Certified Registered Nurse Anesthetist (CRNA) Practice Exam

What is a physical examination finding in tension pneumothorax?

1. Tracheal deviation towards the affected side

2. Normal peak inspiratory pressure

3. Tracheal deviation away from the affected side

4. Hypervolemia

The correct answer is: Tracheal deviation away from the affected side

In the context of tension pneumothorax, a significant physical examination finding is tracheal deviation away from the affected side. This occurs due to increased pressure in the pleural space on the involved side, which pushes the mediastinum and surrounding structures, including the trachea, to the opposite side. In a tension pneumothorax, air enters the pleural cavity but cannot escape, leading to rising intrathoracic pressures that can compromise cardiopulmonary function. As the pressure builds, the mediastinum shifts away from the affected lung, which is the primary reason for the trachea's deviation. This physical sign is critical in clinical assessment and denotes a serious condition requiring immediate intervention. Other findings typically associated with tension pneumothorax include decreased breath sounds on the affected side and signs of respiratory distress, but the tracheal deviation specifically highlights the impact of the abnormal pressure dynamics on thoracic anatomy.