TCAR EXAM WITH 100% CORRECT
ANSWERS 2026
3 questions to ask in trauma correct answers >> -what was
the dose of energy?
-where did it go?
-what injuries are likely?
2 q's to ask in GSW correct answers >> caliber
type of gun
# of entrance/exit wounds
high/low velocity
1st question to ask in any traumatic injury? correct answers
>> what was the dose of energy involved?
(was it high or low?)
what is the caliber of a bullet? correct answers >> diameter
aka diameter of a bullet correct answers >> caliber
what happens to projectiles when they enter the body correct
answers >> projectiles don't travel in a straight line
consider temporary cavity wound
,what should you consider about tissue a projectile enounters
correct answers >> temporary cavitation
primary goal of GSW surgery correct answers >> usually
damage repair & not bullet removal
-if superficial, it may migrate the surface with time
important thing to remember about retained projectiles correct
answers >> they may migrate over time. bullett migration might
explain unexplained clinical findings
(VP Cheney accidentally shot his friend while hunting in 2006. ICU
and did great. moved to an inpatient unit. had a silent MI bc a
shot gun pellets migrated into a canary artery causing an infract.
so had a MI but fibrinolytic not the answer in this case b/c it was a
"projectile embolus"
aka brestbone correct answers >> sternum
what attaches the ribs to the sternum correct answers >>
cartliage
what breaks thoracic bones correct answers >> significant
force
-1-2nd ribs, posterior ribs, sternum, scapulae, T2-10
gives us info about the force aka "dose" of energy received
consider injury to internal structures b/c force
,ribs that are the most frequently broken correct answers >>
ribs 4-9 b/c long, thin, and poorly protecte
it is harder to break a short pencil (T1-2) and easier to break a
longer one
*ask how many and where to understand the force involved
what is the significance of posterior rib fractures correct
answers >> unusual direction of injury
shorter stubby ribs
good muscle profection
**posterior rib fractures have a lot of force so need a high dose.
***PRF need a lot of force so high dose of energy. big red flag for
t-spine injury
indication of c-spine injury correct answers >> to injure c-
spine, you don't need a big energy blow. all it takes is shaking
around.
c spine versus t spine fractures correct answers >> c-spine
doesn't need a big energy blow. just some shaking around
t-spine needs a great strong direct blow (not just a shock_
treatment for rib fractures correct answers >> largely
supportive nursing care like pulmonary toilet
CXR and rib fractures correct answers >> simple rib fractures
are difficult to see on CXR and can be commonly missed
, (1/2 of all rib fractures aren't identified at the POI CXR)
identify a previous rib fracture on CXR correct answers >>
once healed, rib fractures form bony callouses and become more
visible on CXR
how to tell a pt has a pneumonia from a CXR correct answers
>> dark spot that is not equal to the opposite side
consider if a pt has a lower rib fracture correct answers >>
liver & spleen injury
acts like BBQ/marshmellow skewers
how high does the diaphragm rise on inspiration correct
answers >> level of 4th ICS
risk of rib fractures correct answers >> can puncture liver,
spleen,, diaphragm
pop lungs
+2 adjacent rib fractures correct answers >> flail chest
free floating sternum correct answers >> flail chest
definition of flail chest correct answers >> +2 adjacent rib
fracture
free floating sternum
ANSWERS 2026
3 questions to ask in trauma correct answers >> -what was
the dose of energy?
-where did it go?
-what injuries are likely?
2 q's to ask in GSW correct answers >> caliber
type of gun
# of entrance/exit wounds
high/low velocity
1st question to ask in any traumatic injury? correct answers
>> what was the dose of energy involved?
(was it high or low?)
what is the caliber of a bullet? correct answers >> diameter
aka diameter of a bullet correct answers >> caliber
what happens to projectiles when they enter the body correct
answers >> projectiles don't travel in a straight line
consider temporary cavity wound
,what should you consider about tissue a projectile enounters
correct answers >> temporary cavitation
primary goal of GSW surgery correct answers >> usually
damage repair & not bullet removal
-if superficial, it may migrate the surface with time
important thing to remember about retained projectiles correct
answers >> they may migrate over time. bullett migration might
explain unexplained clinical findings
(VP Cheney accidentally shot his friend while hunting in 2006. ICU
and did great. moved to an inpatient unit. had a silent MI bc a
shot gun pellets migrated into a canary artery causing an infract.
so had a MI but fibrinolytic not the answer in this case b/c it was a
"projectile embolus"
aka brestbone correct answers >> sternum
what attaches the ribs to the sternum correct answers >>
cartliage
what breaks thoracic bones correct answers >> significant
force
-1-2nd ribs, posterior ribs, sternum, scapulae, T2-10
gives us info about the force aka "dose" of energy received
consider injury to internal structures b/c force
,ribs that are the most frequently broken correct answers >>
ribs 4-9 b/c long, thin, and poorly protecte
it is harder to break a short pencil (T1-2) and easier to break a
longer one
*ask how many and where to understand the force involved
what is the significance of posterior rib fractures correct
answers >> unusual direction of injury
shorter stubby ribs
good muscle profection
**posterior rib fractures have a lot of force so need a high dose.
***PRF need a lot of force so high dose of energy. big red flag for
t-spine injury
indication of c-spine injury correct answers >> to injure c-
spine, you don't need a big energy blow. all it takes is shaking
around.
c spine versus t spine fractures correct answers >> c-spine
doesn't need a big energy blow. just some shaking around
t-spine needs a great strong direct blow (not just a shock_
treatment for rib fractures correct answers >> largely
supportive nursing care like pulmonary toilet
CXR and rib fractures correct answers >> simple rib fractures
are difficult to see on CXR and can be commonly missed
, (1/2 of all rib fractures aren't identified at the POI CXR)
identify a previous rib fracture on CXR correct answers >>
once healed, rib fractures form bony callouses and become more
visible on CXR
how to tell a pt has a pneumonia from a CXR correct answers
>> dark spot that is not equal to the opposite side
consider if a pt has a lower rib fracture correct answers >>
liver & spleen injury
acts like BBQ/marshmellow skewers
how high does the diaphragm rise on inspiration correct
answers >> level of 4th ICS
risk of rib fractures correct answers >> can puncture liver,
spleen,, diaphragm
pop lungs
+2 adjacent rib fractures correct answers >> flail chest
free floating sternum correct answers >> flail chest
definition of flail chest correct answers >> +2 adjacent rib
fracture
free floating sternum
