EMT-B Chapter 29 - Chest Injuries

When a person is lying supine at the end of exhalation, the diaphragm

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?

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

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

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:

The MOST critical treatment for a tension pneumothorax involves:

Pleural fluid is contained between the:

The thoracic cavity is separated from the abdominal cavity by the

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:

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:

Immediate death from blunt chest trauma following a motor vehicle crash is MOST often the result of

The phrenic nerves control the diaphragm and exit the spinal cord at:

A patient who presents with profound cyanosis following a chest injury:

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:

Elevation of the rib cage during inhalation occurs when:

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?

If a person's tidal volume decreases, but his or her respiratory rate remains unchanged:

Hemoptysis 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

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:

The thoracic cavity is separated from the abdominal cavity by the:

Elevation of the rib cage during inhalation occurs when

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

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

Hemoptysis is defined as

Immediate death from blunt chest trauma following a motor vehicle crash is MOST often the result of:

The ________ nerves control the diaphragm.

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

If a patient with a chest injury is only able to inhale small amounts of air per breath, he or she:

A rapid, irregular pulse following blunt trauma to the chest is MOST suggestive of a:

A flail chest occurs when:

Which of the following is NOT a sign or symptom of a chest injury? a) Bruising of the chest wall b) Clear and equal breath sounds c) Unequal expansion of the chest wall d) Crepitus with palpation of the chest

A simple pneumothorax: a) is caused by penetrating chest trauma. b) often has a nontraumatic cause. c) heals on its own without any treatment. d) is commonly caused by blunt chest trauma.

Hemoptysis

Cardiac tamponade (pericardial tamponade)

Flail chest

Commotio cordis

Immediately life-threatening chest injuries must be found and managed during the _______. a) primary assessment b) secondary assessment c) patient history d) scene size-up

A _____ results when an injury allows air to enter through a hole in the chest wall or the surface of the lung as the patient attempts to breathe, causing the lung on that side to collapse. a) tension pneumothorax b) pneumothorax c) hemothorax d) hemopneumothorax

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

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

Children are often "belly breathers" because _______. a) they are consciously controlling ventilations b) their intercostal muscles are not developed c) their diaphragm is not functional d) they are routinely hypoxic

A patient with blunt trauma who is holding the lateral side of his chest and has rapid and shallow respirations is most likely suffering from a) a pneumothorax. b) a pulmonary contusion. c) a sternal fracture. d) rib fractures.

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: a) administer oxygen and transport to the hospital. b) circumferentially tape a dressing around his chest. c) immediately perform a rapid head-to-toe exam. d) recognize that he needs a needle decompression.

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

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) Engorged jugular veins b) A rapid, irregular pulse c) Diminished breath sounds d) Widening pulse pressure

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

Patients with chest injuries will often present with _______. a) Cheyne-Stokes respirations b) agonal respirations c) Kussmaul respirations d) tachypnea

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: