ATLS Practice Exam 2025 – Complete Guide for Exam Preparation

Tracheal deviation is a physical examination finding that can indicate various underlying conditions, such as tension pneumothorax or massive pleural effusion. The presence of midline tenderness typically points towards irritation or injury in the neck or upper chest and can signal potential displacement of the trachea. In trauma assessments, the trachea should normally be located centrally in the neck. Deviations from this midline positioning can suggest significant pathology that requires further evaluation.

Crepitus is a sound or sensation indicative of subcutaneous emphysema or air in the soft tissues, which does not specifically highlight tracheal position. Step-offs refer to irregularities in the spine that could suggest vertebral injuries, but again don’t provide direct information about tracheal position. Otorrhea, or ear discharge, commonly indicates a potential basilar skull fracture or other cranial issues, without implying tracheal displacement. Therefore, midline tenderness serves as the most relevant indicator of tracheal positioning and its potential deviation.