Chapter 31: Abdominal and Genitourinary Injuries

C.kidney.

A 16-year-old boy was playing football and was struck in the left flank during a tackle. His vital signs are stable; however, he is in severe pain. You should be MOST concerned that he has injured his: A.liver. B.spleen. C.kidney. D.bladder.

True

A patient who has sustained a blunt abdominal injury should be log rolled to a supine position onto a backboard. True/False

True

A very common early sign of a significant abdominal injury is tachycardia. True/False

A. distention

Accumulation of blood in the abdominal cavity will MOST likely cause: A. distention B. nausea and vomiting C. referred pain D. diffuse bleeding

Liver That's Correct! The liver is found in the right upper quadrant, along with the gallbladder, duodenum of the intestines, and a small portion of the pancreas.

Bruising over the right upper quadrant could indicate injury to which of the following? Liver Colon Kidney Appendix

B. a poorly placed lap belt

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

A. diaphragm

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

D. intra-abdominal bleeding

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. a ruptured spleen B. severe liver laceration C. rupture of a hollow organ D. intra-abdominal bleeding

A. red areas of the skin

Early bruising following abdominal trauma often manifests as: A. red areas of the skin B. gross distention C. localized pain D. dark purple marks

C. iliac crests.

Even when seat belts are worn properly and the airbags deploy, injury may occur to the: A. chest. B. extremities. C. iliac crests. D. lower ribcage.

True

Free air in the peritoneal cavity is abnormal and indicates that a hollow organ or loop of bowel has perforated. True/False

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

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

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

The mesentery is: A. the point of attachment between the small and large intestines B. a layer of thick skeletal muscle 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. should be assumed to be a sign of shock

The presence of tachycardia following a significant abdominal injury: A. should be assumed to be a sign of shock B. is most commonly caused by severe pain C. is always accompanied by hypotension D. is typically due to heightened anxiety levels

Liver

What is A

Gallbladder

What is B

Appendix

What is C

Stomach

What is D

Spleen

What is E

Sepsis

What is the major cause of death in hollow organ injury to the abdomen? Evisceration Internal hemorrhage Peritonitis Sepsis

To preserve potential evidence

What is the purpose of wrapping a sexual assault victim in a burn sheet? To maintain body temperature as a result of shock To preserve potential evidence To protect the patient's privacy To keep the patient calm (swaddling)

C. peritonitis might not develop for several hours

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

Liver That's Correct! In pediatric patients, the liver and spleen are very large in proportion to the size of the abdominal cavity and are more easily injured. The soft, flexible ribs of infants and young children do not protect these two organs very well and may allow injury to underlying organs, even without fracturing the ribs.

Where is abdominal injury most likely in young children? Appendix Fractured ribs Gallbladder Liver

Pancreas and spleen

Which of the following are considered solid organs? Liver and intestines Kidneys and bladder Spleen and stomach Pancreas and spleen

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

Which of the following is true about injuries to the kidneys? - Injuries are unusual because the kidneys are well protected. - A penetrating wound that reaches the kidneys almost always involves other organs. - An indication of kidney injury is bruising to the left upper quadrant. - A sign of kidney damage is hematuria.

A. Liver The liver is a highly vascular solid organ, and contains approximately 40% of the body's total blood volume at any given time. If severely injured, bleeding from the liver would be profuse and rapid. Other solid organs, such as the spleen and kidneys, may also produce severe bleeding if injured, though not as rapid as the liver. The stomach and gallbladder are hollow organs; if lacerated, they would spill their contents into the abdominal cavity, resulting in peritonitis.

Which of the following organs would be the MOST likely to bleed profusely if severely injured? A. Liver B. Kidney C. Stomach D. Gallbladder

C. The absence of pain and tenderness rules out intra-abdominal bleeding.

Which of the following statements regarding intra-abdominal bleeding is FALSE? A. Intra-abdominal bleeding often causes abdominal distention. B. Intra-abdominal bleeding is common following blunt force trauma. C. The absence of pain and tenderness rules out intra-abdominal bleeding. D. Bruising may not occur immediately following blunt abdominal trauma.

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

Which of the following statements regarding rebound tenderness is correct? A. the absence of rebound tenderness rules out intra-abdominal injury B. it should be assessed by vigorously palpating the abdomen C. it is a specific sign found with spleen injury D. it is often discovered when the patient is jarred or moved suddenly

A. a deformed steering wheel.

While inspecting the interior of a wrecked automobile, you should be MOST suspicious that the driver experienced an abdominal injury if you find: A. a deformed steering wheel. B. that the airbags deployed. C. a crushed instrument panel. D. damage to the lower dashboard.

Dissecting abdominal aneurysm

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 Kidney damage Ruptured appendix Gallbladder inflammation

B. Legs drawn up

You are transporting a patient with possible peritonitis following trauma to the abdomen. Which position will he MOST likely prefer to assume? A. Sitting up B. Legs drawn up C. Legs outstretched D. On his right side

True

You should allow patients with peritonitis to lie still with their legs drawn up. True/False