Chapter 31
A patient presents with paradoxical chest wall movement after blunt trauma. Which condition is MOST likely?
A. Tension pneumothorax
B. Flail chest
C. Cardiac tamponade
D. Pulmonary contusion
B. Flail chest
BONUS: How many rib fractures constitute a flail chest?
A patient with chest trauma has absent breath sounds on one side and hypotension. You suspect:
A. Simple pneumothorax
B. Tension pneumothorax
C. Rib fracture
D. Pulmonary edema
B. Tension pneumothorax
Which injury may present with Kehr’s sign (referred shoulder pain)?
A. Liver laceration
B. Splenic rupture
C. Kidney injury
D. Pancreatic injury
B. Splenic rupture
What is the purpose of sealing an open chest wound?
A. Prevent bleeding
B. Prevent infection
C. Prevent air from entering pleural space
D. Reduce pain
C. Prevent air from entering pleural space
In abdominal evisceration, you should:
A. Push organs back in
B. Cover with moist sterile dressing
C. Apply direct pressure
D. Leave exposed
B. Cover with moist sterile dressing
Which finding is MOST indicative of a tension pneumothorax?
A. Equal breath sounds
B. Tracheal deviation
C. Hemoptysis
D. Bradycardia
B. Tracheal deviation
LATE SIGN!!!
Which finding suggests liver injury?
A. Left shoulder pain
B. Right upper quadrant pain
C. Pelvic instability
D. Back pain
B. Right upper quadrant pain
What is the priority treatment for flail chest?
A. Splinting the segment
B. Oxygen and ventilation support
C. Pain medication
D. Rapid transport only
B. Oxygen and ventilation support
Which sign suggests internal bleeding in abdominal trauma?
A. Bradycardia
B. Hypertension
C. Tachycardia
D. Warm, flushed skin
C. Tachycardia
A patient with cardiac tamponade will MOST likely present with:
A. Bounding pulses
B. Narrow pulse pressure
C. Hypertension
D. Bradycardia
B. Narrow pulse pressure
A sucking chest wound should initially be managed with:
A. Full occlusive dressing taped on all sides
B. Occlusive dressing taped on three sides
C. Bulky dressing with pressure
D. Immediate needle decompression
B. Occlusive dressing taped on three sides
Before dressing the wound, you should attempt to keep this wound covered with a gloved hand.
Which organ is MOST commonly injured in penetrating abdominal trauma?
A. Liver
B. Small intestine
C. Spleen
D. Kidneys
B. Small intestine
Which organ is MOST commonly injured in blunt abdominal trauma?
A. Liver
B. Spleen
C. Kidneys
D. Pancreas
B. Spleen
Which condition causes air to enter the chest but not escape?
A. Commotio Cordis
B. Cardiac Tamponade
C. Tension pneumothorax
D. Hemothorax
C: Tension pneumothorax
BONUS: When does a simple pneumothorax become a TENSION pneumothorax?
In trauma, the MOST immediate life threat from chest injury is:
A. Infection
B. Hypoxia
C. Pain
D. Fever
B. Hypoxia
REMEMBER: ABC's are ALWAYS FIRST!
Beck’s triad is associated with:
A. Tension pneumothorax
B. Cardiac tamponade
C. Pulmonary embolism
D. Hemothorax
B. Cardiac tamponade
What is Becks Triad?
A patient with a rigid, distended abdomen likely has:
A. Simple contusion
B. Internal bleeding or peritonitis
C. Pneumothorax
D. Rib fracture
B. Internal bleeding or peritonitis
A patient develops worsening respiratory distress after chest trauma. You should suspect:
A. Improvement
B. Developing pneumothorax
C. Dehydration
D. Stroke
B. Developing pneumothorax
A hemothorax is BEST described as:
A. Air in pleural space
B. Blood in pleural space
C. Fluid in pericardium
D. Air in pericardium
B. Blood in pleural space
Which abdominal quadrant contains the liver?
A. LUQ
B. RUQ
C. LLQ
D. RLQ
B. RUQ
Which organ lies in the retroperitoneal space?
A. Stomach
B. Liver
C. Kidneys
D. Spleen
C. Kidneys
BONUS: What is another Retroperitoneal Organ?
Which is the MOST reliable sign of blunt abdominal trauma in an unconscious patient?
A. Patient complaint of pain
B. Mechanism of injury
C. Skin color
D. Heart rate
B. Mechanism of injury
Which structure separates the thoracic and abdominal cavities?
A. Pleura
B. Peritoneum
C. Diaphragm
D. Mediastinum
C. Diaphragm
Which injury is MOST associated with pulmonary contusion?
A. Penetrating trauma
B. Blunt chest trauma
C. Burn injury
D. Spinal injury
B. Blunt chest trauma
Which of the following is a late sign of shock?
A. Anxiety
B. Tachycardia
C. Hypotension
D. Pale skin
C. Hypotension
What does Hypotension normally mean related to SHOCK?