Your patient's medical record indicates severe chest trauma and recent onset of subcutaneous emphysema. Upon palpation of the patient's chest, you are most likely to feel
a. beads of air under the skin that pop with the pressure of your fingers, making a crackling sound.
b. a hard swollen mass covering the area of trauma.
c. air escaping around his chest tube that is being trapped by his bandages.
d. air flowing into his subcutaneous tissue as his lungs attempt to reinflate.
A
Crepitus is a coarse, crackling sensation palpable over the skin surface. It occurs when air escapes from the lung and enters the subcutaneous tissue. The presence of crepitus, also referred to as subcutaneous emphysema, can also be described as a feeling similar to bubble-packing material that can be palpated and popped. It is usually felt earliest in the clavicular region but can easily be found in the neck, face, and torso. Any condition that interrupts the integrity of the pleura and the lungs can lead to crepitus. These include pneumothorax, chest trauma, thoracic surgery, mediastinal emphysema, alveolar rupture, and tearing of pleural adhesions.
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