Chapter 27 Chest Injuries

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Chapter 27 Chest Injuries
2014-04-25 22:11:49
Chapter 27 Chest Injuries

Chapter 27 Chest Injuries
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  1. The chest (thoracic cage) extends from the lower end of the ____ to the ____.
    • neck
    • diaphragm
  2. The ____ ____ is a network of nerves, arteries, and veins lying closely along the inferior of and slightly posterior to the lowest margin of each rib and can be a source of significant bleeding into the pleural space.
    neurovascular bundle
  3. The ____ pleura is the inner chest wall lining.
  4. The ____ pleura covers the lung.
  5. The fluid between the parietal and visceral pleura, allows the lungs to move freely against the inner chest wall as a person breathes.
  6. The central part of the chest containing the heart, great vessels, esophagus, and trachea.
  7. Occurs when a weakened portion of the aorta wall develops a false lumen that eventually ruptures and causes fatal hemorrhage in the thorax.
    thoracic aortic aneurysm
  8. Muscle that separates the thoracic cavity from the abdominal cavity.
  9. A patient whose spinal cord is injured below the __ level will lose the power to move the intercostal muscles.
  10. A patient whose spinal cord is injured below the C5 level will lose the power to move the:
    intercostal muscles.
  11. There are two basic types of chest injuries:
    • open
    • closed
  12. Almost one third of people killed immediately in car crashes die as a result of traumatic rupture of the:
  13. Patients with chest injuries often have ____ (rapid respirations) and ____ respirations because it hurts to take a deep breath.
    • tachypnea
    • shallow
  14. Note whether the jugular veins are distended which is a sign of:
    pressure (tamponade) on the heart
  15. pressure (tamponade) on the heart may be the result of (two things):
    • tension pneumothorax
    • injury to the heart allowing bleeding into the pericardium (pericardial tamponade)
  16. Unequal chest expansion indicates loss of ____ function and may be due to a ____ injury to the chest wall or may be related to an injury of the ____ controlling those muscles.
    • muscle
    • direct
    • nerves
  17. Check for paradoxical motion, an abnormality associated with:
    multiple fractured ribs.
  18. If breathing is inadequate, provide positive-pressure ventilations.  Do not use for patients with a:
  19. Commonly called a collapsed lung.  It describes an accumulation of air in the pleural space.
  20. An open chest wound is often called an ____ pneumothorax or a sucking chest wound.
  21. A one-way valve that allows air to leave the chest cavity but not return.
    flutter valve
  22. Pneumothorax caused by structural weakness rather than trauma
  23. Pneumothorax that does not result in major changes in a patient’s physiology.  This type of injury is commonly the result of blunt trauma that results in fractured ribs.
  24. Pneumothora that results from significant air accumulation in the pleural space.  This air greatly increases the pressure in the chest, causing complete collapse of the unaffected lung.
  25. A condition in which blood collects in the pleural space from bleeding around the rib cage or from a lung or great vessel.
  26. The presence of air and blood in the pleural space is known as a:
  27. Occurs more commonly with penetrating chest trauma, although it may occur in blunt trauma.  The protective membrane around the heart (pericardium) fills with blood or fluid (eg, pus).  The heart then cannot pump an adequate amount of blood.
    Cardiac tamponade
  28. Beck’s triad:
    • Distended or engorged jugular veins seen on both sides of the trachea
    • Narrowing pulse pressure
    • Muffled heart sounds
  29. What does Beck’s triad indicate?
    cardiac tamponade
  30. A fracture of one of the upper ____ ribs is a sign of a very substantial MOI.
  31. Caused by compound rib fractures that detach a segment of the chest wall.  The detached portion of the chest wall moves opposite of normal.  In during exhalation.  Out during inhalation.
    Flail chest
  32. Should always be suspected in a patient with a flail chest
    Pulmonary contusion
  33. Blunt chest injury caused by a sudden, direct blow to the chest that occurs only during the critical portion of a person’s heartbeat.  The result may be immediate cardiac arrest.
    Commotio cordis
  34. __________ is the exchange of air in the lung tissue.
  35. What is the normal breathing rate for an adult?
    12 to 20 breaths/min
  36. When blood or fluid collect inside the sac around the heart, it is called:
    pericardial tamponade.
  37. _________ should always be suspected in patients with a flail chest.
    Pulmonary contusion
  38. You are transporting a stable patient with a possible pneumothorax. The patient is receiving 100% oxygen and has an oxygen saturation of 95%. During your reassessment, you find that the patient is now confused, hypotensive, and profusely diaphoretic. What is MOST likely causing this patient's deterioration?
    A. compression of the aorta and vena cava
    B. a total collapse of the affected lung
    C. blood accumulation in the pleural space
    D. hidden bleeding in the thoracic cavity
    A. compression of the aorta and vena cava
    (this multiple choice question has been scrambled)