TCAR QUESTIONS WITH CORRECT
ANSWERS
3 bquestions bto bask bin btrauma b- bcorrect banswers✔✔-what bwas bthe bdose bof
benergy?
-where bdid bit bgo?
-what binjuries bare blikely?
2 bq's bto bask bin bGSW b- bcorrect banswers✔✔caliber
type bof bgun
# bof bentrance/exit bwounds
high/low bvelocity
1st bquestion bto bask bin bany btraumatic binjury? b- bcorrect banswers✔✔what bwas bthe
bdose bof benergy binvolved?
(was bit bhigh bor blow?)
what bis bthe bcaliber bof ba bbullet? b- bcorrect banswers✔✔diameter
aka bdiameter bof ba bbullet b- bcorrect banswers✔✔caliber
what bhappens bto bprojectiles bwhen bthey benter bthe bbody b- bcorrect
banswers✔✔projectiles bdon't btravel bin ba bstraight bline
consider btemporary bcavity bwound
what bshould byou bconsider babout btissue ba bprojectile benounters b- bcorrect
banswers✔✔temporary bcavitation
primary bgoal bof bGSW bsurgery b- bcorrect banswers✔✔usually bdamage brepair b& bnot
bbullet bremoval
-if bsuperficial, bit bmay bmigrate bthe bsurface bwith btime
important bthing bto bremember babout bretained bprojectiles b- bcorrect banswers✔✔they
bmay bmigrate bover btime. bbullett bmigration bmight bexplain bunexplained bclinical
bfindings b
(VP bCheney baccidentally bshot bhis bfriend bwhile bhunting bin b2006. bICU band bdid
bgreat. bmoved bto ban binpatient bunit. bhad ba bsilent bMI bbc ba bshot bgun bpellets
,bmigrated binto ba bcanary bartery bcausing ban binfract. bso bhad ba bMI bbut bfibrinolytic bnot
bthe banswer bin bthis bcase bb/c bit bwas ba b"projectile bembolus"
aka bbrestbone b- bcorrect banswers✔✔sternum
what battaches bthe bribs bto bthe bsternum b- bcorrect banswers✔✔cartliage
what bbreaks bthoracic bbones b- bcorrect banswers✔✔significant bforce
-1-2nd bribs, bposterior bribs, bsternum, bscapulae, bT2-10
gives bus binfo babout bthe bforce baka b"dose" bof benergy breceived
consider binjury bto binternal bstructures bb/c bforce
ribs bthat bare bthe bmost bfrequently bbroken b- bcorrect banswers✔✔ribs b4-9 bb/c blong,
bthin, band bpoorly bprotecte
it bis bharder bto bbreak ba bshort bpencil b(T1-2) band beasier bto bbreak ba blonger bone
*ask bhow bmany band bwhere bto bunderstand bthe bforce binvolved
what bis bthe bsignificance bof bposterior brib bfractures b- bcorrect banswers✔✔unusual
bdirection bof binjury
shorter bstubby bribs
good bmuscle bprofection
**posterior brib bfractures bhave ba blot bof bforce bso bneed ba bhigh bdose.
***PRF bneed ba blot bof bforce bso bhigh bdose bof benergy. bbig bred bflag bfor bt-spine
binjury
indication bof bc-spine binjury b- bcorrect banswers✔✔to binjure bc-spine, byou bdon't bneed
ba bbig benergy bblow. ball bit btakes bis bshaking baround.
c bspine bversus bt bspine bfractures b- bcorrect banswers✔✔c-spine bdoesn't bneed ba bbig
benergy bblow. bjust bsome bshaking baround b
t-spine bneeds ba bgreat bstrong bdirect bblow b(not bjust ba bshock_
treatment bfor brib bfractures b- bcorrect banswers✔✔largely bsupportive bnursing bcare
blike bpulmonary btoilet
CXR band brib bfractures b- bcorrect banswers✔✔simple brib bfractures bare bdifficult bto
bsee bon bCXR band bcan bbe bcommonly bmissed
(1/2 bof ball brib bfractures baren't bidentified bat bthe bPOI bCXR)
identify ba bprevious brib bfracture bon bCXR b- bcorrect banswers✔✔once bhealed, brib
bfractures bform bbony bcallouses band bbecome bmore bvisible bon bCXR
how bto btell ba bpt bhas ba bpneumonia bfrom ba bCXR b- bcorrect banswers✔✔dark bspot
bthat bis bnot bequal bto bthe bopposite bside
,consider bif ba bpt bhas ba blower brib bfracture b- bcorrect banswers✔✔liver b& bspleen
binjury
acts blike bBBQ/marshmellow bskewers
how bhigh bdoes bthe bdiaphragm brise bon binspiration b- bcorrect banswers✔✔level bof
b4th bICS
risk bof brib bfractures b- bcorrect banswers✔✔can bpuncture bliver, bspleen,, bdiaphragm
pop blungs
+2 badjacent brib bfractures b- bcorrect banswers✔✔flail bchest
free bfloating bsternum b- bcorrect banswers✔✔flail bchest
definition bof bflail bchest b- bcorrect banswers✔✔+2 badjacent brib bfracture
free bfloating bsternum
why bis bflail bchest ba bproblem b- bcorrect banswers✔✔b/c bbreathing bis ba bmechanical
bprocess
paradoxical bchest bmovements b- bcorrect banswers✔✔in bflail bchest
s/s bof bflail bchest b- bcorrect banswers✔✔paradoxical bchest bwall bmovement
where bon bthe btissue boxygenation bcascade bis bthoracic bcage bfractures ba bproblem b-
bcorrect banswers✔✔ventilation
parameters bto bassess bventilation b- bcorrect banswers✔✔ETCO2, bPaCO2, bclinical
bassessment
what bare bconsidered b"great bvessels" b- bcorrect banswers✔✔
thorax b- bcorrect banswers✔✔
what btype bof binjuries boccur bwhen bthe blungs bare bsubjected bto bforce? b- bcorrect
banswers✔✔bruise b= bcontusion
tear b= blacerations
pop b= bpunctures
inhalation binjury
bruise bon bthe blungs b- bcorrect banswers✔✔pulmonary bcontusion
causes bof bpulmonary bcontusions b- bcorrect banswers✔✔high bspeed bblunt bor
bpenetrating binjury
, what bhappens bto bthe blungs bin bpulmonary bcontusions b- bcorrect banswers✔✔big
bboggy bbruise bon bthe blungs
diffusion bproblems
when bit bbecomes bcontused b& bedematous, bit bbecomes bdifficult bfor boxygen bto bmove
bfrom bthe balveoli binto bthe bcapillaries
where bon bthe btissue boxygenation bcascade bdo bpulmonary bcontusions bcause btheir
bproblems b- bcorrect banswers✔✔diffusion
all bcontusions bover btime b- bcorrect banswers✔✔all bcontusions b"blossom" bover btime.
bthe bfull bextent bof bthe binjury bis bnot binitially bapparent
important bthing bto bremember bwhen byou bare bevaluating ba bpatient bfor bpulmonary
bcontusions b- bcorrect banswers✔✔70% bof bpulmonary bcontusions baren't binitial bon
bthe binitial bCXR
what bshould byou bmonitor bwhen ba bpt bhas btrauma bto bthe bthroax b- bcorrect
banswers✔✔closely bmonitor bfor bpulmonary bcontustiobs b= b70% bnot bpresent bon bthe
binitial bCXR band b"blossom" bover btime
-monitor bfor bprogress be bdeterioration bin bhours/days bpost binjury
*might blook bok bin bER
best bparameter bof bserial bmonitoring bfor bpt's bwho bhave brisk bfactors bfor bpulmonary
bcontusions b- bcorrect banswers✔✔anticipate b"blossoming" bover btime bb/c b70% bof
bpulmonary bcontusions baren't bpresent bon bthe binitial bCXR
P:F bratio
problem bof busing bCXR bas ba bdefinitive bclinical bdx btool b- bcorrect banswers✔✔CXR
bmay blag bbehind bclinical bstatus
*b/c b70% bof bpulmonary bcontusions baren't bpresent bon binitial bCXR. bthey b"blossom"
bover btime
tear bin blung btissue b- bcorrect banswers✔✔pulmonary blaceration
problem bof bpulmonary blacerations b- bcorrect banswers✔✔risk bof bmassive bhemothoax
bb/c bthose bvessels bare bvery bvascular
simple bv. btension bv. bopen bv. bclosed. bv. bhemothorax bv. bhemopneumothorax b-
bcorrect banswers✔✔
what bis ba bsimple bpneumothorax b- bcorrect banswers✔✔any bair bthat benters bthe
bpleural bcavity bcan balso bleave bat bthe bsame brate. blungs bdeflated bbut bno bincrease
bin bintrathroacic bpressure. bair bin/out bexits bat bthe bsame brate. bpt bmight bbe bable bto
btolerate ba bsimple bpneumothraox
causes ba bproblem bat bthe bventilation bpoint bat bthe btissue boxygen bcascade
ANSWERS
3 bquestions bto bask bin btrauma b- bcorrect banswers✔✔-what bwas bthe bdose bof
benergy?
-where bdid bit bgo?
-what binjuries bare blikely?
2 bq's bto bask bin bGSW b- bcorrect banswers✔✔caliber
type bof bgun
# bof bentrance/exit bwounds
high/low bvelocity
1st bquestion bto bask bin bany btraumatic binjury? b- bcorrect banswers✔✔what bwas bthe
bdose bof benergy binvolved?
(was bit bhigh bor blow?)
what bis bthe bcaliber bof ba bbullet? b- bcorrect banswers✔✔diameter
aka bdiameter bof ba bbullet b- bcorrect banswers✔✔caliber
what bhappens bto bprojectiles bwhen bthey benter bthe bbody b- bcorrect
banswers✔✔projectiles bdon't btravel bin ba bstraight bline
consider btemporary bcavity bwound
what bshould byou bconsider babout btissue ba bprojectile benounters b- bcorrect
banswers✔✔temporary bcavitation
primary bgoal bof bGSW bsurgery b- bcorrect banswers✔✔usually bdamage brepair b& bnot
bbullet bremoval
-if bsuperficial, bit bmay bmigrate bthe bsurface bwith btime
important bthing bto bremember babout bretained bprojectiles b- bcorrect banswers✔✔they
bmay bmigrate bover btime. bbullett bmigration bmight bexplain bunexplained bclinical
bfindings b
(VP bCheney baccidentally bshot bhis bfriend bwhile bhunting bin b2006. bICU band bdid
bgreat. bmoved bto ban binpatient bunit. bhad ba bsilent bMI bbc ba bshot bgun bpellets
,bmigrated binto ba bcanary bartery bcausing ban binfract. bso bhad ba bMI bbut bfibrinolytic bnot
bthe banswer bin bthis bcase bb/c bit bwas ba b"projectile bembolus"
aka bbrestbone b- bcorrect banswers✔✔sternum
what battaches bthe bribs bto bthe bsternum b- bcorrect banswers✔✔cartliage
what bbreaks bthoracic bbones b- bcorrect banswers✔✔significant bforce
-1-2nd bribs, bposterior bribs, bsternum, bscapulae, bT2-10
gives bus binfo babout bthe bforce baka b"dose" bof benergy breceived
consider binjury bto binternal bstructures bb/c bforce
ribs bthat bare bthe bmost bfrequently bbroken b- bcorrect banswers✔✔ribs b4-9 bb/c blong,
bthin, band bpoorly bprotecte
it bis bharder bto bbreak ba bshort bpencil b(T1-2) band beasier bto bbreak ba blonger bone
*ask bhow bmany band bwhere bto bunderstand bthe bforce binvolved
what bis bthe bsignificance bof bposterior brib bfractures b- bcorrect banswers✔✔unusual
bdirection bof binjury
shorter bstubby bribs
good bmuscle bprofection
**posterior brib bfractures bhave ba blot bof bforce bso bneed ba bhigh bdose.
***PRF bneed ba blot bof bforce bso bhigh bdose bof benergy. bbig bred bflag bfor bt-spine
binjury
indication bof bc-spine binjury b- bcorrect banswers✔✔to binjure bc-spine, byou bdon't bneed
ba bbig benergy bblow. ball bit btakes bis bshaking baround.
c bspine bversus bt bspine bfractures b- bcorrect banswers✔✔c-spine bdoesn't bneed ba bbig
benergy bblow. bjust bsome bshaking baround b
t-spine bneeds ba bgreat bstrong bdirect bblow b(not bjust ba bshock_
treatment bfor brib bfractures b- bcorrect banswers✔✔largely bsupportive bnursing bcare
blike bpulmonary btoilet
CXR band brib bfractures b- bcorrect banswers✔✔simple brib bfractures bare bdifficult bto
bsee bon bCXR band bcan bbe bcommonly bmissed
(1/2 bof ball brib bfractures baren't bidentified bat bthe bPOI bCXR)
identify ba bprevious brib bfracture bon bCXR b- bcorrect banswers✔✔once bhealed, brib
bfractures bform bbony bcallouses band bbecome bmore bvisible bon bCXR
how bto btell ba bpt bhas ba bpneumonia bfrom ba bCXR b- bcorrect banswers✔✔dark bspot
bthat bis bnot bequal bto bthe bopposite bside
,consider bif ba bpt bhas ba blower brib bfracture b- bcorrect banswers✔✔liver b& bspleen
binjury
acts blike bBBQ/marshmellow bskewers
how bhigh bdoes bthe bdiaphragm brise bon binspiration b- bcorrect banswers✔✔level bof
b4th bICS
risk bof brib bfractures b- bcorrect banswers✔✔can bpuncture bliver, bspleen,, bdiaphragm
pop blungs
+2 badjacent brib bfractures b- bcorrect banswers✔✔flail bchest
free bfloating bsternum b- bcorrect banswers✔✔flail bchest
definition bof bflail bchest b- bcorrect banswers✔✔+2 badjacent brib bfracture
free bfloating bsternum
why bis bflail bchest ba bproblem b- bcorrect banswers✔✔b/c bbreathing bis ba bmechanical
bprocess
paradoxical bchest bmovements b- bcorrect banswers✔✔in bflail bchest
s/s bof bflail bchest b- bcorrect banswers✔✔paradoxical bchest bwall bmovement
where bon bthe btissue boxygenation bcascade bis bthoracic bcage bfractures ba bproblem b-
bcorrect banswers✔✔ventilation
parameters bto bassess bventilation b- bcorrect banswers✔✔ETCO2, bPaCO2, bclinical
bassessment
what bare bconsidered b"great bvessels" b- bcorrect banswers✔✔
thorax b- bcorrect banswers✔✔
what btype bof binjuries boccur bwhen bthe blungs bare bsubjected bto bforce? b- bcorrect
banswers✔✔bruise b= bcontusion
tear b= blacerations
pop b= bpunctures
inhalation binjury
bruise bon bthe blungs b- bcorrect banswers✔✔pulmonary bcontusion
causes bof bpulmonary bcontusions b- bcorrect banswers✔✔high bspeed bblunt bor
bpenetrating binjury
, what bhappens bto bthe blungs bin bpulmonary bcontusions b- bcorrect banswers✔✔big
bboggy bbruise bon bthe blungs
diffusion bproblems
when bit bbecomes bcontused b& bedematous, bit bbecomes bdifficult bfor boxygen bto bmove
bfrom bthe balveoli binto bthe bcapillaries
where bon bthe btissue boxygenation bcascade bdo bpulmonary bcontusions bcause btheir
bproblems b- bcorrect banswers✔✔diffusion
all bcontusions bover btime b- bcorrect banswers✔✔all bcontusions b"blossom" bover btime.
bthe bfull bextent bof bthe binjury bis bnot binitially bapparent
important bthing bto bremember bwhen byou bare bevaluating ba bpatient bfor bpulmonary
bcontusions b- bcorrect banswers✔✔70% bof bpulmonary bcontusions baren't binitial bon
bthe binitial bCXR
what bshould byou bmonitor bwhen ba bpt bhas btrauma bto bthe bthroax b- bcorrect
banswers✔✔closely bmonitor bfor bpulmonary bcontustiobs b= b70% bnot bpresent bon bthe
binitial bCXR band b"blossom" bover btime
-monitor bfor bprogress be bdeterioration bin bhours/days bpost binjury
*might blook bok bin bER
best bparameter bof bserial bmonitoring bfor bpt's bwho bhave brisk bfactors bfor bpulmonary
bcontusions b- bcorrect banswers✔✔anticipate b"blossoming" bover btime bb/c b70% bof
bpulmonary bcontusions baren't bpresent bon bthe binitial bCXR
P:F bratio
problem bof busing bCXR bas ba bdefinitive bclinical bdx btool b- bcorrect banswers✔✔CXR
bmay blag bbehind bclinical bstatus
*b/c b70% bof bpulmonary bcontusions baren't bpresent bon binitial bCXR. bthey b"blossom"
bover btime
tear bin blung btissue b- bcorrect banswers✔✔pulmonary blaceration
problem bof bpulmonary blacerations b- bcorrect banswers✔✔risk bof bmassive bhemothoax
bb/c bthose bvessels bare bvery bvascular
simple bv. btension bv. bopen bv. bclosed. bv. bhemothorax bv. bhemopneumothorax b-
bcorrect banswers✔✔
what bis ba bsimple bpneumothorax b- bcorrect banswers✔✔any bair bthat benters bthe
bpleural bcavity bcan balso bleave bat bthe bsame brate. blungs bdeflated bbut bno bincrease
bin bintrathroacic bpressure. bair bin/out bexits bat bthe bsame brate. bpt bmight bbe bable bto
btolerate ba bsimple bpneumothraox
causes ba bproblem bat bthe bventilation bpoint bat bthe btissue boxygen bcascade
