Question 1

In the initial assessment of a patient suspected with thoracic injury, what is a rapid indication of respiratory status that confirms adequate cerebral perfusion?&#10;A) A patient has an alert level of consciousness&#10;B) Respiratory rate of 20 cpm&#10;C) O2 saturation of 98%&#10;D) A patient is able to complete a sentence in one breath and give a lucid answer to a question

Accepted Answer

A patient is able to complete a sentence in one breath and give a lucid answer to a question&#10;

Question 2

What finding can be found upon palpation of the thorax or back when there is subcutaneous emphysema indicating an air leak from pneumothorax?&#10;A) Coarse crepitus&#10;B) Fine crackling&#10;C) Asymmetry of the chest wall&#10;D) All are correct

Accepted Answer

Fine crackling&#10;

Question 3

An urgent intervention for tension pneumothorax to decompress the thoracic cavity through the placement of a large bore cannula in the second intercostal space, in the midclavicular line on the affected side.

A) Thoracostomy
B) Thoracotomy
C) Endoscopic thoracic sympathectomy
D) Lobectomy

Thoracostomy

Accepted Answer

Thoracostomy, specifically needle thoracostomy, is the correct intervention for an urgent decompression of the thoracic cavity in the case of a tension pneumothorax. It involves the insertion of a large bore cannula in the second intercostal space, midclavicular line on the affected side.

Question 4

A term coined to describe patients who have evidence of ongoing volume loss that can be controlled with higher than normal volume infusion of crystalloid and/or blood products.&#10;A) Haemodynamic instability&#10;B) Metastability&#10;C) Haemodynamic stability&#10;D) Metainstability

Accepted Answer

Metastability refers to a state where patients exhibit ongoing volume loss but can be managed with higher than usual volumes of crystalloids or blood products, indicating a precarious balance that can be maintained with intervention.

Question 5

What is the proper way of assessing the effectiveness of analgesia in patients with rib fractures?&#10;A) Ask the patient to take a deep breath and cough&#10;B) Ask the patient to lean forwards and take a deep breath&#10;C) Reassess the pain 2 hours after the administration of analgesia&#10;D) Reassess the pain 5 minutes after the administration of analgesia

Accepted Answer

Asking the patient to take a deep breath and cough is a functional assessment that can indicate if the analgesia is effective in managing pain associated with rib fractures.

Question 6

In assessing scapular fractures, what observation/s should be included in the assessment?&#10;A) Range of shoulder motion&#10;B) Distal radial pulses&#10;C) Distal ulner pulses&#10;D) All are correct

Accepted Answer

All observations are important in assessing scapular fractures to ensure there is no associated vascular injury and to evaluate the impact on shoulder function.

Question 7

A clinical condition resulting from the segmental fracture of two or more adjacent ribs in two or more places, with associated chest-wall deformation:&#10;A) Costochondral joint disruption&#10;B) Pulmonary contusion&#10;C) Flail chest&#10;D) Pigeon chest

Accepted Answer

Flail chest occurs when a segment of the rib cage breaks due to trauma and becomes detached from the rest of the chest wall. This condition is characterized by the fracture of two or more adjacent ribs in two or more places, leading to a segment of the chest wall that moves independently from the rest, often causing severe pain and respiratory difficulty.

Question 8

Which among the following can confirm the diagnosis of tension pneumothorax?&#10;A) Chest X-ray&#10;B) CT scan&#10;C) Presence of shock and unilateral absence of breath&#10;D) All are correct

Accepted Answer

Tension pneumothorax is a clinical diagnosis, often confirmed by the presence of shock and unilateral absence of breath sounds, rather than imaging.

Question 9

It is also known as the 'sucking chest wound' and involves injury to the full-thickness loss of chest wall-tissue.&#10;A) Haemothorax&#10;B) Simple closed pneumothorax&#10;C) Tension pneumothorax&#10;D) Open pneumothorax

Accepted Answer

An open pneumothorax, often referred to as a "sucking chest wound," occurs when an injury to the chest wall is severe enough to create a full-thickness loss of tissue, allowing air to move freely in and out of the thoracic cavity with each breath, disrupting normal lung function.

Question 10

Which among the following is a sign demonstrating potential aortic injury?&#10;A) Deviation of nasogastric tube to left&#10;B) Deviation of trachea to left&#10;C) Depression of left mainstem bronchus&#10;D) Fracture of 9th and 10th rib

Accepted Answer

Depression of the left mainstem bronchus can indicate aortic injury due to the pressure exerted by a hematoma or aneurysm on the bronchus.

Deck 45: Thoracic and Neck Trauma