Thoracic and Cardiovascular Trauma Flashcards

Pulmonary contusion is best described as which of the following?

Answer: Bruising of lung tissue causing alveolar hemorrhage and edema without laceration

Pulmonary contusion is direct injury to lung parenchyma causing alveolar hemorrhage and edema, worsening over 24–48 hours.

A trauma patient develops worsening hypoxia 24 hours after admission despite supplemental oxygen. Chest X-ray shows bilateral opacities. Which condition is most likely?

Answer: Acute respiratory distress syndrome (ARDS)

ARDS following trauma presents with bilateral infiltrates and refractory hypoxia, typically peaking 24–72 hours after injury.

Which intervention is contraindicated in a patient with suspected esophageal perforation from trauma?

Answer: Nasogastric tube insertion by the nurse without further assessment

Blind nasogastric tube placement can worsen esophageal perforation; surgical consultation should guide any tube placement.

A trauma patient has breath sounds on the right but gastric sounds audible over the left chest. Which injury does this suggest?

Answer: Left diaphragmatic rupture with herniation of abdominal contents

Bowel sounds auscultated in the chest cavity indicate diaphragmatic rupture with herniation of abdominal organs into the thorax.

Which mechanism of injury most commonly causes traumatic diaphragmatic rupture?

Answer: High-energy blunt abdominal trauma causing a sudden increase in intra-abdominal pressure

Sudden compression of the abdomen raises intra-abdominal pressure beyond the diaphragm's tensile limit, causing it to rupture.

When monitoring a patient after pericardiocentesis for traumatic tamponade, which improvement indicates successful decompression?

Answer: Increasing blood pressure, decreasing JVD, and improving heart sounds

Successful pericardiocentesis relieves pericardial compression, resulting in improved cardiac output demonstrated by rising BP and resolving JVD.