EMTB CH 27 HW and Quiz Questions

The phrenic nerves control the diaphragm and exit the spinal cord at: a) C3, C4, and C5. b) C3 and C4. c) C1 and C2. d) C1, C2, and C3.

C3, C4, and C5.

A flail chest occurs when: a) a segment of fractured ribs bulges during the inhalation phase. b) a segment of the chest wall is detached from the thoracic cage. c) multiple ribs are fractured on both sides of the thoracic cage. d) more than three ribs are fractured on the same side of the chest.

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

Pneumothorax is defined as: a) accumulation of air between the lungs. b) accumulation of air in the pleural space. c) blood collection within the pleural space. d) blood collection within the lung tissue.

accumulation of air in the pleural space.

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: a) perform a secondary assessment. b) request a paramedic ambulance. c) suspect a severe hemopneumothorax. d) aggressively manage his airway.

aggressively manage his airway.

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: a) request a paramedic ambulance. b) aggressively manage his airway. c) suspect a severe hemopneumothorax. d) perform a secondary assessment.

aggressively manage his airway.

An open pneumothorax occurs when: a) extreme pleural pressure causes the lung to rupture. b) a fractured rib perforates the tissue of the lung. c) air enters the pleural space from a perforated lung. d) air enters the pleural space from outside the body.

air enters the pleural space from outside the body.

Subcutaneous emphysema is an indication that: a) at least half of one lung has completely collapsed. b) your patient is experiencing a pericardial tamponade. c) blood is slowly accumulating within the tissue of the lung. d) air is escaping into the chest wall from a damaged lung.

air is escaping into the chest wall from a damaged lung.

Patients with rib fractures will commonly: a) take a series of deep breaths. b) prefer to lie in a supine position. c) develop a sucking chest wound. d) breathe rapidly and shallowly.

breathe rapidly and shallowly.

Hemoptysis is defined as: a) vomiting blood b) coughing up blood. c) abnormal blood clotting. d) blood in the pleural space.

coughing up blood.

The thoracic cavity is separated from the abdominal cavity by the: a) diaphragm. b) anterior rib cage. c) intercostal margin. d) costovertebral angle.

diaphragm.

The thoracic cavity is separated from the abdominal cavity by the: a) anterior rib cage. b) intercostal margin. c) diaphragm. d) costovertebral angle.

diaphragm.

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? a) widening pulse pressure b) diminished breath sounds c) a rapid, irregular pulse d) engorged jugular veins

engorged jugular veins

A spontaneous pneumothorax would MOST likely occur as the result of: a) exertion of a person with a congenital lung defect. b) abnormally slow breathing in a patient with pleurisy. c) excessive coughing in a patient with pneumonitis. d) blunt or penetrating trauma to the anterior chest wall.

exertion of a person with a congenital lung defect.

Common signs and symptoms of a chest injury include all of the following, EXCEPT: a) chest wall ecchymosis. b) localized pain. c) tachypnea. d) hematemesis.

hematemesis.

Common signs and symptoms of a chest injury include all of the following, EXCEPT: a) localized pain. b) tachypnea. c) chest wall ecchymosis. d) hematemesis.

hematemesis.

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) immediately request ALS support. b) obtain a set of baseline vital signs. c) insert an oropharyngeal airway. d) perform a focused secondary exam.

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) immediately request ALS support. b) obtain a set of baseline vital signs. c) perform a focused secondary exam. d) insert an oropharyngeal airway.

immediately request ALS support.

The MOST critical treatment for a tension pneumothorax involves: a) inserting a needle through the rib cage into the pleural space. b) surgically removing the portion of the lung that is damaged. c) assisting the patient's breathing with increased tidal volume. d) placing a bulky dressing over the affected side of the chest.

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: a) pericardial tamponade. b) massive hemothorax. c) tension pneumothorax. d) laceration of the aorta.

laceration of the aorta.

If a person's tidal volume decreases, but his or her respiratory rate remains unchanged: a) excess carbon dioxide will be eliminated. b) minute volume will decrease. c) minute volume will increase. d) minute volume will remain 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: a) often breathes at a slower rate because of lung damage caused by the injury. b) will eliminate more carbon dioxide than if he or she were breathing deeply. c) will maintain adequate minute volume if his or her respiratory rate stays the same. d) must increase his or her respiratory rate to maintain adequate minute volume.

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

A rapid, irregular pulse following blunt trauma to the chest is MOST suggestive of a: a) ruptured aorta. b) tension pneumothorax. c) myocardial contusion. d) pericardial tamponade.

myocardial contusion.

A spinal cord injury at the level of C7 would MOST likely result in: a) paralysis of all the respiratory muscles. b) paralysis of the diaphragm. c) paralysis of the intercostal muscles. d) immediate cardiac arrest.

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: a) begin ventilatory assistance. b) partially remove the dressing. c) begin rapid transport at once. d) call for a paramedic ambulance.

partially remove the dressing.

The ________ nerves control the diaphragm. a) phrenic b) vagus c) costal d) intercostal

phrenic

Irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation is called: a) dyspnea. b) pleurisy. c) pneumonitis. d) pneumothorax.

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: a) cardiac tamponade. b) myocardial contusion. c) pneumothorax. d) flail chest.

pneumothorax.

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: a) prepare for immediate transport. b) apply an automated external defibrillator (AED) and take his blood pressure. c) determine if he has cardiac problems. d) apply bulky dressings to the sternum.

prepare for immediate transport.

When assessing a patient with a hemothorax, you will MOST likely find: a) ipsilateral tracheal deviation. b) distant or muffled heart tones. c) jugular venous engorgement. d) signs and symptoms of shock.

signs and symptoms of shock.

When assessing a patient with a hemothorax, you will MOST likely find: a) jugular venous engorgement. b) signs and symptoms of shock. c) distant or muffled heart tones. d) ipsilateral tracheal deviation

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: a) request a paramedic to decompress the chest. b) reassess the adequacy of the patient's breathing. c) make note of it and continue your assessment. d) stabilize the chest wall with a bulky dressing.

stabilize the chest wall with a bulky dressing.

Elevation of the rib cage during inhalation occurs when: a) the diaphragm descends. b) abdominal contents descend. c) intrathoracic pressure decreases. d) the intercostal muscles contract.

the intercostal muscles contract.

Elevation of the rib cage during inhalation occurs when: a) the diaphragm descends. b) the intercostal muscles contract. c) abdominal contents descend. d) intrathoracic pressure decreases.

the intercostal muscles contract.

Very young children tend to breathe predominantly with their diaphragm because: a) there is no nerve innervation of the intercostal muscles. b) their chest wall and ribs are very pliable. c) their intercostal muscles are not fully developed. d) they require less tidal volume per breath.

their intercostal muscles are not fully developed.

Immediate death from blunt chest trauma following a motor vehicle crash is MOST often the result of: a) a massive cardiac contusion. b) a tension pneumothorax. c) penetrating lung injuries. d) traumatic aortic rupture.

traumatic aortic rupture.

Immediate death from blunt chest trauma following a motor vehicle crash is MOST often the result of: a) a massive cardiac contusion. b) penetrating lung injuries. c) a tension pneumothorax. d) traumatic aortic rupture.

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? a) asystole secondary to massive intrathoracic hemorrhage due to traumatic rupture of the aorta b) ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle c) fracture of the sternum that caused a rupture of the myocardium and led to a cardiac dysrhythmia d) collapse of both lungs due to fractured ribs that perforated the lung tissue and caused cardiac arrest

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

Pleural fluid is contained between the: a) parietal pleura and the chest wall. b) visceral pleura and the lung. c) visceral and parietal pleurae. d) parietal pleura and the heart.

visceral and parietal pleurae.