Ch 36 Abdomen

You are caring for a patient who experienced blunt abdominal trauma. The patient is conscious, but restless. His respirations are rapid and shallow and his pulse is rapid and weak. What will maximize this patient's chances of survival?

Basic airway and circulation support at the scene, prompt transport to a trauma center, and IV fluid boluses as needed en route

Which of the following organs lies within the retroperitoneal space?

Kidneys

What membranous tissue functions as the point of attachment for the various abdominal organs?

Mesentery

What type of motor vehicle crash poses the LEAST threat for abdominal trauma if the patient is properly restrained?

Rear-end crash

Which of the following is NOT a function of the pancreas?

Reservoir for bile

Which of the following statements regarding stomach injuries is correct?

Rupture of the stomach following blunt trauma is usually associated with a recent meal or inappropriate seat belt use.

Which of the following assessment findings is MOST suggestive of intraabdominal hemorrhage?

Signs of shock

Which of the following factors does NOT contribute to the extent of injury from a gunshot wound to the abdomen?

Size of the patient

Which of the following statements regarding the liver is correct?

The liver is a solid organ that lies in the right upper abdominal quadrant and detoxifies the blood.

What do the spleen and liver have in common?

They are both highly vascular and bleed profusely when injured.

Which of the following factors can decrease the potential damage caused by trauma to the abdomen?

Toned abdominal muscles and an empty bladder

What are the two layers that cover the testicles?

Tunica albuginea and tunica vaginalis

When assessing a patient with abdominal trauma for distention, you must recall that:

a significant amount of blood volume in the abdominal cavity is required to produce distention.

During the third collision in a motor vehicle crash:

abdominal organs shear from their points of attachment.

A 17-year-old high school football player was struck in the abdomen by another player during a tackle. Your assessment reveals signs of shock and pain to the patient's left shoulder, which is unremarkable for trauma. Examination of the patient's abdomen is also unremarkable for obvious injury. Based on your assessment findings and the patient's clinical presentation, you should be MOST suspicious of:

an injury to the spleen.

Injuries to the vascular structures in the intraperitoneal space:

are often caused by shearing forces secondary to blunt trauma.

The periumbilical area refers to the:

area around the umbilicus.

A 39-year-old man sustained an abdominal evisceration after he was cut in the abdomen with a machete. The patient is semiconscious and is breathing shallowly. You should:

assist ventilations with a bag-mask device; cover the exposed bowel with moist, sterile dressings and protect them from injury; transport at once; and initiate IV therapy en route

The LEAST helpful technique when assessing the patient with abdominal trauma is

auscultation.

Gross hematuria and suprapubic pain following a pelvic injury is MOST indicative of injury to the:

bladder.

A 59-year-old construction worker collapsed on the job and fell into a pile of steel rods. Your assessment reveals that he is pulseless and apneic, and has a 12-inch steel rod impaled in his epigastrium. As your partner and an emergency medical responder begin CPR, you should:

control any external bleeding, stabilize the rod in place with bulky dressings, apply the cardiac monitor, and start at least one large-bore IV line en route to the hospital

A 36-year-old female was sexually assaulted and is experiencing intense pain. Your assessment reveals several open lacerations to her vaginal area and a painful distended abdomen. Her blood pressure is 86/50 mm Hg and her heart rate is 120 beats/min and weak. In addition to administering supplemental oxygen, you should

cover her open wounds with sterile dressings, establish at least one large-bore IV, and give a 20-mL/kg fluid bolus

Anatomically, the abdominal cavity extends from the:

diaphragm to the pelvis

Generalized abdominal pain following rupture of a hollow organ is MOST suggestive of:

diffuse peritoneal contamination

Grey Turner sign is defined as ecchymosis to the _________ and is indicative of _________

flank, retroperitoneal bleeding

The abdomen extends superiorly to the level of the:

fourth intercostal space.

Traumatic urinary bladder rupture is seen MOST frequently in patients who are

intoxicated

At least two thirds of all abdominal injuries

involve blunt trauma.

Following blunt force trauma to the lower right rib cage, a 40-year-old man presents with restlessness, tachycardia, and unlabored tachypnea. You should be MOST concerned that he has a:

liver injury.

Fractures of the lower rib cage should make you MOST suspicious for injuries to the:

liver or spleen.

Penetrating abdominal trauma MOST commonly results from:

low-velocity gunshot or stab wounds.

When blood is released into the peritoneal cavity:

nonspecific signs such as tachycardia and hypotension may occur.

You should suspect a ruptured kidney if a patient presents with flank pain, gross hematuria, and:

pain with inhalation.

Because of its anatomic position in the retroperitoneum, it typically takes high-energy force to damage the:

pancreas.

Intraperitoneal organs include all of the following, EXCEPT the:

pancreas.

The major complication associated with hollow organ injury is:

peritonitis caused by rupture and spillage of toxins.

As contents exit the stomach, they FIRST pass through the:

pylorus.

EMS providers can have the MOST positive impact on mortality and morbidity from abdominal trauma by:

recognizing the need for rapid transport.

Periumbilical ecchymosis is:

referred to as Cullen sign and may take hours or days to develop following abdominal trauma.

You are dispatched to the parking lot of a shopping mall for an injured person. While en route to the scene, it is MOST important for you to:

request law enforcement assistance.

Fournier gangrene is a potential complication associated with

scrotal lacerations

Intraabdominal bleeding may produce few signs and symptoms of trauma because:

the intraabdominal cavity can accommodate large amounts of blood.

A 24-year-old male intentionally placed a commercially manufactured constricting object around the base of his penis. He complains of moderate pain, and assessment of his penis reveals that it is cyanotic. You should:

transport him to the hospital and provide emotional support en route

The diaphragm curves from its point of attachment at the _______ rib and peaks in the center at the _______ intercostal space.

twelfth, fourth

Left shoulder pain following injury to the spleen

usually does not occur until 1 to 2 hours after the injury