12. What is a sucking wound of the chest?
Correct answer: A pneumothorax will also result from a penetrating wound of the chest wall produced, for example, by a knife stab or gunshot wound. The lips of the wound may also have a valvular effect so that air is…
11. What is surgical emphysema?
Correct answer: This is an alternative name for subcutaneous emphysema. In the context of rib fractures, the rib tears the overlying soft tissues and allows air to enter the subcutaneous tissues, resulting in subcutaneous emphysema. The skin over the trunk,…
10. In the case of a tension pneumothorax, in which direction is the trachea deviated?
Correct answer: The trachea will be deviated away from the affected side.
9. What is a tension pneumothorax?
Correct answer: In the context of rib fractures a bony spicule may penetrate the lung, which results in air escaping into the pleural cavity to cause a pneumothorax. A tension pneumothorax results if the pleural tear is valvular, allowing air…
8. Why might a patient with a flail chest become anoxic?
Correct answer: This is because of failure of adequate expansion of the affected side and also because of shunting of deoxygenated air from the lung on the side of the fracture into the opposite side. The pendulum movements of the…
7. What is a flail chest?
Correct answer: Crush injuries of the chest, in which the whole sternum is loosened by fractured ribs on either side or several ribs are fractured in two places, result in the condition of flail chest. On inspiration, the flail part…
6. What are the main complications of a fractured rib?
Correct answer: (1) Flail chest. (2) Pneumothorax. (3) Subcutaneous emphysema (surgical emphysema). (4) Sucking wound of the chest. (5) Haemothorax. (6) Other visceral injury. (7) Traumatic asphyxia.
5. How would you investigate a patient with a suspected fractured rib?
Correct answer: Chest X-ray may confirm rib fractures, and will identify underlying lung damage or haemorrhage that might not have been suspected from the trivial nature of the patient’s symptoms. A chest X-ray may not always demonstrate a fracture, and,…
3. Which ribs are most often fractured?
Correct answer: The commonest injury to the chest is fracture of the ribs by a direct blow. The most commonly affected ribs are the seventh, eighth and ninth, in which the fracture occurs in the region of the midaxillary line….
2. What are the dangerous complications of chest injury?
Correct answer: Paradoxical respiration; pneumothorax; penetration of the lung; haemothorax; cardiac tamponade due to laceration of the heart; large vessel damage. Serious damage can also result from blunt (crush) injuries that do not penetrate the chest; thus, a main bronchus…
