Florida State Paramedic Practice Exam

In regards to a thoracic injury, which sign might suggest a hemothorax?

1. Flat neck veins

2. Tracheal deviation

3. Dullness upon chest percussion

4. All of the above

The correct answer is: All of the above

A hemothorax is the accumulation of blood in the pleural space and can be suggested by specific signs during a physical examination. Dullness upon chest percussion is particularly significant, as it indicates that there is fluid—such as blood—in the pleural cavity, which causes light to be transmitted differently than it would in a healthy lung filled with air. Flat neck veins can sometimes be seen in cases where intrathoracic pressure is altered, but this is less directly correlated with hemothorax than the other findings. Tracheal deviation can indicate a serious pathology, such as tension pneumothorax or significant mediastinal shift, but it may not consistently be observed in a case of hemothorax. The inclusion of all these signs collectively (dullness upon chest percussion, flat neck veins, and tracheal deviation) contributes to a comprehensive clinical assessment, suggesting that a hemothorax could be present. However, the primary indicator among these choices is the dullness upon percussion; it is the most direct clue indicating the presence of blood in the pleural space. Thus, while all signs might contribute to the clinical picture and warrant further evaluation, the standout sign for a suspected hemothorax is the