PHTLS 10TH EDITION SELF TEST EXAM 2026
UPDATED PRACTICE QUESTIONS AND
SOLUTIONS
◉ Valvular rupture Answer: Rupture of the supporting structures of
the heart valves or the valves themselves typically renders the valves
incompetent.
◉ Blunt cardiac rupture Answer: A rare event, occurs in less than
1% of PTs with blunt chest trauma. Most of these PTs will die at the
scene from exsanguination or fatal cardiac tamponade.
◉ Cardiac tamponade Answer: Occurs then the heart allows fluid to
acutely accumulate between the pericardial sac and the heart. This
rising pericardial pressure impedes venous return to the heart and
leads to diminished cardiac output and BP.
◉ Beck's triad is a constellation of findings indicative of cardiac
tamponade Answer: 1) muffled heart sounds
2) JVD
3) low BP
,◉ Commotio cordis Answer: the clinical situation in which an
apparently innocuous blow to the anterior chest results in sudden
cardiac arrest.
◉ Traumatic aortic disruption Answer: results from a
deceleration/acceleration mechanism of significant force.
◉ Signs of traumatic aortic disruption Answer: -pulse quality may be
different between two upper extremities (stronger in right arm than
left)
-pulse quality may differ between upper (brachial artery) and lower
extremities (femoral artery).
-BP may be higher in upper extremities than lower extremities.
◉ Traumatic Asphyxia Answer: The mechanism is abrupt, significant
increase in thoracic pressure resulting from a crush to the torso.
This results in blood being forced back out of the heart and into the
veins in a retrograde direction.
◉ Diaphragmatic Rupture Answer: Blunt diaphragmatic injury
results from the application of sufficient force to the abdomen to
increase abdominal pressure acutely, abruptly, and sufficiently to
disrupt the diaphragm. Use of PASG is contraindicated.
◉ Vertebral Column Answer: -7 Cervical (C1-atlas) (C2-axis)
,-12 Thoracic
-5 Lumbar
-5 Sacral
-4 Coccygeal
◉ Sacrum supports... Answer: between 70-80% of body's total
weight.
◉ Foramen magnum Answer: Hold in which the spinal cord passes
through. Spinal cord starts at brainstem and goes down to L2.
◉ Ascending nerve tracts Answer: carry sensory impulses from the
body parts through the cord up to the brain.
◉ Descending nerve tracts Answer: are responsible for carrying
motor impulses from the brain through the cord down to the body,
and they control all muscle movement and muscle tone.
◉ -Dorsal root
-Ventral root Answer: -Dorsal root is for sensory impulses.
-Ventral root is for motor impulses.
, ◉ Intervertebral disc Answer: cartilage between each vertebral
body. These discs act as shock absorbers. If damaged, the cartilage
may protrude into the spinal canal, compressing the cord or the
nerves that come through the intervertebral foramina.
◉ Dermatome Answer: the sensory area on the body for which a
nerve root is responsible. Nipple level (T4), umbilicus level (T10),
phrenic nerves arising form cord between C2-C5.
◉ axial loading Answer: compression of the spine which may occur
when the head strikes an object, or PT sustains a fall from a
substantial height and lands in standing position.
◉ -excessive flexion (hyperflexion)
-excessive extension (hyperextension)
-excessive rotation (hyper-rotation) Answer: all cause bone damage
and tearing of muscle and ligaments, resulting in impingement on or
stretching of the spinal cord.
◉ Sudden or excessive lateral bending requires more or less
movement than flexion or extension before injury occurs? Answer:
Less
UPDATED PRACTICE QUESTIONS AND
SOLUTIONS
◉ Valvular rupture Answer: Rupture of the supporting structures of
the heart valves or the valves themselves typically renders the valves
incompetent.
◉ Blunt cardiac rupture Answer: A rare event, occurs in less than
1% of PTs with blunt chest trauma. Most of these PTs will die at the
scene from exsanguination or fatal cardiac tamponade.
◉ Cardiac tamponade Answer: Occurs then the heart allows fluid to
acutely accumulate between the pericardial sac and the heart. This
rising pericardial pressure impedes venous return to the heart and
leads to diminished cardiac output and BP.
◉ Beck's triad is a constellation of findings indicative of cardiac
tamponade Answer: 1) muffled heart sounds
2) JVD
3) low BP
,◉ Commotio cordis Answer: the clinical situation in which an
apparently innocuous blow to the anterior chest results in sudden
cardiac arrest.
◉ Traumatic aortic disruption Answer: results from a
deceleration/acceleration mechanism of significant force.
◉ Signs of traumatic aortic disruption Answer: -pulse quality may be
different between two upper extremities (stronger in right arm than
left)
-pulse quality may differ between upper (brachial artery) and lower
extremities (femoral artery).
-BP may be higher in upper extremities than lower extremities.
◉ Traumatic Asphyxia Answer: The mechanism is abrupt, significant
increase in thoracic pressure resulting from a crush to the torso.
This results in blood being forced back out of the heart and into the
veins in a retrograde direction.
◉ Diaphragmatic Rupture Answer: Blunt diaphragmatic injury
results from the application of sufficient force to the abdomen to
increase abdominal pressure acutely, abruptly, and sufficiently to
disrupt the diaphragm. Use of PASG is contraindicated.
◉ Vertebral Column Answer: -7 Cervical (C1-atlas) (C2-axis)
,-12 Thoracic
-5 Lumbar
-5 Sacral
-4 Coccygeal
◉ Sacrum supports... Answer: between 70-80% of body's total
weight.
◉ Foramen magnum Answer: Hold in which the spinal cord passes
through. Spinal cord starts at brainstem and goes down to L2.
◉ Ascending nerve tracts Answer: carry sensory impulses from the
body parts through the cord up to the brain.
◉ Descending nerve tracts Answer: are responsible for carrying
motor impulses from the brain through the cord down to the body,
and they control all muscle movement and muscle tone.
◉ -Dorsal root
-Ventral root Answer: -Dorsal root is for sensory impulses.
-Ventral root is for motor impulses.
, ◉ Intervertebral disc Answer: cartilage between each vertebral
body. These discs act as shock absorbers. If damaged, the cartilage
may protrude into the spinal canal, compressing the cord or the
nerves that come through the intervertebral foramina.
◉ Dermatome Answer: the sensory area on the body for which a
nerve root is responsible. Nipple level (T4), umbilicus level (T10),
phrenic nerves arising form cord between C2-C5.
◉ axial loading Answer: compression of the spine which may occur
when the head strikes an object, or PT sustains a fall from a
substantial height and lands in standing position.
◉ -excessive flexion (hyperflexion)
-excessive extension (hyperextension)
-excessive rotation (hyper-rotation) Answer: all cause bone damage
and tearing of muscle and ligaments, resulting in impingement on or
stretching of the spinal cord.
◉ Sudden or excessive lateral bending requires more or less
movement than flexion or extension before injury occurs? Answer:
Less
