A 32-year-old man is brought to the emergency department after a high-speed motor vehicle accident. He is experiencing severe chest pain and difficulty breathing. On physical examination, the physician observes abnormal chest movements during respiration.
Which of the following is characteristic of flail chest?
A. Painless condition
B. Usually result from stab trauma to chest
C. Characterized by paradoxical movements of chest
D. Two or less ribs are fractured at one place
Answer:
The Correct Answer is: C. Characterized by paradoxical movements of chest
Explanation:
Characterized by paradoxical movements of chest (C):
– Flail chest is a serious condition that occurs when multiple adjacent ribs are fractured in more than one place, creating a segment of the chest wall that moves independently from the rest of the chest.
– This “flail segment” exhibits paradoxical movement during respiration: it moves inward during inspiration and outward during expiration, which is the opposite of normal chest wall movement. This paradoxical movement can severely impair ventilation and oxygenation.
Explanation of Incorrect Options:
Painless condition (A):
– Flail chest is typically a very painful condition due to multiple rib fractures. The pain can severely impair the patient’s ability to breathe deeply and cough, leading to complications like pneumonia.
Usually result from stab trauma to chest (B):
– Flail chest is most commonly the result of blunt trauma, such as that sustained in motor vehicle accidents or falls. While stab wounds can cause significant chest injuries, they do not typically result in the multiple rib fractures needed to create a flail segment.
Two or less ribs are fractured at one place (D):
– Flail chest involves the fracture of three or more adjacent ribs in at least two places. This creates a segment of the chest wall that loses its structural integrity and moves paradoxically.
In conclusion, flail chest is characterized by paradoxical movements of the chest, making option C the correct answer.