediate death from blunt chest trauma following a motor vehicle crash is MOST often the result of
traumatic aortic rupture.
