Answer to Legend of Sleepy Hollow

Correct answer is E. When ribs are fractured as indicated in the image, the resulting condition is described as a flailed chest, and paradoxical breathing will ensue. It can be life threatening because the jagged ends of the ribs may injure the parietal pleura and lead to a pneumothorax. Atelectasis is often called a collapsed lung, but is not the same as a collapsed lung, i.e., a pneumothorax. In a  pneumothorax air escapes from the lung., whereas in atelectasis the collapse is caused by blockage of the bronchus and bronchioles, or pressure on the outside of the lungs.  Bronchitis simply refers to inflammation of the bronchioles, likely to an infection. Lung fibrosis refers to thickening of lung tissue, e.g., scarring. Pneumonia is an infection that inflames the air sacs. All conditions could eventually result from the injury that caused the flailed chest. Initially, however, at the ED, the clinicians will worry about a pneumothorax.

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Answer to this question is based on material presented in lectures 5 of the Thorax Lecture Series.