New York State Emergency Medical Technician (EMT) Practice Exam

Which of the following best describes paradoxical movement of the chest wall?

1. Multiple rib fractures that cause a marked deformity of the chest wall

2. A marked decrease in chest wall movement due to abdominal breathing

3. Only one section of the chest rises on inspiration while another area falls

4. One side of the chest wall moves opposite the direction of the other

The correct answer is: Only one section of the chest rises on inspiration while another area falls

Paradoxical movement of the chest wall refers to a specific pattern of movement that occurs when there is a disruption in the normal mechanics of breathing, often due to injuries like rib fractures or flail chest. When one section of the chest rises during inhalation while another section falls, it indicates that the affected area is not working in harmony with the rest of the chest wall. This abnormal movement results from underlying injuries that cause certain segments of the chest wall to become unstable. In a healthy individual, when the chest expands, all parts of the chest wall move outward, allowing for efficient inhalation and exhalation. However, in cases of paradoxical movement, the affected area will move in the opposite direction compared to adjacent areas, leading to inefficient breathing and potential respiratory distress. Understanding this phenomenon is crucial for EMTs, as it directs attention to severe thoracic injuries and their impact on respiratory function, necessitating quick intervention to support ventilation and oxygenation.