EMT Ch.31 Gastrointestinal pain

The mesentery is: A.) The point of attachment between the small and large intestines. B.) a layer of thick skeletal muscles that protects the abdominal organs. C.) a complex network of blood vessels that supply blood to the liver. D.) a membranous fold that attaches the intestines to the walls of the body.

A membranous fold that attaches the intestines to the walls of the body

Compression injuries to the abdomen that occur during a motor vehicle crash or typically the result of: airbag deployment. failure to wear seat belts. a poorly placed lap belt. rapid vehicle deceleration.

A poorly placed lap belt

When worn properly, a seat belt should lie: A.) below the anterior superior iliac spines of the pelvis and against the hip joints. B.) across the abdominal wall at the level of the diaphragm and below the hip joints. C.) Above the anterior posterior iliac spines of the pelvis and below the hip joints. D.) across the abdominal wall at the level of the umbilicus and against the hip joints.

A.) below the anterior superior iliac spines of the pelvis and against the hip joints.

A man has a large laceration across his lower abdominal wall and a loop of bowel is protruding from the wound. He is conscious and alert and there is minimal bleeding from the wound. You should: A.) cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage. B.) gently irrigate the exposed bowel with sterile saline and then cover the wound with a dry sterile dressing. C.) cover the bowel with a dry sterile dressing, elevate his lower extremities, and cover him with a blanket. D.) make one attempt to replace the bowel back into the abdomen and then cover the wound with a sterile dressing.

A.) cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage.

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask, and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should: A.) perform a comprehensive secondary assessment to determine why his clinical status has changed. B.) insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag valve mask. C.) reassess his vital signs and then notify the receiving hospital of the change in his clinical status. D.) suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min.

B.) insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag valve mask.

Contraction or tensing of the abdominal muscle to ease pain is called flexing. referring. guarding. withdrawing.

Guarding

A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his pulse is rapid. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be most pertinent to ask him? What does your blood pressure normally run? Do you take any over-the-counter medications? Has blood soaked through your undergarments? Have you experienced recent abdominal trauma?

Have you experienced recent abdominal trauma?

During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of: a ruptured spleen. a severe liver laceration. intra-abdominal bleeding. rupture of a hollow organ.

Intra-abdominal bleeding

Which of the following organs would most likely bleed profusely when injured: Bladder Liver Stomach Intestine

Liver

Assuming that no obvious signs of intra-abdominal injury are present, which of the following injuries would most likely cause an injury to the liver or spleen to be overlooked? Femur fracture Pelvic fracture Shoulder fracture Lumbar spine fracture

Shoulder Fracture

All of the following are Hallow abdominal organs except the: spleen. bladder. ureters. stomach.

Spleen

Which of the following statements regarding abdominal trauma is correct? A.) Most of the vital abdominal organs lie within the retroperitoneal space. B.) The absence of abdominal pain does not rule out intra-abdominal bleeding. C.) The liver is well protected and is rarely injured during a traumatic event. D.) Hollow abdominal organs are vascular and bleed profusely when injured.

The absence of abdominal pain does not rule out intra-abdominal bleeding.

A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The most appropriate treatment for this patient includes: applying direct pressure with a dry, sterile dressing. covering the avulsion with moist, sterile dressings. requesting a paramedic to administer pain medication. administering 100% oxygen via a nonrebreathing mask.

applying direct pressure with a dry, sterile dressing.

A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should: transport only if signs of shock begin to develop. carefully probe the wound to determine its depth. assume that the arrow injured an internal organ. clean the wound and apply a dry, sterile dressing.

assume that the arrow injured an internal organ.

When documenting a call involving a female patient who was sexually assaulted, the EMT should

avoid speculation and document only factual data.

A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be most suspicious for: external genitalia injury. a lacerated liver or spleen. blunt injury to the kidney. a ruptured urinary bladder.

blunt injury to the kidney.

Difficulty breathing and a sunken appearance of the anterior abdominal wall is most indicative of a ruptured: aorta. spleen. stomach. diaphragm.

diaphragm

Accumulation of blood in the abdominal cavity will most likely cause: distention. referred pain. diffuse bruising. nausea or vomiting.

distention

A 40-year-old male presents with severe abdominal pain after blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, except: covering him with a warm blanket. giving him small sips of plain water. promptly transporting him to the hospital. administering supplemental oxygen.

giving him small sips of plain water.

A sign of kidney damage after blunt trauma is: hematuria. hemoptysis. hematemesis. hematochezia.

hematuria

Peritonitis usually occurs when: A.) solid abdominal organs bleed secondary to penetrating trauma. B.) the vessels that supply the abdominal organs become inflamed. C.) bacteria or viruses invade the walls of the gastrointestinal tract. D.) hollow abdominal organs are damaged and spill their contents.

hollow abdominal organs are damaged and spill their contents

During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of: a ruptured spleen. a severe liver laceration. intra-abdominal bleeding. rupture of a hollow organ.

intra-abdominal bleeding.

Which of the following statements regarding rebound tenderness is correct: It should be assessed for by vigorously palpating the abdomen. Rebound tenderness is a specific sign found with a spleen injury. It is often discovered when the patient is jarred or moved suddenly. The absence of rebound tenderness rules out intra-abdominal injury.

it is often discovered when the patient is jarred or moved suddenly

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her airbag deployed. You should: perform a head-to-toe assessment while she is in the car. lift the airbag and look for deformity to the steering wheel. carefully assess her upper chest for seatbelt-related injuries. extricate her immediately and transport to a trauma center.

lift the airbag and look for deformity to the steering wheel.

Bruising to the right upper quadrant of the abdomen, after blunt trauma is most suggestive of injury to the: liver. spleen. kidney. stomach.

liver

Placing a pregnant patient in a supine position during the third trimester of pregnancy A.) might decrease the amount of blood that returns to the heart. B.) often causes hypotension secondary to cardiac compression. C.) results in spontaneous urinary incontinence if the bladder is full. D.) is recommended if the patient has severe abdominal discomfort.

might decrease the amount of blood that returns to the heart

When a hollow organ is punctured during a penetrating injury to the abdomen: the abdomen will become instantly distended. peritonitis might not develop for several hours. it will bleed profusely and rapidly cause shock. it commonly protrudes through the injury site.

peritonitis may not develop for several hours.

Because the depth of an organ, abdominal wound is often difficult to determine: vital signs should be monitored frequently. prompt transport to the hospital is essential. the EMT must perform a thorough exam. the abdomen must be vigorously palpated.

prompt transport to the hospital is essential.

Which of the following organs is at most risk for injury as a result of a pelvic fracture? Pancreas Fallopian tubes Urinary bladder Liver or spleen

urinary bladder