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Following blunt trauma to the chest, a 33-year-old male has shallow, painful breathing. On assessment, you note that an area to the left side of his chest collapses during inhalation and bulges during exhalation. These are signs of a/an:
flail chest.
isolated rib fracture.
pneumothorax.
pulmonary contusion.
The correct answer is: flail chest.
Following blunt trauma to the chest, the signs of a flail chest include paradoxical movement of a segment of the chest wall separate from the rest of the thoracic cage. This segment collapses inward during inhalation and bulges outward during exhalation due to the loss of bony support in the affected area. This results in a decrease in the efficiency of ventilation, causing shallow, painful breathing. In contrast, while isolated rib fractures can cause pain with breathing, they do not typically result in paradoxical chest movement. Pneumothorax involves the presence of air in the pleural space, leading to lung collapse and potentially causing respiratory distress, but it does not display the characteristic paradoxical chest wall movement seen in flail chest. Pulmonary contusion refers to lung tissue injury and bleeding due to blunt chest trauma, which can cause respiratory distress and may be accompanied by bruising, but it does not involve the distinct paradoxical chest wall movement observed in flail chest.