Chapter 29 Chest Injuries Flashcards
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Questions and Answers

When a person is laying supine at the end of exhalation, how high may the diaphragm rise?

as high as the nipple line

A rapid, irregular pulse following blunt trauma to the chest is MOST suggestive of what condition?

myocardial contusion

What should you do during your assessment of a patient with blunt chest trauma and paradoxical movement of the left chest wall?

stabilize the chest wall with a bulky dressing

Based on the mechanism of injury, what MOST likely occurred when a 19 year old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball?

<p>ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle</p> Signup and view all the answers

What does subcutaneous emphysema indicate?

<p>air is escaping into the chest wall from a damaged lung</p> Signup and view all the answers

How is hemoptysis defined?

<p>coughing up blood</p> Signup and view all the answers

Common signs and symptoms of a chest injury include all of the following EXCEPT?

<p>Hematemesis</p> Signup and view all the answers

What should you do in addition to applying 100% oxygen for a patient with severe chest pain after being struck in the chest?

<p>prepare for immediate transport</p> Signup and view all the answers

Patients with rib fractures will commonly breathe how?

<p>rapidly and shallowly</p> Signup and view all the answers

Signs and symptoms of a tension pneumothorax include all of the following EXCEPT?

<p>Collapsed jugular veins</p> Signup and view all the answers

In order to avoid exacerbating a patient's injury, what should you use extreme caution with?

<p>positive-pressure ventilation to patients with a pneumothorax</p> Signup and view all the answers

What should you do when you find a patient who was assaulted with severely labored breathing and a large bruise on the chest?

<p>immediately request ALS support</p> Signup and view all the answers

What injury should you be MOST suspicious of in a patient with signs of respiratory distress and collapsed jugular veins after a vehicle crash?

<p>laceration of the aorta</p> Signup and view all the answers

What occurs during inhalation when the rib cage is elevated?

<p>the intercostal muscles contract</p> Signup and view all the answers

The ___ nerves control the diaphragm.

<p>phrenic</p> Signup and view all the answers

What is a flail chest?

<p>a segment of the chest wall is detached from the thoracic cage</p> Signup and view all the answers

Which of the following organs or structures does NOT reside within the mediastinum?

<p>Lungs</p> Signup and view all the answers

What should you do for a patient experiencing shortness of breath and pleuritic chest pain while jogging?

<p>administer oxygen and transport to the hospital</p> Signup and view all the answers

Pleural fluid is contained between which two structures?

<p>visceral and parietal pleurae</p> Signup and view all the answers

What should you do following blunt trauma to the chest for a patient presenting with respiratory distress and cyanosis?

<p>provide some form of positive pressure ventilation</p> Signup and view all the answers

What is called irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation?

<p>pleurisy</p> Signup and view all the answers

What does a patient who presents with profound cyanosis following a chest injury require?

<p>prompt oxygenation and ventilation</p> Signup and view all the answers

What is the definitive care for a tension pneumothorax?

<p>inserting a needle through the rib cage into the pleural space</p> Signup and view all the answers

Study Notes

Chest Injuries Overview

  • Supine position at end of exhalation allows diaphragm to rise to nipple line.
  • Blunt chest trauma with rapid, irregular pulse indicates possible myocardial contusion.

Assessment and Treatment

  • Paradoxical movement of chest wall requires stabilization with a bulky dressing during oxygen administration.
  • Unresponsive, apneic, pulseless young male likely experienced ventricular fibrillation due to chest impact timing within cardiac cycle.

Symptoms and Indicators

  • Subcutaneous emphysema signifies air escaping into chest wall from damaged lung.
  • Hemoptysis refers to coughing up blood; commonly observed in chest trauma.
  • Hematemesis is NOT typically associated with chest injuries.
  • Tension pneumothorax signs exclude collapsed jugular veins.

Patient Management

  • Rib fractures typically result in rapid, shallow breathing patterns.
  • Severe chest pain with large ecchymosis over sternum and irregular pulse necessitates immediate transport.
  • Caution is critical when providing positive-pressure ventilation to those with pneumothorax to avoid exacerbating injury.

Specific Cases and Responses

  • Assault victim with labored breathing, jugular venous distention, and absent breath sounds needs ALS support.
  • Motor vehicle crash patient showing signs of shock likely has aortic laceration; evidence includes collapsed jugular veins and tachycardia.

Respiratory Functions and Anatomy

  • Elevation of the rib cage during inhalation involves contraction of intercostal muscles; controlled by phrenic nerves.
  • A flail chest results when a segment of the chest wall detaches from the thoracic cage.

Mediastinum and Pleurae

  • Lungs do NOT reside within the mediastinum's boundaries.
  • Pleural fluid exists between visceral and parietal pleurae, essential for lung function.

Emergency Protocols

  • Young male with acute shortness of breath and pleuritic pain needs oxygen and hospital transport.
  • Respiratory distress with low blood pressure following blunt trauma warrants positive pressure ventilation.
  • Pleurisy describes irritation causing sharp chest pain during inhalation.
  • Profound cyanosis after chest injury requires immediate oxygenation and ventilation.
  • Definitive care for tension pneumothorax involves needle insertion into pleural space through rib cage.

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Description

Test your knowledge on chest injuries with these flashcards from Chapter 29. Covering key concepts such as diaphragm position and injuries resulting from blunt trauma, this quiz is essential for understanding emergency response in chest trauma cases.

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