Flail Chest and Pneumothorax

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

• Two adjacent ribs

• Three adjacent ribs

• Four adjacent ribs

• Five adjacent ribs

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

• 5 to 10 days

• 10 to 15 days

• 15 to 20 days

• 20 to 25 days

Which of the following are the clinical manifestations of a flail chest?

1. During inspiration the fractured ribs are pushed inward
2. During expiration the ribs bulges outward
3. During inspiration the fractured ribs are pushed outward
4. During expiration the ribs bulges inward

• 1 and 2

• 3 and 4

• 2 and 3

• 1 and 4

Which of the following may cause a pneumothorax?

1. Pneumonia

2. Tuberculosis

3. Chronic obstructive pulmonary disease

4. Blebs

• 1 and 2 only

• 2 and 3 only

• 2, 3, and 4 only

• 1, 2, 3, and 4

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

• 5%

• 10%

• 15%

• 20%

When gas moves between the pleural space and the atmosphere during a ventilatory cycle, the patient is said to have a(n):

• Closed pneumothorax

• Iatrogenic pneumothorax

• Sucking chest wound

• Valvular pneumothorax

When gas enters the pleural space during inspiration but is unable to leave during expiration, the patient is said to have a(n):

1. Iatrogenic pneumothorax

2. Valvular pneumothorax

3. Tension pneumothorax

4. Open pneumothorax

• 1 only

• 3 only

• 2 and 3 only

• 3 and 4 only

Which of the following is true regarding a tension pneumothorax?

1. Mediastinum shifts away from the affected side
2. Mediastinum moves towards the affected side
3. Decreases venous return and cardiac output
4. Can result in cardiovascular collapse

• 1, 3 and 4

• 2, 3 and 4

• 1 and 4

• 2 and 4