Chapter 30 Abdominal and Genitourinary Injuries

55.All of the following male genitalia lie outside the pelvis cavity EXCEPT the

: Seminal vesicles.

56.Suspect kidney damage if the patient has a history or physical evidence of all of the following EXCEPT

A hematoma in the umbilical region.

105.Which of the following is true about injuries to the kidneys?

A sign of kidney damage is hematuria. A penetrating wound that reaches the kidneys almost involves other organs.

48.When performing a history on a patient with abdominal trauma, which of the following questions would be appropriate regarding trauma/?

A. is there an blood in your stool? B. does your pain go anywhere? C. do you have any nausea, vomiting, or diarrhea? =D. all of the above=

27.Open abdominal injury

An injury in which there is a break in the surface of the skin or mucous, exposing deeper tissue to potential contamination.

103.melena

Black, foul-smelling, tarry stool containing digested blood

102.hematuria

Blood in the urine.

98.Low-velocity injuries

Caused by hand-held or hand-powered objects such as knives and other edged weapons

53.When treating a patient with an evisceration, you should

Cover the protruding contents with moist, sterile gauze compresses.

32.Which of the following is NOT a solid organ of the abdomen?

Gallbladder.

108.Which of the following signs would indicate that an injury to the kidney has occurred?

Hematuria

9.Which of the following is true regarding injury to the kidneys?

Injury to the kidneys usually indicates injury to other organs.

106.You should have an index of suspicion that a patient with pain referred to the right shoulder has an injury to which organ?

Liver

40.The largest organ in the abdomen is the

Liver.

107.Which of the following are considered solid organs?

Pancreas and spleen

112.Which of the following is an indication of a spleen injury?

Referred left shoulder pain

104.The genitourinary system controls

Reproductive functions, The waste discharge system

42.Blunt abdominal injuries may result from

Seatbelts.

110.What is the major cause of death following injury to a hollow organ in the abdomen?

Sepsis

44.The most common sign of significant abdominal injury is

Tachycardia.

113.Which of the following statements regarding abdominal trauma is MOST correct?

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

16.Which of the following statements regarding abdominal eviscerations is correct?

The protruding organs should be kept warm and moist.

101.flank

The region below the rib cage and above the hip.

111.What is the purpose of wrapping a sexual assault victim in a burn sheet?

To preserve potential evidence

90.Which of the following organs is at MOST risk for injury as the result of a pelvic fracture?

Urinary bladder

37.You are dispatched to a motor vehicle collision. You see a 25-year- old woman who was restrained but is complaining of abdominal pain. She is alert and oriented. The patient's airway is open, and she is breathing normally. Her pulse is regular but weak ad rapid. She has a radial pulse. You inspect the abdomen for possible bleeding. You would expect to see all of the following EXCEPT

Urticaria.

85.An unresponsive trauma patient has a large open abdominal wound with massive external bleeding. You should

apply direct pressure to the wound.

20.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.

13.Injuries to the external male genitalia _______.

are rarely life-threatening

83.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

assume that the arrow injured an internal organ.

14.Your documentation on a sexual assault victim should _______.

be objective and factual

17.You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should

closely monitor him and reassess him frequently.

109.You are assessing a patient who reports pain that is tearing and describes it as going from the abdomen posteriorly. What should you suspect?

dissecting abdominal aneurysm

10.When a patient stiffens the muscles of the abdomen, it is known as _______.

guarding.

116.Airbags, in conjunction with properly worn seatbelts, are of MOST benefit when a person is involved in a

head-on crash.

73.Damage to solid organs typically leads to _______.

hemorrhage

4.Abdominal pain, vomiting, and fever are most likely due to _______.

infection

77.Management of evisceration injuries includes _______.

keeping the injury moist and warm

94.Right lower quadrant (RLQ)

large and small intestines that include the ascending colon and the right half of the transverse colon. descending colon, called the appendix

18.In pediatric patients, the liver and spleen are _______.

larger in proportion to the abdomen

82.While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should

lift the air bag and look for deformity to the steering wheel.

91.Right upper quadrant (RUQ) consist of?

liver, gallbladder, duodenum of the intestines, and a small portion of the pancreas

114.All of the following are signs of a significant abdominal injury, EXCEPT

localized pain.

5.Placing a pregnant patient in a supine position during the third trimester of pregnancy

may decrease the amount of blood that returns to the heart.

115.The mesentery is/are

membranous folds that attach the intestines to the walls of the body.

117.It can be difficult to assess the severity of injuries to the genitourinary system following sexual assault because

patients may be hesitant to allow you to examine them.

8.When a hollow organ is punctured during a penetrating injury to the abdomen

peritonitis may not develop for several hours.

118.A 30-year-old male has a large laceration to his right lower abdominal quadrant with a loop of bowel protruding through the wound. When treating this patient, the EMT-B should recall that the

protruding bowel should be kept warm and moist.

71.Early bruising following abdominal trauma often manifests as

red areas of skin.

70.The presence of tachycardia following a significant abdominal injury

should be assumed to be a sign of shock.

19.All of the following are hollow abdominal organs, EXCEPT the

spleen.

78.Most of the ________ system lies behind the digestive tract.

urinary

61.In cases of sexual assault, which of the following is true?

Advise the patient not to wash, urinate, or defecate.

21.Closed abdominal injury

An injury in which there is soft-tissue damage inside the body but the skin remains intact.

58.Suspect a possible injury of the urinary bladder in all of the following findings EXCEPT

Bruising to the left upper quadrant.

100.High-velocity injuries

Caused by larger weapons such as high-powered rifles and the higher-powered handguns

99.Medium-velocity penetrating wounds

Caused by smaller caliber handguns and shotguns

24.Guarding

Contracting the stomach muscles to minimize the pain of abdominal movement; a sign of peritonitis.

59.When treating a patient with an amputation of the penile shaft, your top priority is

Controlling bleeding.

38.Air in the abdominal cavity can cause all of the following EXCEPT

Diarrhea.

35._______ takes place in the solid organs.

Energy production.

64.Contraction or tensing of the abdominal muscles in an effort to ease pain is called

Guarding.

66.A sign of kidney damage following blunt trauma is

Hematuria.

36.Because solid organs have a rich supply of blood, any injury can result in major

Hemorrhaging.

63.Peritonitis, an intense inflammatory reaction of the abdominal cavity, usually occurs when

Hollow abdominal organs are damaged and spill their contents.

1.Compression injury is most likely due to which of the following?

Improperly placed lab belt

57.Signs of injury to the kidney may include any of the following EXCEPT

Increased urgency of urination.

81.Which of the following statements regarding rebound tenderness is correct?

It is often discovered when the patient is jarred or moved suddenly.

54.The solid organs of the urinary system include the

Kidneys.

26.Kehr sign

Left shoulder pain caused by blood in the peritoneal cavity.

15.Which of the following organs would MOST likely bleed profusely when injured?

Liver

97.Three levels of velocity that are common in traumatic injuries

Low-velocity injuries; Medium-velocity penetrating wounds; High-velocity injuries

46.Your primary concern when dealing with an unresponsive patient with an open abdominal injury is

Maintaining the airway.

33.The first signs of peritonitis include all of the following EXCEPT

Nausea.

29.Solid organs

Solid masses of tissue where much of the chemical work of the body takes place (eg. the liver, spleen, pancreas, and kidneys).

25.Hollow organs

Structures through which materials pass, such as the stomach, small intestines, large intestines, ureters, and urinary bladder.

28.Peritoneal cavity

The abdominal cavity.

22.Evisceration

The displacement of organs outside of the body.

30.All of the following systems contain organs that make up the contents of the abdominal cavity EXCEPT

The limbic system.

92.Left upper quadrant (LUQ)

The stomach occupies most of the LUQ, but it shares this space with the spleen. The pancreas occupies some of this space but is mostly posterior to the region.

79.Which of the following statements regarding trauma during pregnancy is correct?

Uterine trauma is likely to cause shock in the pregnant patient.

3.You should suspect a kidney injury anytime the patient presents with _______.

a hematoma in the flank region

67.The mesentery is

a membranous fold that attaches the intestines to the walls of the body.

80.Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of

a poorly placed lap belt.

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

avoid speculation and document only factual data.

87.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

blunt injury to the kidney.

75.The temporary wound channel caused by high-velocity weapons is called _______.

cavitation

2.Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured

diaphragm.

68.Accumulation of blood in the abdominal cavity will MOST likely cause

distention.

84.A 40-year-old male presents with severe abdominal pain following 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

giving him small sips of plain water.

76.Abdominal rigidity and periumbilical bruising are signs of _______.

internal bleeding

72.During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of

intra-abdominal bleeding.

12.Because the depth of an open abdominal wound is often difficult to determine

prompt transport to the hospital is essential.

49.When used alone, diagonal shoulder safety belts can cause all of the following EXCEPT

A ruptured appendix.

74.What is the most common mechanism of injury in geriatric patients?

Falls

52.You are called to the local bar where a fight has taken place. The police department tells you that you have a 36-year-old man who has been stabbed twice in the abdomen. Upon your arrival, the patient is alert and oriented. His airway is open. His respirations are at 24 breaths/min; pulse is rapid, regular, and weak. He has distal pulses. With the penetrating trauma, you should assume that the object

Has penetrated the peritoneum, has entered the abdominal cavity, or has possibly injured one or more organs.

88.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?

Have you experienced recent abdominal trauma?

50.You are dispatched to a motor vehicle collision. Your patient is a 42-year-old restrained woman. The air bag did deploy, and the woman has abrasions on her face. She is complaining of pain to both her chest and abdomen. Her airway is open and respirations are within normal limits. Her pulse is a little rapid but strong and regular. She has distal pulses. In assessing this patient, which of the following statements is NOT true?

If light touch elicits pain, perform deep palpation to assess further injury.

45.Late signs of abdominal injury include all of the following EXCEPT

Increased blood pressure.

96.guarding

Involuntary muscle contractions (spasm) of the abdominal wall to minimize the pain of movement and protect the inflamed abdomen; a sign of peritonitis

60.In any case of trauma to a female patient, you should always determine if the patient

Is pregnant.

47.You respond to an 18-year-old high school football player who was hit in the right flank with a helmet several hours ago. He is complaining of pain in the area. He is alert and oriented. His airway is open, and his respirations are within normal limits. His pulse is rapid and regular. He has a radial pulse. He tells you that he is noticing blood in his urine. Based on this information, the patient is likely to have an injury to the

Kidney.

65.You are dispatched to a residence for a young female who was kicked in the abdomen by her boyfriend. While en route to the scene, you should ask the dispatcher if

Law enforcement is at the scene.

31.Which of the following is NOT a hollow organ of the abdomen?

Liver.

62.Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the

Liver.

34.Late signs of peritonitis may include

Nausea.

6.When should you visually inspect the external genitalia on your patient?

Only when there is a complaint of severe pain or other injury

43.The major complaint of patients with abdominal injury is

Pain.

51.Patients with open abdominal injuries often complain of

Pain.

41.Open abdominal injuries are also known as

Penetrating injuries.

39.The abdomen is divided into four

Quadrants.

93.Left lower quadrant (LLQ)

The left lower quadrant holds both the large and small intestines, notably the descending colon and the left half of the transverse colon.

95.peritoneum

The membrane lining the abdominal cavity (parietal peritoneum) and covering the abdominal organs (visceral peritoneum).

23.Flank

The posterior region below the margin of the lower rib cage.

69.When worn properly, a seatbelt should lie

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

7.Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should

control any external bleeding, administer oxygen, and transport at once.

86.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

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

11.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

insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM.