Advanced Trauma Life Support (ATLS) 2025 – 400 Free Practice Questions to Pass the Exam

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What should be palpated during chest wall examination in a trauma assessment?

Heart sounds

Crepitus and deformity

During a trauma assessment, palpating for crepitus and deformity of the chest wall is critical for several reasons. Crepitus may indicate the presence of air in the subcutaneous tissue, which is often associated with pneumothorax or other traumatic injuries that allow air to escape from the respiratory tract or lung parenchyma. Detecting crepitus can help in identifying significant injuries that require immediate medical attention.

Deformity of the chest wall, such as flail segments or rib fractures, can provide insights into the severity and type of trauma sustained. Flail chest—a condition where multiple adjacent ribs are fractured in multiple places—can compromise respiratory mechanics and necessitate urgent intervention. Thus, palpating for both crepitus and deformity is crucial for determining the extent of injury and guiding further evaluation and treatment.

The other options, while important in the overall assessment of a patient, do not provide the same immediate diagnostic value regarding structural integrity and injury to the thoracic system as palpating for crepitus and deformity does. Heart sounds primarily indicate cardiac function rather than chest wall injury, and while skin temperature and external bleeding can inform about the patient's overall condition and circulation, they do not specifically assess for injuries related to the chest

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Skin temperature

External bleeding

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