Which finding is most characteristic of a flail chest?

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Multiple Choice

Which finding is most characteristic of a flail chest?

Paradoxical chest movement is the hallmark of a flail chest. When several adjacent ribs are fractured in two places, a segment of the chest wall becomes detached from the rest of the thorax. During breathing, that free-floating section moves inward when you inhale and outward when you exhale, in the opposite direction of the rest of the chest. That opposite, or paradoxical, motion directly demonstrates the instability of the chest wall. Other findings can appear with chest trauma—bilateral wheezing suggests airway constriction, decreased breath sounds can come from lung contusion or a pneumothorax, and tracheal deviation points to tension pneumothorax or other shifting of the mediastinum. But none of those are the defining sign of a flail chest the way paradoxical movement is.

Paradoxical chest movement is the hallmark of a flail chest. When several adjacent ribs are fractured in two places, a segment of the chest wall becomes detached from the rest of the thorax. During breathing, that free-floating section moves inward when you inhale and outward when you exhale, in the opposite direction of the rest of the chest. That opposite, or paradoxical, motion directly demonstrates the instability of the chest wall.

Other findings can appear with chest trauma—bilateral wheezing suggests airway constriction, decreased breath sounds can come from lung contusion or a pneumothorax, and tracheal deviation points to tension pneumothorax or other shifting of the mediastinum. But none of those are the defining sign of a flail chest the way paradoxical movement is.

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