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.