Chapter 30 Abdominal and Genitourinary Injuries

Displacement of organs outside the body

Evisceration

Stomach, small intestine, ureters

Hollow organs

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

Improperly placed lap belt

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

Liver

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

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

Injury where there is a break in the skin or mucous membrane

P[em abdominal injury (open?)

The mesentery is:

a membranous fold that reattaches the intestines to the walls of the body

injuries to the external male genitalia ___.

are rarely life-threatening

Your documentation on a sexual assault victim should ___.

be objective and factual

When worn properly, a seatbelt should lie:

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

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

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

diaphragm

Accumulation of blood in the abdominal cavity will MOST likely cause:

distension

Another name for the right and left upper quadrants is the ___.

flank

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

guarding

Peritonitis usually occurs when:

hollow abdominal organs are damaged and spill their contents into the peritoneal cavity

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

infection

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

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

is pregnant

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

liver

The largest organ in the abdomen is the:

liver

The first signs of peritonitis include all of the following, EXCEPT:

nausea

Early bruising following abdominal trauma often manifests as:

red areas of skin

All of the following systems contain organs that make up the contents of the abdominal cavity, EXCEPT:

the limbic system

The ___ system is responsible for filtering waste.

urinary

Soft-tissue damage inside the body without breaking the skin

Closed abdominal injury

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

Injury to the kidneys usually indicates injury to other organs

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?

Shoulder fracture

Liver, pancreas, spleen

Solid organs

Which of the following statements regarding abdominal eviscerations is correct?

The protruding organs should be kept warm and moist

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

a hematoma in the flank region

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

Suspect a possible injury of the urinary bladder in all of the following findings, EXCEPT:

bruising to the left upper quadrant

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

When treating a patient with an evisceration, you should:

cover the protruding contents with moist, sterile gauze compresses

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

guarding

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

In pediatric patients, the liver and spleen are ___.

larger in proportion to the abdomen

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

Blood may irritate the ___ and cause the patient to report abdominal pain.

peritoneal cavity

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

peritonitis may not develop for several hours

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

prompt transport to the hospital is essential

The presence of tachycardia following a significant abdominal injury:

should be assumed to be a sign of shock

Severe bleeding may occur with injury to ___ organs.

solid

All of the following are hollow abdominal organs, EXCEPT the:

spleen