Injuries and wounds: flail chest: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Injuries and wounds: flail chest

Sample item

After a crush injury to the chest, a man is breathless and one segment of the chest wall moves inward on inspiration. Which injury explains this?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Fractures of several adjacent ribs, each in two places

When adjacent ribs are broken at two sites, the free segment moves paradoxically with respiration, called flail chest. It reduces ventilation and the underlying lung contusion worsens hypoxia. Traumatic asphyxia shows facial cyanosis and petechiae.

Option by option

  • A. Fracture of the sternum only

    An isolated sternal fracture does not give a paradoxical moving segment.

  • B. Traumatic asphyxia

    Traumatic asphyxia presents with congested cyanosed face and petechiae above the compression.

  • C. Tension pneumothorax

    Tension pneumothorax shows hyperresonance and tracheal shift without a paradoxical segment.

  • D. Fractures of several adjacent ribs, each in two places (correct)

    Correct. A segment broken at two sites per rib produces paradoxical movement.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is D, Fractures of several adjacent ribs, each in two places. When adjacent ribs are broken at two sites, the free segment moves paradoxically with respiration, called flail chest.

Why is "Fracture of the sternum only" not the answer?

An isolated sternal fracture does not give a paradoxical moving segment.

Why is "Traumatic asphyxia" not the answer?

Traumatic asphyxia presents with congested cyanosed face and petechiae above the compression.

Why is "Tension pneumothorax" not the answer?

Tension pneumothorax shows hyperresonance and tracheal shift without a paradoxical segment.

What concept does this question test?

It tests Injuries and wounds: flail chest in Forensic Medicine. It reduces ventilation and the underlying lung contusion worsens hypoxia. Traumatic asphyxia shows facial cyanosis and petechiae.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Injuries and wounds: flail chest?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.