Thoracic and Abdominal Trauma Flashcards
6 cards from real TNCC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Thoracic and Abdominal Trauma flashcards as text
A patient with left lower rib fractures (ribs 9-12) should be evaluated for injury to which organ?
Answer: Spleen
Left lower rib fractures (ribs 9-12) overlie the spleen, and direct fracture fragments or transmitted force significantly increases the risk of splenic injury.
Tracheobronchial injury following blunt chest trauma should be suspected when:
Answer: A chest tube has been placed but there is a persistent large air leak and the lung fails to re-expand
A persistent large air leak through the chest tube with failure of the lung to re-expand despite adequate drainage suggests a tracheobronchial disruption — air is entering the pleural space faster than the chest tube can evacuate it.
A patient with a deceleration injury has a widened mediastinum on chest X-ray. This finding is most concerning for:
Answer: Traumatic aortic disruption
A widened mediastinum (>8 cm on supine AP film) after deceleration injury is the classic screening finding for traumatic aortic disruption, requiring urgent CT angiography for definitive evaluation.
Diagnostic peritoneal lavage (DPL) is considered positive for significant intra-abdominal hemorrhage when the red blood cell count exceeds:
Answer: 100,000/mm³
A DPL is positive for blunt trauma when the RBC count in the lavage fluid exceeds 100,000/mm³ (for penetrating trauma, the threshold is lower at 10,000-20,000/mm³).
A patient presents after a motor vehicle collision with a rigid, distended abdomen, absent bowel sounds, and involuntary guarding. These findings are most consistent with:
Answer: Peritonitis from hollow viscus perforation
A rigid, distended abdomen with absent bowel sounds and involuntary guarding indicates peritoneal irritation from hollow viscus perforation, with bowel contents contaminating the peritoneal cavity.
Which injury should be suspected in a trauma patient with Kehr's sign (left shoulder pain) following blunt abdominal trauma?
Answer: Splenic injury with diaphragmatic irritation
Kehr's sign is referred pain to the left shoulder caused by blood or fluid irritating the left hemidiaphragm, most commonly from splenic injury. The phrenic nerve (C3-C5) carries the referred pain sensation.