CAISS Thorax Injuries 3 — Questions and Answers
Question 1: A traumatic aortic injury classified as AIS 5 most likely involves:
- Intimal tear without adventitial disruption
- Aortic laceration with contained hematoma
- Aortic transection with free hemorrhage (Correct answer)
- Aortic contusion without imaging findings
Correct answer: Aortic transection with free hemorrhage
AIS 5 (critical) thoracic aortic injuries involve full transection or near-transection with free hemorrhage, which is immediately life-threatening.
Question 2: Which structure's injury is coded in the AIS thorax region when the diaphragm is lacerated?
- Abdomen region
- Thorax region (Correct answer)
- Spine region
- External region
Correct answer: Thorax region
Diaphragm injuries are coded in the AIS thorax body region (region 4) regardless of the mechanism of injury.
Question 3: Beck's triad (hypotension, muffled heart sounds, distended neck veins) following thoracic trauma suggests:
- Tension pneumothorax
- Massive hemothorax
- Pericardial tamponade (Correct answer)
- Myocardial contusion
Correct answer: Pericardial tamponade
Beck's triad is the classic presentation of pericardial tamponade, caused by blood accumulating in the pericardial sac compressing the heart.
Question 4: A 'massive hemothorax' is typically defined by initial drainage of at least:
- 500 mL
- 750 mL
- 1,000 mL
- 1,500 mL (Correct answer)
Correct answer: 1,500 mL
Massive hemothorax is defined by ≥1,500 mL (or ≥1/3 of blood volume) drained on initial chest tube insertion, classified as AIS 4.
Question 5: In AIS coding, myocardial contusion without arrhythmia or wall motion abnormality is coded as:
- AIS 2
- AIS 3 (Correct answer)
- AIS 4
- AIS 5
Correct answer: AIS 3
Myocardial contusion without complications (no arrhythmia, no wall motion abnormality, no hemodynamic compromise) is classified as AIS 3.
Question 6: Which AIS descriptor best applies to an open chest wound (sucking chest wound) without pneumothorax?
- AIS 1 — minor
- AIS 2 — moderate
- AIS 3 — serious (Correct answer)
- AIS 4 — severe
Correct answer: AIS 3 — serious
An open chest wound communicating with the pleural space is coded as AIS 3 (serious) due to its potential to cause tension pneumothorax if untreated.
Question 7: Which of the following thoracic injuries has the HIGHEST AIS severity score?
- Flail chest
- Cardiac laceration involving a coronary artery (Correct answer)
- Bilateral massive hemothorax
- Tracheal transection
Correct answer: Cardiac laceration involving a coronary artery
Cardiac laceration involving a coronary artery is coded AIS 5 and carries an extremely high mortality, typically higher than other listed injuries.
CAISS Thorax Injuries 3
A traumatic aortic injury classified as AIS 5 most likely involves: