PHTLS Thoracic Trauma 5

Question 1

A restrained passenger has blunt chest trauma from the steering wheel and complains of pain worsening with swallowing. Which injury should this symptom prompt you to consider?

Accepted Answer

Esophageal rupture

Answer

Pain on swallowing (odynophagia) following blunt chest trauma should raise suspicion for esophageal injury, which can lead to life-threatening mediastinitis.

Question 2

Which mechanism of injury is most commonly associated with traumatic diaphragmatic rupture?

Accepted Answer

All of the above are associated mechanisms

Answer

Traumatic diaphragmatic rupture occurs with both penetrating injuries to the thoracoabdominal region and blunt compression mechanisms, so all listed mechanisms are relevant.

Question 3

In managing a patient with suspected massive hemothorax, which fluid resuscitation strategy aligns with current PHTLS hemorrhagic shock guidelines?

Accepted Answer

Permissive hypotension targeting SBP 80–90 mmHg until surgical hemorrhage control

Answer

PHTLS supports hypotensive resuscitation (SBP 80–90 mmHg) in hemorrhagic shock from thoracic injury to avoid dilution coagulopathy and clot disruption before surgical control.

Question 4

A patient with a stab wound to zone III of the thorax (below the nipple line anteriorly / below the scapular tip posteriorly) should be evaluated for which additional injury?

Accepted Answer

Intra-abdominal organ injury

Answer

The lower thoracic zone overlaps with the upper abdomen; penetrating injuries here can injure intra-abdominal organs such as the liver, spleen, and stomach.

Question 5

Which of the following correctly describes the physiologic reason why tension pneumothorax reduces cardiac output?

Accepted Answer

Mediastinal shift kinks the great veins, reducing venous return to the heart

Answer

Mediastinal shift from a tension pneumothorax compresses and kinks the superior and inferior vena cava, dramatically reducing venous return and causing obstructive shock.

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS Thoracic Trauma 5