胸部闭合性损伤(肋骨骨折、血胸和气胸)考试试题

医药卫生考试：胸部闭合性损伤试题及答案（题库版）1、问答题开放性气胸的治疗原则是什么？正确答案：急救处理：将开放性气胸立即变为闭合性气胸并迅速转运。

<参考解析：试题答案急救处理：将开放性气胸立即变为闭合性气胸并迅速转运。

（江南博哥）送达医院后的处理：给氧，补充血容量，纠正休克；清创、缝合胸壁伤口，做胸腔闭式引流；给予抗生素，鼓励病人咳嗽排痰，预防感染；如疑有胸腔内脏器严重损伤或进行性出血，则需行开胸探查。

2、问答?气胸是指？正确答案：胸膜腔内积气称为气胸。

气胸的形成多由于肺组织、气管、支参考解析：试题答案胸膜腔内积气称为气胸。

气胸的形成多由于肺组织、气管、支气管、食管破裂，空气逸入胸膜腔，或因胸壁伤口穿破胸膜腔与外界沟通，外界空气进入所致。

3、问答题单纯肋骨骨折是指？正确答案：指肋骨骨折不伴有呼吸运动异常、不伴血胸和气胸等并发症。

参考解析：试题答案指肋骨骨折不伴有呼吸运动异常、不伴血胸和气胸等并发症。

4、问答题闭合性气胸的临床表现及诊断要点？正确答案：闭合性气胸：轻者病人可无明显症状，重者有呼吸困难。

查体参考解析：试题答案闭合性气胸：轻者病人可无明显症状，重者有呼吸困难。

查体可发现伤侧胸廓饱满，呼吸活动度降低，气管向健侧移位，伤侧胸部叩诊呈鼓音，呼吸音降低。

胸部X线检查可见肺萎缩和胸膜腔积气。

5、问答?血胸的诊断要点、临床表现是什么？正确答案：（1）临床表现：血胸在临床上主要表现为失血，依失血量多参考解析：试题答案（1）临床表现：血胸在临床上主要表现为失血，依失血量多少而临床症状不同，可以从无症状、心悸，到躁动不安、失血性休克。

体检时可见伤侧呼吸运动减弱，肋间隙饱满，患侧叩诊为实音，呼吸音减弱或消失。

胸腔内大量积血可压迫肺脏使肺萎陷，纵隔、气管向健侧移位。

进行性血胸凝固性血胸感染性血胸（2）放射学征象：X线胸像上，小量血胸可见到伤侧肋膈角变钝，液面不超过膈顶；中量血胸液面达到肺门水平；大量血胸液平面超过肺门水平。

胸部损伤相关试题（一）A1型题1.胸部损伤中，发生率最高的是A.气胸B.血胸C.血气胸D.肋骨骨折E.胸腹联合伤2.肋骨骨折的好发部位是A.1~3肋骨B.4~7肋骨C.8~9肋骨D.10~11肋骨E.第12肋骨3.纵隔扑动指的是A,吸气时纵隔不动，呼气时纵隔摆向伤侧B.吸气时纵隔向伤侧移位，呼气时纵隔不动C.吸气时纵隔向健侧移位，呼气时纵隔不动D.吸气时纵隔向健侧移位，呼气时纵隔摆向伤侧E.吸气时纵隔向伤侧移位，呼气时纵隔摆向健侧4.张力性气胸最确切的诊断依据是A.伤侧肺呼吸音消失B.广泛而严重的皮下气肿C.胸膜腔穿刺抽出高压气体D.胸部X线见伤肺完全萎陷E.严重缺氧导致呼吸循环衰竭5.引流气胸的最佳位置A.腋中线第6肋间B.腋中线第7肋间C.锁骨中线第1肋间D.锁骨中线第2肋间E.锁骨中线第3肋间6.开放性气胸首要的急救措施是A.纠正休克B.封盖伤口C.清创缝合D.胸膜腔穿刺E.胸膜腔引流7.Beck三联征是A.静脉压降低，心搏微弱，动脉压降低B.静脉压升高，呼吸困难，动脉压降低C.静脉压升高，心悸胸闷，动脉压降低D.静脉压降低，呼吸困难，动脉压升高E.静脉压升高，心搏微弱，动脉压降低8.创伤性窒息的病因是A.张力性气胸B.严重的肺挫伤C.多发性肋骨骨折D.严重的胸部挤压伤E.毒性气体的吸收造成严重的肺损伤9.胸部损伤剖胸探查的禁忌证是A.心脏损伤B.肺爆震伤C.胸腹联合伤D.广泛肺裂伤E.胸膜腔内进行性出血10.闭合性气胸的病人如无明显症状，肺菱陷应小于A.10%B.20%C.30%D.40%E.50%。

胸部损伤有关试题及答案一、单选题1. 胸部损伤中，最常见的损伤类型是：A. 肋骨骨折B. 气胸C. 血胸D. 肺挫伤答案：A2. 胸部损伤后，以下哪项检查对于诊断气胸最为重要？A. 胸部X线片B. 胸部CTC. 胸部超声D. 胸部MRI答案：A3. 胸部损伤后，以下哪项症状提示可能存在张力性气胸？A. 胸痛B. 呼吸困难C. 脉搏细速D. 血压下降答案：B4. 胸部损伤后，以下哪项体征提示可能存在血胸？A. 叩诊实音B. 叩诊鼓音C. 叩诊浊音D. 叩诊清音答案：A5. 胸部损伤后，以下哪项检查对于诊断肋骨骨折最为直接？A. 胸部X线片B. 胸部CTD. 胸部超声答案：B二、多选题1. 胸部损伤后，以下哪些症状可能提示存在肺挫伤？A. 胸痛B. 呼吸困难C. 咳嗽D. 血痰答案：ABCD2. 胸部损伤后，以下哪些体征可能提示存在张力性气胸？A. 气管偏移B. 呼吸音减弱C. 脉搏细速答案：ABCD3. 胸部损伤后，以下哪些检查可能有助于诊断血胸？A. 胸部X线片B. 胸部CTC. 胸部超声D. 胸腔穿刺答案：ABCD4. 胸部损伤后，以下哪些情况需要紧急处理？A. 张力性气胸B. 大量血胸C. 心脏压塞D. 肋骨骨折合并肺挫伤答案：ABC三、判断题1. 胸部损伤后，所有患者都需要进行胸部CT检查。

（错误）2. 胸部损伤后，如果患者出现呼吸困难，应立即进行胸部X线片检查。

（正确）3. 胸部损伤后，如果患者出现脉搏细速和血压下降，应立即考虑张力性气胸。

（正确）4. 胸部损伤后，如果患者出现叩诊实音，应立即考虑血胸。

（正确）5. 胸部损伤后，如果患者出现血痰，应立即考虑肺挫伤。

（正确）四、简答题1. 简述胸部损伤后常见的并发症有哪些？答：胸部损伤后常见的并发症包括气胸、血胸、肺挫伤、肋骨骨折、心脏压塞、气管支气管损伤等。

2. 简述胸部损伤后张力性气胸的临床表现。

答：张力性气胸的临床表现包括突发性胸痛、呼吸困难、脉搏细速、血压下降，以及气管偏移、呼吸音减弱等。

外科学胸部损伤试题及答案一、选择题1. 下列哪项不是开放性胸部损伤的特点？A. 胸壁可见伤口B. 胸膜完整性受损C. 胸内器官可能暴露D. 损伤程度较轻答案：D2. 张力性气胸的紧急处理措施是：A. 立即行胸腔闭式引流B. 给予高流量吸氧C. 立即进行胸腔穿刺抽气D. 立即进行胸腔镜检查答案：C3. 以下哪项不是闭合性胸部损伤的常见类型？A. 肋骨骨折B. 气胸C. 血胸D. 腹膜炎答案：D4. 胸部损伤后，患者出现进行性呼吸困难，首先应考虑的并发症是：A. 肺挫伤B. 张力性气胸C. 心脏挫伤D. 肋骨骨折答案：B5. 对于胸部损伤患者，以下哪项检查不是常规首选？A. 胸部X线片B. 胸部CTC. 胸部超声D. 心电图答案：C二、简答题1. 简述胸部损伤的临床分类。

答：胸部损伤根据损伤的类型可以分为开放性胸部损伤和闭合性胸部损伤。

开放性胸部损伤通常由锐器或火器造成，胸壁有可见伤口，胸膜完整性受损，胸内器官可能暴露。

闭合性胸部损伤则是由于外力作用于胸壁，但胸壁完整性未被破坏，常见的有肋骨骨折、气胸、血胸等。

2. 张力性气胸的临床表现有哪些？答：张力性气胸的临床表现包括：患者出现严重呼吸困难、发绀、大汗淋漓、烦躁不安；气管和心脏向健侧移位；患侧胸部隆起，呼吸运动减弱；叩诊呈鼓音；听诊呼吸音消失。

3. 胸部损伤后，如何进行初步评估？答：胸部损伤后的初步评估包括：询问病史，了解损伤的机制和程度；进行全面的体格检查，包括观察胸壁是否有开放性伤口，评估呼吸运动是否对称，听诊呼吸音是否存在，观察有无气胸或血胸的体征；进行必要的辅助检查，如胸部X线片、CT扫描或超声检查，以确定损伤的具体类型和程度。

三、病例分析题1. 患者男性，35岁，车祸后被送至急诊。

患者主诉胸痛、呼吸困难。

体检发现右侧胸壁有一处开放性伤口，伤口处有气体进出的声音，呼吸时可见反常呼吸运动。

请问该患者可能的诊断是什么？应采取哪些紧急处理措施？答：该患者可能的诊断是开放性气胸。

医师练习题--胸部损伤1.诊断张力性气胸最充分的根据是A.呼吸困难并伴有皮下气肿B.伤侧胸部叩诊呈高调鼓音C.伤侧呼吸音消失D.X线所见纵隔向健侧移位E.胸膜腔抽出高压气体2.可致纵隔扑动的疾病是A.闭合性气胸B.张力性气胸C.开放性气胸D.血气胸E.脓胸3.单侧多根多处肋骨骨折最严重的生理改变是A.疼痛、呼吸运动减弱B.胸壁软化，反常呼吸C.咳嗽，血痰D.严重皮下气肿E.出血，休克4.闭合性肋骨骨折的治疗要点是A.止痛、防治并发症B.胸腔穿刺C.胸腔闭式引流D.开胸探查E.气管插管或气管切开5.血胸活动性出血的征象不包括A.脉快、血压下降，补液后血压不升或回升后又下降B.血红蛋白、血球压积持续降低C.胸片阴影逐渐增大D.穿刺液涂片红细胞与白细胞之比为100：1E.闭式引流量连续3小时，每小时超过200ml6.血胸欲行胸腔闭式引流术的最佳引流位置是A. 腋前线第6～8肋间B. 腋前线与腋中线之间第6-8肋间C. 腋中线第6~8肋间D. 腋中线与腋后线之间第6-8肋间E. 随后线第6～8肋间7.外伤性血气胸最简便可靠的诊断依据是A.呼吸困难B.气管移位C.胸透见有液平面D.胸穿抽出血液和气体E. 胸部超声探查见有液平面8.胸部损伤的主要临床表现有A.胸痛B.呼吸困难C.略血D.循环衰竭E.咳痰9.关于肋骨骨折，下列选项错误的是A.老年人骨质较疏松，容易折断B.肋骨骨折常易合并血胸、气胸C.骨摩擦音是诊断肋骨骨折的有力证据D.胸片可明确骨折的数目E.助软骨骨折亦可经胸片发现10.多根多处肋骨骨折的紧急处理首先是拉A.给氧B.输血C.加压包扎D.大量抗生素E.手术固定11.老年人肋骨骨折，咳嗽时引起胸部剧痛，最好采用A.胸壁胶布固定B.吗啡皮下注射C.口服可待因D.肋间神经阻滞E.肋骨牵引固定12.单根单处助骨骨折的主要表现是A.局部疼痛B.呼吸困难C.皮下气肿D.骨摩擦音E.局部畸形13.肋骨骨折治疗原则不包括A.止痛B.清理呼吸道分泌物C.固定胸廓D.防止并发症E.立即急诊手术治疗14.开放性气胸的现场急救措施为A.给氧、输液B.胸穿抽气C.清创术D.立即用清洁物品填塞伤口E.镇静、止痛15.右胸外伤后，稍感气促，右肺呼吸音减低，X线检查右侧气胸10%，第4肋右端有骨折线，无移位。

After the transfusion of blood transfusion, the blood pressure did not rise or fall rapidlyEWhich of the following is falseA side negative pressure disappearsB the side of the lung collapsedThe convection of some of the gas in the lungD mediastinumE injured side has abnormal breathingEThe most important first aid for patients with open air chest breathing difficultiesA oxygenB transfusionC-trachea cannula is assisted breathingD immediately dissection the chestE quickly closed the chest woundEThe major pathophysiological changes of the tension pneumothoraxA medially shifts away from the edgeB mediastinumC chest wall abnormal breathingD lung convection in the lungSubcutaneous emphysemaa.The tension pneumothorax causes shock・ First aid is firstA blood transfusionB boosterC is anti-shock and open chestD suffers from lateral chest decompressionE trachea intubation assists breathingThe most reliable basis for the diagnosis of blood chest secondary infectionA cold war, high feverB cell count goes upC thoracic puncture, the ratio of red blood cells to white blood cells is 300:1D chest piercing fluidE puncture liquid is found in bacteria, and bacterial culture is positiveEAfter chest injury, the venous vein of the neck vein, qi, blood pressure drop, and the pulse differential decrease, the first thought should beA closed pneumothoraxB tension pneumothoraxC traumatic pneumothoraxD traumatic blood pericardiumE traumatic asphyxiaDA patient has been hit by a car and injured his right chest 20 times・ The chest X-ray examines the right side of the chest, the lung is 20%, and the fourth rib has a fracture line・ Principles of management isA chest exhaustB general observationC intercostal closed drainageD traction fixationEgum fixationBChest trauma 2 hours・ Check body: pulse 120 times・ Divide, blood pressure 12.8 kPa, right chest can touch bone rub and subcutaneous emphysema, percussion drum sound, breath sound disappear, emergency treatment isA transfusion, rehydration, shock resistanceB immediately exhaust in the chestC tape fixationD applied to the boosterOxygen inhalationBMale, 25 years old, the house collapses, upper body is crushed, the hospital is admitted in 20 minutes, the mind is clear, the breath is difficult, no abdominal pain and vomiting・Physical examination: the temperature is 36. 5 °C, pulse is 100 times/min, b lood pressure is 16/10 kpa, breathing 30 times/min, pupillary reflex is normal, palpebral conjunctiva hemorrhage, neck limbs to normal. Test: Hbl2g, WBC 10 x 10 to the 9th/L, chest X-ray and normal normal, the maximum possible diagnosis isA crush syndromeB extensive soft tissue contusionC traumatic shockD damage asphyxiaE brain injuryDMale, 25 years old, 12 hours after injury・Pulse 100 times/cent, blood pressure 16/10kpa, breathing 30 times/min, the side chest has accumulated fluid, the chest is drawn out of the blood, theblood will not solidify after resting, the main treatment isA immediately open the chest operation to stop the bleedingB transfusion infusionC thoracic puncture removes the accumulation of bloodD zhou body antibiotics to prevent infectionE thoracic closed drainageCMale, 28 years old, car driver, front chest hits the steering wheel, injured about an hour・ Physical examination: clear consciousness, pulse is 130 / cent, pulsus paradoxus (+), blood pressure is 12/10.7 kPa, breathing 32 times/min, jugular vein engorgement, cardiac dullness to expand, the weak heart sounds, two normal lung breath sounds, diagnosis is most likelyA closed pneumothoraxB tension pneumothoraxC pulmonary contusionD hemothoraxE pericardial blood Right blood chest patient, emergency hospital admission. Physical examination: 120 times/min pulse, blood pressure10. 7/6・ 7 kPa, trachea left, blood transfusion and make rightthoracic closed drainage, 1 hour of 200 ml, 2 hours is 250 ml, the third hour of 180 ml, blood pressure is not pick up through a blood transfusion, it is the most effective treatmentA continues the transfusionb-hemostaticC cut the chest to stop the bleedingD. closed drainage with negative pressureE to the vasculatureCPatients with chest injury, emergency hospital admission, oxygen and breathing difficulties, cyanosis, shock・Physical examination: left breast plump, trachea shift to the right, the left can reach the bone fricative, drums of knocking sound, auscultation breath sounds disappeared, subcutaneous emphysema, diagnosis is considered in the first placeA rib fractureB tension pneumothoraxC rib fracture and tension pneumothoraxD pericardial bloodE closedCOne tension pneumothorax is admitted in the emergency room・ X ray film completely right lung atrophy, mediastinal shift to the right, immediately to the second floor right collarbone midline between closed drainage overflow of gas, but the patient breathing difficulties, better left breath sounds disappeared, subcutaneous emphysema have spread, this diagnosis should be consideredA bronchobronchial or lung is widely fracturedB esophageal fissureC drainage tube is too highD pericardial bloodE concurrent blood chesta.Men, 30 years old, were injured in a car accident for half an hour. Physical examination: cyanosis, restlessness, difficulty breathing ・ The left side of the chest is softened, and the two lungs are wet・ The first treatment isA emergency breast surgeryB oxygen and atomization inhalationC clears the respiratory secretionsD softens the chest wall tractionE to the left thoracic drainageCMen, 40 years old, were injured in a car accident for two hours・Physical examination: cyanosis, difficulty breathing・ The left side of the chest softened・ Which of the following is wrong when the chest wall is towed to the wallA fixed time is 3 to 4 weeksThe weight of B is 2 3kgC grip the central part of the ribsD is suitable for the fixation of the bandageE does not apply to patients with open rib fracturesa.Men, 20 years, and right thoracic knife were stabbed for 1 hour, which of the following is inaccurate about progressive blood chestA pulse increases rapidly and blood pressure continues to declineB pleural cavity f1ow is equal to 200ml/hAfter the infusion of blood transfusion, the blood pressure went up and fell rapidlyA continuous review of D hemoglobin, red blood cell count and red blood cell pressure is continuously reducedE pleural cavity puncture does not take out blood, but the chest film indicates that the shadow of the pleura is enlargedBMale, 34 years old, right breast car accident injured 1 hour, breathing difficulty, cyanosis・ Check body: the right anterior chest can see the abnormal breathing movement・ When the patient inhales, which of the following pathologic changes is incorrectA softens the chest wa11B mediastinum to the healthy sideC is going up in the mediastusD venous reflux is blockedE carbon dioxide is strandedCMen, 38, were injured in a car accident for three hours・ X-ray examination of the right lung compression 20 percent, the 5th rib single fracture・ Treatment should be preferredA oxygenB sedative, pain reliefC-chest exhaustD pleural cavity drainageE keeps the airways openBMen, 33 years old, a car accident in the right breast injured an hour ・ The difficulty of breathing, the cyanosis・ Check body: pulse 130 times, blood pressure 76/50mmhg, right anterior chest and subcutaneous emphysema, right thoracic sound, and the right lung breath is gone・ The most likely diagnosis isA tension pneumothoraxB closed the chestC traumatic blood chestD traumatic shockE multiple rib fracturesa.The man, 38, was injured in a car accident for half an hour・Check: cyanosis, irritability, difficulty breathing. At the Sth rib of the left breast, the diameter is approximately 4cm in diameter and it can smell and air・ The pathophysiological change of this case isA mediastinum causes circulatory failureB acute pulmonary edema leads to reduced gas exchangeC. mediastinum is shifted to the side and the side of the lung is compensatedIncreased pressure in the D pleural cavity causes respiratory failureE in the inhalation, the pressure increases in the lateral thoracic cavity, and the mediastinum is on the injured side a.Male, 44 years old, right breast car accident 2 hours, breathing difficulty, cyanosis・ Check body: no abnormal breathing movement in the right anterior chest・ Chest compressional test positive, right lung breath tone decreases・ The chest film shows a fracture in the back end of the ribs on the right side・ The wrong thing to do isA chestB traction fixationC sedative analgesiaD applied antibioticsE clears the respiratory secretionsBMen, 7 years old, fell down from a truck six hours ago, and they had difficulty breathing and gradually increased・ Admission check: pulse 130 beats per cent, blood pressure 10. 7/6.7 kPa,The breathing is difficult to breathe・ The chest has a subcutaneous emphysema, the trachea is shifted to the left, and the right breath disappears・ The diagnosis was first thoughtA dogan suffered A broken ribB hemothoraxC pericardial bloodD is open to the chestE tension pneumothoraxEMen, 7 years old, fell down from a truck six hours ago, and they had difficulty breathing and gradually increased. The admission charge: 130 times/min pulse, blood pressure 10. 7/6・ 7 kPa, breath is 22 times/min, facial cyanosis, inspiratory dyspnea, chest neck subcutaneous emphysema, tracheal shift to the left, the right side of the breath sounds・ First aid measures areA immediately the infusion of blood transfusion was anti-shockB is anti-shock and open the chestC-thoracic closed drainage is decompressionD mass absorption of oxygenE ventilator assisted breathingCMale, 32 years old, 30 minutes of chest bump, conscious right chest pain・ Check body: pulse 80 times/cent, blood pressure 120/80mnihg, breathing 16 times/cent, the tracheal center, the right and left chest all have the tenderness, the two lung breath sound exists・The most likely diagnosis is the diagnosisA pneumothoraxB hemothoraxC hemopneumothoraxD dogan suffered a broken ribE simple rib fractureEMale, 32 years old, 30 minutes after chest bump, conscious rightchest pain・ Check body: pulse 80 times/cent, blood pressure120/80mmhg, breathing 16 times/cent, the tracheal center, the right and left chest all have the tenderness, the two lung breath sound exists・ The principle isA adhesiveB pressure is fixedInternal fixation of CD traction fixationE thoracic closed drainagea.The patient was injured in the chest and was admitted to the emergency room・ Through oxygen and oxygen, the difficulty of breathing is not improved, and there is cyanosis and shock・ Check body: the left breast is full, the trachea moves to the right, the left side can touch the bone, the rattle, the listening to the breath, the subcutaneous emphysema is obvious・ The first consideration is the diagnosisA rib fractureB tension pneumothoraxC rib fracture and tension pneumothoraxD pericardial bloodE frameCThe patient was injured in the chest and was admitted to the emergency room・ Through oxygen and oxygen, the difficulty of breathing is not improved, and there is cyanosis and shock. Check body: the left breast is full, the trachea moves to the right, the left side can touch the bone, the rattle, the listening to the breath, the subcutaneous emphysema is obvious・ Principles of management isA booster is anti-shockB immediately cut the chestC ribs are fixed, chest exhaustD respirator pressurized breathingE rapid transfusion infusionC46.Male, 30 years old, left chest and a half hours and physical examination: restlessness, damp, cool skin was pale, breathing difficulties, veins thin, 140 / cent, jugular vein engorgement, blood pressure is 70/50 MMHG. See about 4cm knife wound in the 5th rib of left front chest・ The pathophysiological change of thiscase isA low blood volume shockB mediastinum, the heart is pressedPressure continued to rise in the left chest of CThe D is blocked, and the blood flow decreasesE mediastinum, respiratory failure47.Male, 30 years old, left chest knife stabbing and a half hours, physical examination, dysphoria, damp, cool skin was pale, breathing difficulties, veins thin, 140 / cent, jugular vein engorgement, blood pressure is 70/50 MMHG・ See about 4cm knife wound in the 5th rib of left front chest・ The most likely diagnosis isA heart pressure plugB hemorrhagic shockProgressive blood chest on the left side of CD is the tension pneumothorax on the leftE the heart of the heart rupturesa.48.Male, 30 years old, left chest and a half hours and physicalexamination: restlessness, damp, cool skin was pale, breathing difficulties, veins thin, 140 / cent, jugular vein engorgement, blood pressure is 70/50 MMHG. See about 4cm knife wound in the 5th rib of left front chest・The best choice for both diagnostic and therapeutic value isA pleural punctureB pericardial punctureC thoracoscopyD cardiac catheterizationThe closed drainage of the E thoracic cavityB49.Male, 30 years old, left chest knife stabbing and a half hours, physical examination, dysphoria, damp, cool skin was pale,breathing difficulties, veins thin, 140 / cent, jugular vein engorgement, blood pressure is 70/50 MMHG・ See about 4cm knife wound in the 5th rib of left front chest・ When the diagnosis is clear, the correct treatment should be doneThe pleural cavity is attracted to the negative pressure of the closed drainageB rapid blood transfusion, rehydration, shock resistanceC pericardium puncture decompression and emergency operationThe D trachea is cut and the breathing machine assists breathingAfter the rapid expansion of E, the application of vascularized drugsCMen, 25, were injured in a car accident for an hour・ Check body: pulse 130 times, blood pressure 86/60mmhg・ Fidgeting, cyanosis, severe breathing difficulties, cold skin, skin of the left cervical chest, the right movement of the trachea, the left breast full, the left lung breathing out・ The left lung of the chest was completely lost・ The most likely diagnosis isA left side of the blood chestThe left of B is closedOpen air on the left side of CD is the tension pneumothorax on the leftE to the leftDMen, 25, were injured in a car accident for an hour・ Check body: pulse 130 times, blood pressure 86/60mmhg・ Fidgeting, cyanosis, severe breathing difficulties, cold skin, skin of the left cervical chest, the right movement of the trachea, the left breast full, the left lung breathing out・ The left lung of the chest was completelylost・ First aid treatment isA shock resistantB tube intubationC high flow of oxygenD ventilator assisted breathingE to the left parietal pleuraEMen, 25, were injured in a car accident for an hour・ Check body: pulse 130 times, blood pressure 86/60mmhg・ Fidgeting, cyanosis, severe breathing difficulties, cold skin, skin of the left cervical chest, the right movement of the trachea, the left breast full, the left lung breathing out・ The left lung of the chest was completely lost・ After emergency treatment, the disease improved rapidly and rapidly deteriorated・ The treatment should be immediateA tracheotomyB clears the respiratory secretionsC left parietal canal drainageRapid blood transfusion for DE long chest bandage with a fixed chest wallCProgressive blood chest performance is shownA abnormal breathing exerciseB pleural cavity pressure continues to riseThe D is elevated, the heart is weak, and the arterial pressure decreasesE pleural cavity drainage of > 200ml/h for 3 hoursEMultiple rib fractures occurA abnormal breathing exerciseB pleural cavity pressure continues to riseCThe D is elevated, the heart is weak, and the arterial pressure decreasesE pleural cavity drainage of > 200ml/h for 3 hoursa.The characteristic of cardiac pressure isA abnormal breathing exerciseB pleural cavity pressure continues to riseThe D is elevated, the heart is weak, and the arterial pressure decreasesE pleural cavity drainage of > 200ml/h for 3 hoursDThe tension pneumothorax is performedA abnormal breathing exerciseB pleural cavity pressure continues to riseCThe D is elevated, the heart is weak, and the arterial pressure decreasesE pleural cavity drainage of > 200ml/h for 3 hours。

胸部外伤、血胸、气胸题库1-0-8问题：[单选]胸部创伤下列哪种情况不是立即开胸探查指征（）A.进行性血胸B.食管裂伤C.胸内异物存留，有严重咯血等临床症状D.创伤性窒息E.气管、支气管断裂问题：[单选]关于肋骨骨折发生的部位与年龄，下列不正确的是（）A.第11、12肋骨前端游离不固定，易发生骨折B.第4～7肋骨较长且固定，易骨折C.儿童肋骨不易骨折D.老年人肋骨易骨折E.第1～3肋骨较少发生骨折问题：[单选]下列指标尚不能够提示存在进行性血胸的是（）A.血压逐渐下降，脉搏逐渐增快B.补液后血压不升或升高后又迅速下降C.血红蛋白、血细胞比容值持续下降D.胸腔闭式引流200mlh，持续3小时E.中心静脉压12cmH2O进行性血胸是胸部损伤行开胸手术的最常见原因，前4条均是进行性血胸的临床表现，但中心静脉压升高通常是由于右心衰或心脏压塞所致，不是进行性血胸的表现。

(辽宁11选5 )问题：[单选]胸壁软化是由于（）A.肋骨骨折伴胸骨骨折B.多根多处肋骨骨折C.两根以上肋骨骨折D.肺挫伤增加呼吸肌做功E.二氧化碳潴留问题：[单选]开放性气胸的紧急处理措施是（）A.立即行气管内插管呼吸器辅助呼吸B.快速输血、输液纠正休克C.立即行清创术D.立即用无菌不透气材料覆盖包扎伤口E.立即行胸腔闭式引流术问题：[单选]胸腔闭式引流术的适应证是（）A.脓胸脓液黏稠需要持续排脓者B.中量血胸C.气胸需要持续排气者D.开胸术后者E.以上都是问题：[单选]目前肋骨骨折后最有效的镇痛方法是（）A.口服药物镇痛B.肌注药物镇痛C.胸部宽胶布固定D.肋间神经阻滞E.肋骨牵引问题：[单选]男性，52岁。

车祸伤2小时。

体格检查：神志清，血压10575mmHg。

气管向左侧移位，右胸壁大量皮下捻发感，右胸叩诊鼓音，右侧呼吸音明显减弱。

胸片：右第4、8、9肋骨折，左第7、8、9肋骨折，右肺压缩90％。

首要的处理是（）A.牵引固定B.胸带固定C.胸腔闭式引流D.剖胸探查，修补肺破裂处E.气管插管，加压扩张肺部。

护理资格知识：肋骨骨折最常见理论考试试题及答案1.闭合性单处肋骨骨折最明显的症状是 [单选题] *A.呼吸改变B.局部疼痛(正确答案)C.排痰困难D.休克E.发热2.胸部外伤后出现胸廓软化是由于 [单选题] *A.一根肋骨多处骨折B.胸骨骨折C.锁骨骨折D.多根多段肋骨骨折(正确答案)E.胸肌大面积损伤3.判断肋骨骨折胸部检查最可靠的依据是 [单选题] *A.局部肿胀B.皮下瘀斑C.皮下气肿D.胸式呼吸消失E.直接和间接压痛(正确答案)4.可出现反复呼吸运动的是 [单选题] *A.脓胸B.桶状胸C.漏斗胸D.连枷胸(正确答案)E.血气胸5.肋骨骨折多见于 [单选题] *A.第1-3肋骨B.第4-7肋骨(正确答案)C.第7-9肋骨D.第8-10肋骨E.第11-12肋骨6.多根多处肋骨骨折导致呼吸衰竭的主要原因是 [单选题] *A.剧痛不敢呼吸B.反复呼吸运动(正确答案)C.肺不张D.纵膈摆动E.继发肺部感染7.多根多处肋骨骨折最主要的影响是 [单选题] *A.胸部疼痛B.妨碍正常呼吸C.痰不易咳出D.反常呼吸(正确答案)E.骨折端摩擦8.患者男，43岁。

因胸部挤压伤收住院。

查体：左侧胸廓塌陷畸形，左侧第3-7肋骨骨折。

此时该患者的首要评估内容是 [单选题] *A.疼痛是否可以耐受B.生命体征是否平稳C.体温是否异常D.是否有药物过敏史E.是否可以维持有效气体交换(正确答案)9.患者女，23岁，因车祸致胸部损伤后出现吸气时胸壁内陷，呼气时胸壁外凸，护士为其评估病情，应考虑为 [单选题] *A.血胸B.张力性气胸C.多根多处肋骨骨折(正确答案)D.闭合性气胸E.胸部爆震伤10.患者，男，37岁。

2日前不慎从高处坠下后发生多根多处肋骨骨折，立即进行手术，下列不属于术后促进患者排痰的方法是 [单选题] *A.鼓励患者咳嗽、咳痰B.痰液粘稠给予雾化吸入C.指导患者深呼吸和有效地咳嗽、咳痰D.刺激气管诱发咳嗽、排痰E.用面罩法使患者充分吸氧(正确答案)11.患者男，28岁。

胸部损伤病人的护理相关试题及答案1,最常见的胸部损伤是A,肋骨骨折B.开放性气胸C.张力性气胸D.血胸E.胸壁软组织损伤答案：A2.最易发生肋骨骨折的是A.第1~3肋B.第4~7肋C.第7~8肋D.第9~10肋E.第11~12肋答案：B3.产生连枷胸的原因是A.胸骨骨折B.胸壁内陷C.多根肋骨多处骨折D.单根肋骨单处骨折E.单根肋骨多处骨折解析：严重的闭合性胸部损伤导致多根多处肋骨骨折，使局部胸壁失去肋骨支撑而软化，并出现反常呼吸，即吸气时软化区胸壁内陷，呼气时外突，称为连枷胸。

答案：C4.开放性气胸产生纵隔摆动的主要原因是A.伤侧肺萎缩B.健侧肺膨胀不全C.纵隔移向健侧D.吸气与呼气时两侧胸膜腔内的压力改变E.伤侧胸膜腔内压力超过大气压解析：开放性气胸时，吸气与呼气时两侧胸膜腔内的压力差改变，从而引起纵隔摆动（或扑动）和残气对流（或摆动气)，导致严重的通气、换气功能障碍。

答案：D5.中量血胸是指胸膜腔内积血A.200ml以下B.200~300mlC.300~500mlD.500~1000mlE.1000ml以上解析：小量血胸成人积血量<0.5L；中量血胸（积血量约0.5~1L)；大量血胸(积血量>1L)。

答案：D6.损伤性血胸病人胸腔内积血不凝固的原因是A.出血量太大B.凝血因子减少C.胸腔内存在抗凝物质D.肺及膈肌的去纤维化作用E.胸腔内渗出液的稀释作用解析：由于心、肺和膈肌的运动有去纤维蛋白的作用，故胸膜腔内的积血不易凝固。

但若短期内大量积血，去纤维蛋白的作用不完善，即可凝固成血块。

答案：D7.张力性气胸最主要的病理生理变化是A.反常呼吸运动B.纵隔摆动C.进行性伤侧肺压缩D.呼吸无效腔增加E.血氧分压下降解析：张力性气胸其裂口与胸膜腔相通，且形成活瓣，致吸气时空气从裂口进入胸膜腔内，呼气时活瓣关闭，空气只能进入而不能排出，使胸膜腔内积气不断增多，压力不断升高。

胸膜腔内的高压迫使伤侧肺逐渐萎缩。

胸部外伤、血胸、气胸题库6-1-8问题：[单选]女性，35岁，胸部外伤后，除外下列哪一项情况，应及时剖胸探查（）A.胸膜腔进行性出血B.胸腹联合伤C.肋骨骨折，合并伤侧肺压缩50%D.胸内异物存留E.心脏损伤问题：[单选]男性，29岁，胸部外伤后，出现下列征象中，除外哪一种情况皆提示胸内进行性出血（）A.血压持续下降，脉搏逐渐增快B.经输血、补液后，血压才开始回升C.复查血红蛋白和红细胞压积继续降低D.胸穿抽出不凝血，胸片提示胸膜腔阴影增大E.胸腔闭式引流量200mlh，持续3小时问题：[单选]损伤性血胸，胸腔内积血不凝固的原因是（）A.胸腔内渗出液稀释B.多种凝血因子的减少C.主要是凝血酶原减少D.肺、心脏、膈活动去纤维蛋白作用E.出血量太少肺、心脏、膈活动的去纤维蛋白作用可以使胸腔内的中少量积血不凝固，但当胸腔内出血量较大或较迅速时也可以凝固。

(11选5 )问题：[单选]胸部损伤后咯血或痰中带血提示（）A.血胸B.气胸C.肺或支气管损伤D.食管损伤E.肋骨骨折问题：[单选]胸部损伤后出现颈静脉怒张、奇脉、血压下降，脉压差变小，此时首先应想到（）A.张力性气胸B.闭合性气胸C.外伤性气胸D.外伤性血心包E.气管断裂问题：[单选]开放性气胸患者呼吸困难最主要的急救措施是（）A.输血补液B.吸氧C.气管插管行辅助呼吸D.迅速封闭胸部伤口E.应用激素开放性气胸时由于健侧胸腔压力仍可随呼吸周期而增减，从而引起纵隔摆动（或扑动）和残气对流（或摆动气），导致严重的通气、换气功能障碍。

同时纵隔摆动引起心脏大血管来回扭曲以及胸腔负压受损，使静脉血回流受阻，心排出量减少。

所以应迅速封闭胸部伤口，改开放性气胸为封闭性气胸，再行胸腔闭式引流。

问题：[单选]开放性气胸紧急现场处理为（）A.胸腔闭式引流术B.气管内插管，呼吸机呼气末正压通气C.迅速封闭胸壁创口D.吸氧E.剖胸探查术开放性气胸急救应立即用凡士林纱布、棉垫、毛巾或衣服等，封闭胸壁伤口，有效堵塞的标志是不再听到空气进出的响声，变开放性气胸为闭合性气胸，再穿刺抽气减压，暂时缓解呼吸困难，然后加压包扎，尽快送医院急救。