ATCN 2022 Chapter 4 Thoracic Injuries
______________________ is the most serious consequence of chest injury, the goal of early
intervention is to prevent or correct hypoxia. - ANS-Hypoxia is the most serious consequence of
chest injury, the goal of early intervention is to prevent or correct hypoxia.
\_____________________________________ most commonly results from penetrating
injuries, although blunt injury also can cause the pericardium to fill with blood from the heart,
great vessels, or epicardia vessels. - ANS-Cardiac tamponade most commonly results from
penetrating injuries, although blunt injury also can cause the pericardium to fill with blood from
the heart, great vessels, or epicardia vessels.
\__________________________________________ is a significant cause of mortality; in fact,
many patients with thoracic trauma die after reaching the hospital. - ANS-Thoracic Trauma is a
significant cause of mortality; in fact, many patients with thoracic trauma die after reaching the
hospital.
\____________________________________________ most commonly results from
penetrating injury. - ANS-Esophageal trauma most commonly results from penetrating injury.
\____________________________________________ pressure with no obvious cause may
indicate right ventricular dysfunction secondary to contusion. - ANS-Elevated central venous
pressure with no obvious cause may indicate right ventricular dysfunction secondary to
contusion.
\_____________________________________________ are frequently missed initially when
the chest film is misinterpreted as showing an elevated diaphragm, acute gastric dilation,
loculated hemopneumothorax, or subpulmonic hematoma - ANS-Diaphragmatic injuries are
frequently missed initially when the chest film is misinterpreted as showing an elevated
diaphragm, acute gastric dilation, loculated hemopneumothorax, or subpulmonic hematoma
\________________________________________________ is the most common option for
managing aortic injury and has excellent short-term outcomes. - ANS-Endovascular repair is the
most common option for managing aortic injury and has excellent short-term outcomes.
\__________________________________________________ (rise in venous pressure with
inspiration when breathing spontaneously) is a true paradoxical venous pressure abnormality
that is associated with tamponade. - ANS-Kussmaul's Sign (rise in venous pressure with
inspiration when breathing spontaneously) is a true paradoxical venous pressure abnormality
that is associated with tamponade.
\A hemothorax is a type of pleural effusion in which blood (>1500 ml ) accumulates in the pleural
cavity.
The primary cause of hemothorax is laceration of the lung, great vessels, and intercostal vessel,
or an internal mammary artery from penetrating or blunt trauma. - ANS-A hemothorax is a type
of pleural effusion in which blood (>1500 ml ) accumulates in the pleural cavity.
The primary cause of hemothorax is laceration of the lung, great vessels, and intercostal vessel,
or an internal mammary artery from penetrating or blunt trauma.
\A hyper resonant note on percussion, deviated trachea, distended neck veins and absent
breath sounds are signs of: - ANS-a tension Pneumothroax.
, \A patient with a known pneumothorax should not undergo - ANS-general anesthesia or receive
positive pressure ventilation without having a chest tube inserted.
\A single chest tube (28-32 French) is inserted, usually at the _________________ intercostal
space, ________________________________________ line, and rapid restoration of volume
continues as decompression of the chest cavity is completed. - ANS-A single chest tube (28-32
French) is inserted, usually at the fifth intercostal space, just anterior to the midaxillary line, and
rapid restoration of volume continues as decompression of the chest cavity is completed.
\Although rare, _________________________________________________, caused by the
forceful expulsion of gastric contents onto the esophagus from a severe blow to the upper
abdomen, can be lethal if unrecognized. This forceful ejection produces a linear tear in the lower
esophagus, allowing leakage into the mediastinum. The resulting mediastinitis and immediate or
delayed rupture into the pleural space causes empyema. - ANS-Although rare, blunt
esophageal trauma, caused by the forceful expulsion of gastric contents onto the esophagus
from a severe blow to the upper abdomen, can be lethal if unrecognized. This forceful ejection
produces a linear tear in the lower esophagus, allowing leakage into the mediastinum. The
resulting mediastinitis and immediate or delayed rupture into the pleural space causes
empyema.
\An acute hemothorax that is large enough to appear on the chest x-ray may be treated -
ANS-with a 28-32 French chest tube.
\Any pneumothorax is best treated with a chest tube placed in the - ANS-in the fifth intercostal
rib space, just anterior to the midaxillary line.
\Blast Injuries commonly produce severe injury to: - ANS-air fluid interfaces.
\Causes of PEA Arrest? - ANS-Hypovolemia
Hypoxia
Hydrogen ion acidosis
Hypokalemia / Hyperkalemia
Hypoglycemia
Hypothermia
Toxins
Cardiac Tamponade
Tension Pneumothorax
Thrombus Coronary or Pulmonary
\Definitive treatment of ____________________________________________involves ensuring
adequate oxygenation, administering fluids judiciously, and providing analgesia to improve
ventilation. - ANS-Definitive treatment of flail chest and pulmonary contusion involves ensuring
adequate oxygenation, administering fluids judiciously, and providing analgesia to improve
ventilation.
\During the primary survey, look for: - ANS-evidence of air hunger such as intercostal and
supraclavicular muscle retractions. Listen for evidence of partial upper airway obstruction
(stridor) or marked change in the expected voice quality in patients who are able to speak.
\Evidence suggests that a 5 cm over the needle catheter will reach the pleural space >50% of
the time, where as an 8 cm over-the -needle catheter will reach the pleural space >90% of the
time. - ANS-an 8 cm over-the -needle catheter will reach the pleural space >90% of the time.
______________________ is the most serious consequence of chest injury, the goal of early
intervention is to prevent or correct hypoxia. - ANS-Hypoxia is the most serious consequence of
chest injury, the goal of early intervention is to prevent or correct hypoxia.
\_____________________________________ most commonly results from penetrating
injuries, although blunt injury also can cause the pericardium to fill with blood from the heart,
great vessels, or epicardia vessels. - ANS-Cardiac tamponade most commonly results from
penetrating injuries, although blunt injury also can cause the pericardium to fill with blood from
the heart, great vessels, or epicardia vessels.
\__________________________________________ is a significant cause of mortality; in fact,
many patients with thoracic trauma die after reaching the hospital. - ANS-Thoracic Trauma is a
significant cause of mortality; in fact, many patients with thoracic trauma die after reaching the
hospital.
\____________________________________________ most commonly results from
penetrating injury. - ANS-Esophageal trauma most commonly results from penetrating injury.
\____________________________________________ pressure with no obvious cause may
indicate right ventricular dysfunction secondary to contusion. - ANS-Elevated central venous
pressure with no obvious cause may indicate right ventricular dysfunction secondary to
contusion.
\_____________________________________________ are frequently missed initially when
the chest film is misinterpreted as showing an elevated diaphragm, acute gastric dilation,
loculated hemopneumothorax, or subpulmonic hematoma - ANS-Diaphragmatic injuries are
frequently missed initially when the chest film is misinterpreted as showing an elevated
diaphragm, acute gastric dilation, loculated hemopneumothorax, or subpulmonic hematoma
\________________________________________________ is the most common option for
managing aortic injury and has excellent short-term outcomes. - ANS-Endovascular repair is the
most common option for managing aortic injury and has excellent short-term outcomes.
\__________________________________________________ (rise in venous pressure with
inspiration when breathing spontaneously) is a true paradoxical venous pressure abnormality
that is associated with tamponade. - ANS-Kussmaul's Sign (rise in venous pressure with
inspiration when breathing spontaneously) is a true paradoxical venous pressure abnormality
that is associated with tamponade.
\A hemothorax is a type of pleural effusion in which blood (>1500 ml ) accumulates in the pleural
cavity.
The primary cause of hemothorax is laceration of the lung, great vessels, and intercostal vessel,
or an internal mammary artery from penetrating or blunt trauma. - ANS-A hemothorax is a type
of pleural effusion in which blood (>1500 ml ) accumulates in the pleural cavity.
The primary cause of hemothorax is laceration of the lung, great vessels, and intercostal vessel,
or an internal mammary artery from penetrating or blunt trauma.
\A hyper resonant note on percussion, deviated trachea, distended neck veins and absent
breath sounds are signs of: - ANS-a tension Pneumothroax.
, \A patient with a known pneumothorax should not undergo - ANS-general anesthesia or receive
positive pressure ventilation without having a chest tube inserted.
\A single chest tube (28-32 French) is inserted, usually at the _________________ intercostal
space, ________________________________________ line, and rapid restoration of volume
continues as decompression of the chest cavity is completed. - ANS-A single chest tube (28-32
French) is inserted, usually at the fifth intercostal space, just anterior to the midaxillary line, and
rapid restoration of volume continues as decompression of the chest cavity is completed.
\Although rare, _________________________________________________, caused by the
forceful expulsion of gastric contents onto the esophagus from a severe blow to the upper
abdomen, can be lethal if unrecognized. This forceful ejection produces a linear tear in the lower
esophagus, allowing leakage into the mediastinum. The resulting mediastinitis and immediate or
delayed rupture into the pleural space causes empyema. - ANS-Although rare, blunt
esophageal trauma, caused by the forceful expulsion of gastric contents onto the esophagus
from a severe blow to the upper abdomen, can be lethal if unrecognized. This forceful ejection
produces a linear tear in the lower esophagus, allowing leakage into the mediastinum. The
resulting mediastinitis and immediate or delayed rupture into the pleural space causes
empyema.
\An acute hemothorax that is large enough to appear on the chest x-ray may be treated -
ANS-with a 28-32 French chest tube.
\Any pneumothorax is best treated with a chest tube placed in the - ANS-in the fifth intercostal
rib space, just anterior to the midaxillary line.
\Blast Injuries commonly produce severe injury to: - ANS-air fluid interfaces.
\Causes of PEA Arrest? - ANS-Hypovolemia
Hypoxia
Hydrogen ion acidosis
Hypokalemia / Hyperkalemia
Hypoglycemia
Hypothermia
Toxins
Cardiac Tamponade
Tension Pneumothorax
Thrombus Coronary or Pulmonary
\Definitive treatment of ____________________________________________involves ensuring
adequate oxygenation, administering fluids judiciously, and providing analgesia to improve
ventilation. - ANS-Definitive treatment of flail chest and pulmonary contusion involves ensuring
adequate oxygenation, administering fluids judiciously, and providing analgesia to improve
ventilation.
\During the primary survey, look for: - ANS-evidence of air hunger such as intercostal and
supraclavicular muscle retractions. Listen for evidence of partial upper airway obstruction
(stridor) or marked change in the expected voice quality in patients who are able to speak.
\Evidence suggests that a 5 cm over the needle catheter will reach the pleural space >50% of
the time, where as an 8 cm over-the -needle catheter will reach the pleural space >90% of the
time. - ANS-an 8 cm over-the -needle catheter will reach the pleural space >90% of the time.
