TCAR POST TCAR POST TEST EXAM 50 QUESTIONS AND CORRECT {VERIFIED} ANSWERS NEWESTALREADY GRADED A

TCAR-
POST TEST REAL EXAM WITH 100% VERIFIED QUESTIONSAND CO
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RRECT ANSWERS ALREADY GRADED A+ NEWEST 2024-2025
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bruisedondthedlungsd-dpulmonarydcontusion

causesdofdpulmonarydcontusionsd-dhighdspeeddbluntdordpenetratingdinjury

whatdhappensdtodthedlungsdindpulmonarydcontusionsd-
dbigdboggydbruisedondthedlungsd
diffusiondproblems
whenditdbecomesdcontusedd&dedematous,ditdbecomesddifficultdfordoxygendtodmovedfromdthe
dalveolidintodthedcapillaries




wheredondthedtissuedoxygenationdcascadeddodpulmonarydcontusionsdcausedtheirdproblems
d-ddiffusion




alldcontusionsdoverdtimed-
dalldcontusionsd"blossom"doverdtime.dthedfulldextentdof dthedinjuryd
isdnotdinitiallydapparent

importantdthingdtodrememberdwhendyoudaredevaluatingdadpatientdfordpulmonarydcontusionsd
-d70%dofdpulmonarydcontusionsdaren'tdinitialdondthedinitialdCXR

whatdshoulddyoudmonitordwhendadptdhasdtraumadtodthedthroaxd-
dcloselydmonitordfordpulmonarydcontustiobsd=d70%dnotdpresentdondthedinitialdCXRdandd"bloss

om"doverdtime
-monitordfordprogressdeddeteriorationdindhours/daysdpostdinjury
*mightdlookdokdindER

bestdparameterdofdserialdmonitoringdfordpt'sdwhodhavedriskdfactorsdfordpulmonarydcontusions
d-

danticipated"blossoming"doverdtimedb/cd70%dofdpulmonarydcontusionsdaren'td presentdondthedi
nitialdCXR
P:Fdratio

problemdofdusingdCXRdasdaddefinitivedclinicalddxdtoold-dCXRdmaydlagdbehinddclinicaldstatus
*b/cd70%dofdpulmonarydcontusionsdaren'tdpresentdondinitialdCXR.dtheyd"blossom"doverdtime

teardindlungdtissued-dpulmonarydlaceration

problemdofdpulmonarydlacerationsd-
driskdofdmassivedhemothoaxdb/cdthosedvesselsdared
verydvascular

simpledv.dtensiondv.dopendv.dclosed.dv.dhemothoraxdv.dhemopneumothoraxd-

,whatdisdadsimpledpneumothoraxd-
danydairdthatdentersdthedpleuraldcavitydcandalsodleavedatdthedsamedrate.dlungsddeflateddbutdno

dincreasedindintrathroacicdpressure.dairdin/outdexitsdatd
thedsamedrate.dptdmightdbedabledtodtoler
atedadsimpledpneumothraox
causesdadproblemdatdthedventilationdpointdatdthedtissuedoxygendcascade

intrathroacicdpressuredindsimpledpneumothoraxd-
dairdthatdentersdthedpleuraldcavitydleavesd
atdthedsamedrate
lungsdareddeflateddbutdnodincreasedindpressured
airdin/outdatdthedsamedrate

wheredisdthedproblemdindthedtissuedoxygenationdcascadedindsimpledpneumothroaxd-
ventilation
d




whatdhappensdindpenumothoraxd-
dlungsdaredcollapsed/deflatedd
airedentersdspacedbetweendthedvis
cerald&dparietal

twodlayersdofdthedlungsd-dviscerald&dparietal

Qd-dindadpneumothorax,dnodligamentsdattachdthedlungdtodthedwall.dsodwhatdholdsditdup?d -dA
-
dadthindlayerdofdpleuraldfluidd&dnegativedpressure.dthedliquiddhelpsditdstickdlikedhowdad
spilleddli
quiddformsdadsealdbetweendadglassdanddadsmoothdtabledtop

differencedbetweendadsimpledanddtensiondpneumod-

akadchestdtubed-dchestdthoacotomy
d




purposedofdusingdadchestdtubedindsimpledpneumothoraxd-
dtodallowdfordnegativedpressured
todreestablishd.

tensiondpnumothoraxd-
dairdentersdunderdpressuredbutddoesn'tdexitdatdthedsamedrate.d=d
accumulationdofdairdund
erdpressure

exampledofdtensiondpneumothoraxd-
dlikedusingdadbicycledpumpdtodputdmoredanddmoredaird
intodthedlungsdoverdtime.dnodescape
*pressuredmeansdnodlungdfunctiondondthedsidedofdthedinjurydanddcompromisesdfunctiondondth
edundinjureddheartdanddgreatdvesseldcompression
(decreasesdpreload/COd
increasesdafterload

effectdofdtensiondpneumothoraxdondheartdfunctiond-
dincreasesdintrathoracicdpressured
decreasesdpreload/CO
increasesdafterload

normaldpressuredindthedvenadcavasd-dnormallydisdlow
similardtodthedcentraldvenousdpressuredwhichdisdsimilardtodrightdatrialdpressured(2-
8mmdhg)dsodverydlittledincreasedindpressuredtodimpededvenousdreturndtodthedheart

,3dquestionsdtodaskdindtraumad-d-whatdwasdtheddosedofdenergy?
-whereddidditdgo?
-whatdinjuriesdaredlikely?

2 q'sdtodaskdindGSW d-
dcaliberd
typedofdgun
#dofdentrance/exitdwoundsd
high/lowdvelocity

1stdquestiondtodaskdindanydtraumaticdinjury?d-
dwhatdwasdtheddosedofdenergydinvolved?d (wasditdhighdordlow?)

whatdisdthedcaliberdofdadbullet?d-

diameterdakaddiameterdofdadbulletd-
d




caliber
d




whatdhappensdtodprojectilesdwhendtheydenterdthedbodyd-
dprojectilesddon'tdtraveldindad
straightdline
considerdtemporarydcavitydwound

whatdshoulddyoudconsiderdaboutdtissuedadprojectiledenountersd-

temporarydcavitationdprimarydgoaldofdGSW dsurgeryd-
d




dusuallyddamagedrepaird&dnotdbulletdremoval
-ifdsuperficial,ditdmaydmigratedthedsurfacedwithdtime

importantdthingdtodrememberdaboutdretaineddprojectilesd-
dtheydmaydmigratedoverdtime.d bullettdmigrationdmightdexplaindunexplaineddclinicaldfindin
gs
(VPdCheneydaccidentallydshotdhisdfrienddwhiledhuntingdind2006.dICUdandddiddgreat.dmovedd
todandinpatientdunit.dhaddadsilentdMIdbcdadshotdgundpelletsdmigrateddintodadcanarydarterydcau
singdandinfract.dsodhaddadMIdbutdfibrinolyticdnotdthedanswerdindthisdcasedb/cditdwasdad"project
iledembolus"

akadbrestboned-dsternum

whatdattachesdthedribsdtodthedsternumd-

cartliagedwhatdbreaksdthoracicdbonesd-
d




dsignificantdforce
-1-2nddribs,dposteriordribs,dsternum,dscapulae,dT2-10
givesdusdinfodaboutdthedforcedakad"dose"dofdenergydreceiveddcon
siderdinjurydtodinternaldstructuresdb/cdforce

ribsdthatdaredthedmostdfrequentlydbrokend-dribsd4-
9db/cdlong,dthin,danddpoorlydprotecteditdisdharderdtodbreakdadshortdpencild(T1-

, 2)danddeasierdtodbreakdadlongerdone
*askdhowdmanydanddwheredtodunderstanddthedforcedinvolved