TCAR POST EXAM SCRIPT 2026 UPDATED TEST
QUESTIONS WITH VERIFIED ANSWERS
GUARANTEED TO PASS
◉ 2 q's to ask in GSW. Answer: caliber
type of gun
# of entrance/exit wounds
high/low velocity
◉ 1st question to ask in any traumatic injury?. Answer: what was
the dose of energy involved?
(was it high or low?)
◉ what is the caliber of a bullet?. Answer: diameter
◉ aka diameter of a bullet. Answer: caliber
◉ what happens to projectiles when they enter the body. Answer:
projectiles don't travel in a straight line
consider temporary cavity wound
,◉ what should you consider about tissue a projectile enounters.
Answer: temporary cavitation
◉ primary goal of GSW surgery. Answer: usually damage repair &
not bullet removal
-if superficial, it may migrate the surface with time
◉ important thing to remember about retained projectiles. Answer:
they may migrate over time. bullett migration might explain
unexplained clinical findings
(VP Cheney accidentally shot his friend while hunting in 2006. ICU
and did great. moved to an inpatient unit. had a silent MI bc a shot
gun pellets migrated into a canary artery causing an infract. so had a
MI but fibrinolytic not the answer in this case b/c it was a "projectile
embolus"
◉ aka brestbone. Answer: sternum
◉ what attaches the ribs to the sternum. Answer: cartliage
◉ what breaks thoracic bones. Answer: significant force
-1-2nd ribs, posterior ribs, sternum, scapulae, T2-10
gives us info about the force aka "dose" of energy received
consider injury to internal structures b/c force
,◉ ribs that are the most frequently broken. Answer: ribs 4-9 b/c
long, thin, and poorly protecte
it is harder to break a short pencil (T1-2) and easier to break a
longer one
*ask how many and where to understand the force involved
◉ what is the significance of posterior rib fractures. Answer:
unusual direction of injury
shorter stubby ribs
good muscle profection
**posterior rib fractures have a lot of force so need a high dose.
***PRF need a lot of force so high dose of energy. big red flag for t-
spine injury
◉ indication of c-spine injury. Answer: to injure c-spine, you don't
need a big energy blow. all it takes is shaking around.
◉ c spine versus t spine fractures. Answer: c-spine doesn't need a
big energy blow. just some shaking around
t-spine needs a great strong direct blow (not just a shock_
, ◉ treatment for rib fractures. Answer: largely supportive nursing
care like pulmonary toilet
◉ CXR and rib fractures. Answer: simple rib fractures are difficult to
see on CXR and can be commonly missed
(1/2 of all rib fractures aren't identified at the POI CXR)
◉ identify a previous rib fracture on CXR. Answer: once healed, rib
fractures form bony callouses and become more visible on CXR
◉ how to tell a pt has a pneumonia from a CXR. Answer: dark spot
that is not equal to the opposite side
◉ consider if a pt has a lower rib fracture. Answer: liver & spleen
injury
acts like BBQ/marshmellow skewers
◉ how high does the diaphragm rise on inspiration. Answer: level of
4th ICS
◉ risk of rib fractures. Answer: can puncture liver, spleen,,
diaphragm
pop lungs
QUESTIONS WITH VERIFIED ANSWERS
GUARANTEED TO PASS
◉ 2 q's to ask in GSW. Answer: caliber
type of gun
# of entrance/exit wounds
high/low velocity
◉ 1st question to ask in any traumatic injury?. Answer: what was
the dose of energy involved?
(was it high or low?)
◉ what is the caliber of a bullet?. Answer: diameter
◉ aka diameter of a bullet. Answer: caliber
◉ what happens to projectiles when they enter the body. Answer:
projectiles don't travel in a straight line
consider temporary cavity wound
,◉ what should you consider about tissue a projectile enounters.
Answer: temporary cavitation
◉ primary goal of GSW surgery. Answer: usually damage repair &
not bullet removal
-if superficial, it may migrate the surface with time
◉ important thing to remember about retained projectiles. Answer:
they may migrate over time. bullett migration might explain
unexplained clinical findings
(VP Cheney accidentally shot his friend while hunting in 2006. ICU
and did great. moved to an inpatient unit. had a silent MI bc a shot
gun pellets migrated into a canary artery causing an infract. so had a
MI but fibrinolytic not the answer in this case b/c it was a "projectile
embolus"
◉ aka brestbone. Answer: sternum
◉ what attaches the ribs to the sternum. Answer: cartliage
◉ what breaks thoracic bones. Answer: significant force
-1-2nd ribs, posterior ribs, sternum, scapulae, T2-10
gives us info about the force aka "dose" of energy received
consider injury to internal structures b/c force
,◉ ribs that are the most frequently broken. Answer: ribs 4-9 b/c
long, thin, and poorly protecte
it is harder to break a short pencil (T1-2) and easier to break a
longer one
*ask how many and where to understand the force involved
◉ what is the significance of posterior rib fractures. Answer:
unusual direction of injury
shorter stubby ribs
good muscle profection
**posterior rib fractures have a lot of force so need a high dose.
***PRF need a lot of force so high dose of energy. big red flag for t-
spine injury
◉ indication of c-spine injury. Answer: to injure c-spine, you don't
need a big energy blow. all it takes is shaking around.
◉ c spine versus t spine fractures. Answer: c-spine doesn't need a
big energy blow. just some shaking around
t-spine needs a great strong direct blow (not just a shock_
, ◉ treatment for rib fractures. Answer: largely supportive nursing
care like pulmonary toilet
◉ CXR and rib fractures. Answer: simple rib fractures are difficult to
see on CXR and can be commonly missed
(1/2 of all rib fractures aren't identified at the POI CXR)
◉ identify a previous rib fracture on CXR. Answer: once healed, rib
fractures form bony callouses and become more visible on CXR
◉ how to tell a pt has a pneumonia from a CXR. Answer: dark spot
that is not equal to the opposite side
◉ consider if a pt has a lower rib fracture. Answer: liver & spleen
injury
acts like BBQ/marshmellow skewers
◉ how high does the diaphragm rise on inspiration. Answer: level of
4th ICS
◉ risk of rib fractures. Answer: can puncture liver, spleen,,
diaphragm
pop lungs
