Flail Chest and Pneumothorax Overview

In flail chest, which of the following occur

1. Tidal volume increases

2. atelectasis often occurs

3. intrapulmonary shunting

4. pneumothorax is rare

2. atelectasis often occurs

3. intrapulmonary shunting

When's patient has sever flail chest ,which of the following occurs?

1. Venous return increases

2. Cardiac output increases

3. System in blood pressure increases

4. Central Venous pressure increases

4. Central Venous pressure increases

A flail chest consists of a double fracture of at least?

1. 2 adjacent ribs

2. 3 adjacent ribs

3. 4 adjacent ribs

4. 5 adjacent ribs

2. 3 adjacent ribs

Which of the following respiratory care techniques are commonly used in treatment of severe flail chest?

1. Cough and deep breathe

2. Intubation with continuous mandatory ventilation

3. Negative pressure ventilation

4. PEEP/CPAP

2. Intubation with continuous mandatory ventilation

4. PEEP/CPAP

When mechanical ventilation is used to stabilize a flail chest, how much time is generally needed for adequate bone healing to occur?

1. 5-10days

2. 10-15 days

3. 15-20days

4. 20-25 days

1. 5-10days

When gas moves between the pleural space and the atmosphere during a ventilatory cycle, the patient is said to have an?

1.Closed pneumothorax

2. Iatrogenic pneumothorax

3. Valvular pneumothorax

4. Sucking chest wound

4. Sucking chest wound

When gas enters the pleural space during inspiration but is unable to leave during expiration, the patient is said to have an:

1. Iatrogenic pneumothorax

2. Valvular pneumothorax

3. Tension pneumothorax

4. open pneumothroax

2. Valvular pneumothorax

3. Tension pneumothorax

Which of the following may cause a pneumothorax?

Pneumonia

TB

COPD

Blebs

all of the above

When a patient has a pneumothorax because of a sucking chest wound, which of the following occurs?

1.Intrapleural pressure on the unaffected side increasing during inspiration

2.The mediastinum often moves to the unaffected side during inspiration

3.Intraplueral pressure on the affected side often rises above the atmospheric pressure during expiration

4.The mediastinum often moves to the affected side during expiration

2.The mediastinum often moves to the unaffected side during inspiration

3.Intraplueral pressure on the affected side often rises above the atmospheric pressure during expiration

4.The mediastinum often moves to the affected side during expiration

The increased ventilatory rate commonly manifested in patients with pneumothorax may result from which of the following?

Stimulation of the j receptors

Increased lung compliance

Increased stimulation of the hearing- Breuer reflex

Stimulation of the irritant reflex

Stimulation of the j receptors and Stimulation of the irritant reflex

The physicain usually elects to evacuate the intrathoracic gas when the pneumothorax is greater than

5%

10%

15%

20%

20%

During treatment of a pneumothorax with a chest tube and suction, the negative (suction) pressure usuallly need not exceed?

-6 cmH2O

-8

-10

-12

-12

A patient with a severe tension pneumothorax demonstrates which of the following on the affected side?

Diminished breath sounds

Hyperressonant percussion note

Dull percussion note

Whispered pectoriloquy

Diminished breath sounds and

Hyperressonant percussion note

When a patient has a large tension pneumothorax, which of the following occurs

pH increases

PaCO2 increases

Bicarb decreases

PaCO2 decreases

PaCO2 increases

In the US drowning is the?

leading cause

second leading casue

third leading casue

fourth leading casue

Third leading casue of acciental death

According to the CDC and prevention about how many people drowne each year in the us?

500

1000

1250

>3000

>3000

Which of the following are the major anatomic alterations of the lungs associated with near drowning?

1. consolodation

2. bronchospasms

3. increased alveolar- capillary membrane thickness

4. atelecatasis

5. excessive bronchiole secretions

1.Consolidation

2.bronchospasm

3.increased alveolar- capillary membrane thickness

Which of the following clinical manifestations are associated with near drowning?

Frothy, pink sputum

crackles

increased pH

increased SvO2

Frothy, pink sputum

crackles

Which of the following PFT values are associated with near drowning victims?

N or decreased FEVT

decreased FVC

Decreased RV

N or increase FEV1/FVC ratio

all of the above

About what percentage of hospitalized patients with thermal injury have an acute upper airway obstruction?

0-10

10-20

20-30

30-40

20-30

except for the rate instance of steam inhalation, direct thermal injuries usually do not occur below the level of which of the following structures?

Oral pharynx

Larynx

carina

bronchi

layrnx

when chest wall burns are present, the patient's pulmonary condition may be further aggravated by which of the following? Decrease lung compliance.

increased airway resistance

Administration of narcotics

Immobility

all of the above

which of the following is the pulmonary related pathologic changes associated with smoke inhalation?

1. pneumomediastinum

2. Bronchospasm

3. Pulmonary edema

4. Pulmonary embolism

2, 3, and 4

Which of the following produced carbon monoxide when burned?

1. polyurethanes

2. wood,cotton,paper

3. organic material

4. polyvinylchloride

3 and 4

Which of the following oxygen indices are associated with smoke in inhalation and burn during the early and intermediate stages?

1. increased V02

2. decreased C(a-v)O2

3. decreased DO2

4. decreased SvO2

1 and 4 only

Which of the following hemodynamic indices is associated with body surface burns during their early stage?

1. decreased CO

2. increased SVR

3. decrease PA

4. increase PCWP

1, 2, and 3 only

if an adult entire right arm, right leg and interior trunk have been burned approximately what percentage of the patient's body surface area is burned?

15%

25%

35%

45%

45%

Healing time for a second-degree burn is?

One to seven days

7 to 21 days

21 to 31 days

One to two months

7-21

breathing 100% oxygen at one atmosphere reduces the COHB half-life to less than?

One hour

Two hours

Three hours

Four hours

one hour

when a patient las a large tension pneumothroax, which of the following occurs?

PVR decreases

PA increases

CVP decreases

CO increase

CO increases