National Physical Therapy Examination (NPTE) Practice Exam

When assessing a patient with a hemothorax, which anatomical shift might you expect?

1. Shift of the heart towards the affected side

2. Deviated trachea towards the affected side

3. Compensatory lung hyperinflation

4. Pneumonic congestion

The correct answer is: Deviated trachea towards the affected side

In the case of a hemothorax, fluid accumulation in the pleural space typically leads to a shift in anatomical structures. Specifically, the trachea, which is part of the central airway, tends to deviate away from the affected side. This occurs because the lung on the affected side becomes compressed due to the presence of blood, resulting in increased intrathoracic pressure which pushes nearby structures, including the trachea, towards the opposite side. The presence of a hemothorax indicates that blood has collected in the pleural cavity. This accumulation causes the pleural pressure to rise and can contribute to respiratory distress and diminished lung capacity on the side of the hemothorax. Therefore, in assessing such a patient, the expectation is that the trachea will deviate away from the side where the hemothorax is present, indicating the dynamics of thoracic pressure change due to the fluid accumulation. Ultimately, it's important to recognize that the trachea's deviation is a key indicator in physical assessment and diagnostic processes within the context of respiratory pathology.