After a fall, a 70-year-old man arrives at the emergency department with severe right-sided chest pain and shortness of breath. The patient fell off a ladder while doing yard work, striking his back on several large stones. He immediately felt sharp pain over his posterior chest and struggled to catch his breath. The blood pressure is 120/80 mm Hg, the pulse rate is 88/minute, and the respiration rate is 24/minute. The exhibit includes a chest x-ray. Physical examination of the right side of the chest would most likely reveal which of the following?

Question

After a fall, a 70-year-old man arrives at the emergency department with severe right-sided chest pain and shortness of breath. The patient fell off a ladder while doing yard work, striking his back on several large stones. He immediately felt sharp pain over his posterior chest and struggled to catch his breath. The blood pressure is 120/80 mm Hg, the pulse rate is 88/minute, and the respiration rate is 24/minute. The exhibit includes a chest x-ray.  Physical examination of the right side of the chest would most likely reveal which of the following?

Quizplus · Accepted Answer

Eductional Objective: Traumatic pneumothorax can involve puncture of either the chest wall (eg, penetrating chest trauma) or the lung (eg, by fractured ribs), allowing air to enter the pleural space.  Patients usually experience chest pain and difficulty breathing.  Crepitus, caused by air in the subcutaneous tissues of the chest wall, is often present on physical examination.

After a Fall, a 70-Year-Old Man Arrives at the Emergency