EMT Chest Injuries
The phrenic nerves control the diaphragm and exit the spinal cord at:
C3, C4, and C5.
Which of the following is NOT a sign or symptom of a chest injury?
Clear and equal breath sounds
On inhalation, which of the following does NOT occur?
The pressure inside the chest increases.
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.
During your assessment of a patient with blunt chest trauma, you note that the patient has shallow breathing and paradoxical movement of the left chest wall. You should:
assist ventilations with a bag-valve mask.
Compression of the heart as the result of buildup of blood or other fluid in the pericardial sac, leading to decreased cardiac output
cardiac tamponade (pericardial tamponade)
An injury to the chest in which the skin is not broken, usually caused by blunt trauma
closed chest injury
A blunt chest injury caused by a sudden, direct blow to the chest that occurs only during the critical portion of a person's heartbeat
commotio cordis
You respond to an 18-year-old man who has been assaulted with a baseball bat. He was hit in the chest. He is unresponsive, apneic, and pulseless. This condition is most likely related to:
commotio cordis.
A condition in which three or more ribs are fractured in two or more paces or in association with a fracture of the sternum so that a segment of the chest wall is effectivley detached from the rest of the thoracic cage
flail chest
A one-way valve that allows air to leave the chest cavity but not return; formed by taping three sides of an occlusive dressing to the chest wall, leaving the fourth side open as a valve; may also be part of a commercial vented occlusive dressing
flutter valve
The accumulation of blood and air in the pleural space of the chest
hemopneumothorax
Which of the following organs or structures does NOT reside within the mediastinum?
lungs
Bruising of the heart muscle
myocadial contusion
Which of the following is NOT a pertinent negative to note during your assessment of a patient with chest trauma?
no heart murmurs
An airtight dressing that protects a wound from air and bacteria; a commercial vented version allows air to passivley escape from the chest, while an unvented dressing may be made of petroleum jelly-based Vaseline gauze, aluminum foil, or plastic
occlusive dressing
An injury to the chest in which the chest wall itself is penetrated by a fractured rib, or more frequently , by an external object such as a bullet or a knife
open chest injury
The ________ nerves control the diaphragm.
phrenic
A _____ results when an injury allows air to enter through a hole in the chest wall or the surface of the lung as the patient attempts to breathe, causing the lung on that side to collapse.
pneumothorax
A collection of air in the pleural cavity
pneumothorax
A patient who presents with profound cyanosis following a chest injury:
requires prompt ventilation and oxygenation.
A patient with blunt trauma who is holding the lateral side of his chest and has rapid and shallow respirations is most likely suffering from:
rib fractures
Elevation of the rib cage during inhalation occurs when:
the intercostal muscles contract.
Pleural fluid is contained between the:
visceral and parietal pleura
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 grating or grinding sensation caused by fractured bone ends or joints rubbing together
crepitus
