TCAR EXAM 2026 QUESTIONS AND
ANSWERS 100% VERIFIED GRADED A+
⩥ 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
⩥ +2 adjacent rib fractures. Answer: flail chest
⩥ free floating sternum. Answer: flail chest
⩥ definition of flail chest. Answer: +2 adjacent rib fracture
free floating sternum
ANSWERS 100% VERIFIED GRADED A+
⩥ 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
⩥ +2 adjacent rib fractures. Answer: flail chest
⩥ free floating sternum. Answer: flail chest
⩥ definition of flail chest. Answer: +2 adjacent rib fracture
free floating sternum
