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TCRN Test Review Questions and Answers - Trunk $16.99   Add to cart

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TCRN Test Review Questions and Answers - Trunk

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TCRN Test Review Questions and Answers - Trunk

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  • October 5, 2024
  • 51
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
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TCRN Review - Trunk




What is a collection of excess fluid between the visceral pericardium and the parietal pericardium? -
Answer -Pericardial Tamponade



What are the classic signs and symptoms of a pericardial tamponade? - Answer -Beck's Triad



What are the 3 findings in Beck's Triad? - Answer -Muffled heart tones

Systemic Hypotension

Distended Neck Veins (may not be present with hypovolemia)



What are the cardiovascular effects of Pericardial Tamponade? - Answer -Elevated CVP

Narrowed Pulse Pressure

Rapidly falling cardiac output

Tachycardia

Pulsus alternans

Blunting of the QRS complex

Pulseless Electrical Activity

Pulsus paradoxus or paradoxical pulse



What is Pulsus Alternans? - Answer -Alternating morphology of the QRS complex

,What is pulsus paradoxus or paradoxical pulse? - Answer -A change of more than 10 mmHg in arterial
pressure during inspiration



How is pulsus paradoxus or paradoxical pulse found? - Answer -Usually seen as a decreased amplitude
on the arterial waveform, but may also be palpated as a reduction in the strength of the radial pulse
during inspiration.



What are the non-cardiac indications of a pericardial tamponade? - Answer -Grey, death-like appearance

Extreme anxiety

Inability to lie supine

Dyspnea

Cyanosis



How is pericardial tamponade diagnosed? - Answer -Clinically or via FAST exam



What is the treatment for pericardial tamponade? - Answer -Pericardiocentesis

Observe monitor for ventricular irritation during insertion



How do you determine if blood aspirated from a pericardiocentesis is pericardial blood or ventricular
blood? - Answer -Pericardial blood WILL NOT clot

Ventricular blood WILL clot



In blunt cardiac injury, what part of the heart is most likely to be injured? - Answer -Right ventricle
(anterior chest)



Blunt cardiac injury is frequently associated with _____ and _____. - Answer -External chest wall trauma

Fractures of the sternum or ribs overlying the heart



What are the symptoms of blunt cardiac injury? - Answer -Electrical disturbances

Chest Pain

,Heart Failure



Describe electrical disturbances associated with blunt cardiac injury. - Answer -PVC's

A-Fib

Atrioventricular blocks

S-T segment changes



What is the treatment for electrical disturbances associated with blunt cardiac injury? - Answer -
Continuous ECG monitoring

Antiarrhythmics for clinically significant arrhythmias



Describe chest pain associated with blunt cardiac injury and its treatment. - Answer -Does not radiate or
respond to standard treatment for chest pain.

Treatments: analgesia and treat as per MI



Describe heart failure associated with blunt cardiac injury. - Answer -Right sided heart failure (JVD,
Hypotension, Tachycardia)



What is the treatment for heart failure associated with blunt cardiac injury? - Answer -IV fluids per
hemodynamic parameters

Inotropic drugs



List the Great Vessels - Answer -Aorta

3 branches of the aorta: brachiocephalic, left common carotid, left subclavian

Pulmonary artery and veins

Superior Vena Cava



What percentage of aortic injuries die on scene? - Answer -80%

, Of the patients with aortic injuries that make it to the hospital, how many will die within 6 hours? -
Answer -30%



Of the patients with aortic injuries that make it to the hospital, how many will die with 24 hours? -
Answer -40%



What is the mortality rate in patients with pulmonary vascular trauma? - Answer -60%



Of patients with great vessel injuries, what percentage are asymptomatic? - Answer -30-50%



What are the subjective symptoms of great vessel injuries? - Answer -Chest pain (ripping or tearing)

Radiates through to the back

Difficulty breathing

Vagal complaints

Dysphagia



What are the objective symptoms of great vessel injuries? - Answer -Signs of hemorrhagic shock

Dyspnea

Asymmetric pulse pressure (stronger upper extremity pulses as opposed to femoral pulses)

Vascular bruits over precordium or intrascapular region

Focal neurological findings

Hoarseness



What injury does asymmetric pulse pressure indicate? - Answer -Vascular injury to the descending aorta



What are the treatments for great vessel injuries? - Answer -Keep the patient calm and quiet

Type and cross 10 units of blood (assure blood is readily available)

Beta-blockade with a goal of: SBP: 80-100 and HR 60-80

Operative management

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