Chapter 29

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?

Compression of the aorta and vena cava

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

A flail chest occurs when:

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

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.

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.

Patients with rib fractures will commonly:

breathe rapidly and shallowly.

Hemoptysis is defined as:

coughing up blood.

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.

The MOST critical treatment for a tension pneumothorax involves:

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

A simple pneumothorax:

is commonly caused by blunt chest trauma.

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:

laceration of the aorta.

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.

The ________ nerves control the diaphragm.

phrenic

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

pleurisy.

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.