PHTLS Thoracic Trauma 2

Question 1

A patient with blunt chest trauma presents with absent breath sounds on the right, tracheal deviation to the left, and JVD. Which condition does this most likely represent?

Accepted Answer

Tension pneumothorax

Answer

Tension pneumothorax classically presents with absent breath sounds, tracheal deviation away from the affected side, and JVD due to mediastinal shift.

Question 2

During assessment of a chest trauma patient, you note paradoxical chest wall movement over a section of ribs. What minimum number of consecutive rib fractures in two places typically produces this finding?

Accepted Answer

3 or more ribs in 2 places

Answer

A flail segment requires three or more adjacent ribs fractured in at least two places, creating a free-floating segment that moves paradoxically.

Question 3

Which of the following best describes the pathophysiology of paradoxical motion seen in flail chest?

Accepted Answer

The flail segment moves inward on inspiration and outward on expiration

Answer

The flail segment moves paradoxically — inward during inspiration (when pleural pressure drops) and outward during expiration.

Question 4

A construction worker falls from scaffolding and complains of severe chest pain. Palpation reveals crepitus along the left lateral chest wall. Which immediate life threat should be highest on your differential?

Accepted Answer

Rib fractures with potential hemothorax or pneumothorax

Answer

Crepitus over the chest wall indicates rib fractures, which carry significant risk of associated hemothorax or pneumothorax requiring rapid assessment.

Question 5

In prehospital management of a sucking chest wound, after applying a vented chest seal, the patient deteriorates with increasing respiratory distress and decreasing SpO2. What is the next step?

Accepted Answer

Remove the seal to release potential tension buildup

Answer

If a patient with a vented chest seal deteriorates, the seal should be lifted or removed to relieve a developing tension pneumothorax.

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS Thoracic Trauma 2