Thoracic Trauma Flashcards

What is the primary respiratory intervention for a patient with flail chest causing significant respiratory distress?

Answer: Positive pressure ventilation with supplemental oxygen

Positive pressure ventilation provides internal pneumatic stabilization of the flail segment while supporting oxygenation and ventilation in the distressed patient.

Which chest X-ray finding is most suggestive of traumatic aortic injury?

Answer: Widened mediastinum greater than 8 cm

A widened mediastinum (>8 cm on an AP chest radiograph) is the classic sign of traumatic aortic injury caused by mediastinal hematoma formation from aortic disruption.

Which temporary intervention is performed for hemodynamically unstable cardiac tamponade when immediate surgery is unavailable?

Answer: Pericardiocentesis to aspirate pericardial blood

Pericardiocentesis removes blood from the pericardial sac to relieve tamponade physiology and provides temporary hemodynamic improvement until definitive surgical repair.

What pathophysiology underlies the obstructive shock of tension pneumothorax?

Answer: Increased intrathoracic pressure compressing the heart and great veins, impairing venous return

Tension pneumothorax elevates intrathoracic pressure, compressing the vena cava and right ventricle, which severely reduces venous return and cardiac output, producing obstructive shock.

Which physical exam finding is expected in a patient with a large hemothorax?

Answer: Dullness to percussion and absent breath sounds on the affected side

Blood in the pleural space produces dullness to percussion and displaces air from the lung, eliminating breath sounds on the affected side.

Which mechanism most commonly converts a simple pneumothorax to a tension pneumothorax during positive pressure ventilation?

Answer: A one-way valve mechanism from a lung laceration or chest wound

A one-way valve from a lung laceration allows air to enter the pleural space with each positive pressure breath without a means of escape, rapidly building tension.

A trauma patient presents with facial cyanosis, petechiae of the upper body, and bilateral subconjunctival hemorrhages after being pinned under a heavy object. What injury should be suspected?

Answer: Traumatic asphyxia from prolonged thoracic compression causing retrograde venous hypertension

Traumatic asphyxia results from sustained compressive force on the thorax suddenly raising intrathoracic pressure and forcing blood retrograde into the head and neck venous system.