Question

Following blunt force trauma to the anterior chest, a man presents with difficulty breathing, engorged jugular veins, absent breath sounds over the left side of the chest, and hypotension. Which of the following BEST describes the pathophysiology of this patient's injury?

1) Pericardial tamponade
2) Pulmonary contusion
3) Hemothorax
4) Tension pneumothorax

Answer 1

The symptoms presented are indicative of a tension pneumothorax, where increased intrathoracic pressure reduces venous return and can cause obstructive shock.

Step-by-step explanation:

The symptoms described by the student, such as difficulty breathing, engorged jugular veins, absent breath sounds over the left side of the chest, and hypotension, best match the pathophysiology of a tension pneumothorax. This condition occurs when air enters the pleural cavity and cannot escape, leading to increased intrathoracic pressure, which compresses the lung and reduces venous return to the heart. This can ultimately cause obstructive shock due to impaired cardiac output and compromised oxygen delivery to tissues. Treatments often include the insertion of a chest tube to relieve the air from the thoracic cavity and allow lung re-expansion.