Chapter 35

solid organs in the abdomen

Liver Spleen Pancreas Kidneys

Kehr's sign

Pain that radiates to the left shoulder and down the left arm; results from a spleen injury or rupture.

hallow organs in the abdomen

Stomach Gallbladder Urinary bladder Ureters Internal urethra Fallopian tubes Small intestine Large intestine

An abdominal evisceration should be covered with a moist sterile​ dressing, followed​ by: Question content area bottom Part 1 A. occlusive dressing. B. a dry bandage. C. ​non-sterile bandage. D. a sterile trauma pad.

a

During your focused history and physical exam of a patient with a suspected abdominal​ injury: Question content area bottom Part 1 A. discoloration around the umbilicus indicates bleeding is occurring inside the abdomen. B. palpate the​ abdomen, starting from the point closest to the pain. C. remember that the radial pulse will normally be stronger than the femoral pulse. D. keep in mind that it takes about one liter of blood to expand the abdominal girth by 2 inches.

a

Question content area top Part 1 A​ 16-year-old male has been struck in the genitalia by a baseball. Assessment indicates a tremendous amount of edema as well as hematoma formation and bruising to his scrotum. The primary assessment reveals no​ life-threatening conditions;​ however, the patient is crying and rates the pain as​ 10/10. Which action is most appropriate for this​ patient? Question content area bottom Part 1 A. Place cool compresses to the testicles B. Rapid transport using lights and sirens C. Application of warm packs to the scrotum D. Apply direct pressure to the site of injury

a

Question content area top Part 1 A​ middle-aged male sustained blunt force trauma to the​ abdomen, resulting in an isolated tear and perforation of the large intestine. When following up on the​ patient, what would the EMT suspect​ occurred, given the organ that was​ injured? Question content area bottom Part 1 A. The patient developed an infection B. The patient has profound hypoxia C. The patient rapidly decompensated into shock D. The patient developed severe internal bleeding

a

A patient has been shot in the abdomen. Assessment reveals that the bullet entered the body in the right upper quadrant and exited the lower right back. Given this​ finding, the EMT should assume which solid organs may have been​ injured? Question content area bottom Part 1 A. Liver and gallbladder B. ​Liver, right​ kidney, and pancreas C. ​Liver, gallbladder, and right kidney D. ​Liver, gallbladder, right​ kidney, and small intestine

b

You have arrived on the scene of an assault involving a knife. Assessment of the unresponsive​ 21-year-old male patient reveals him to have sustained multiple lacerations to the arms and​ abdomen, and a section of his intestine is now protruding through a large laceration in the area around the umbilicus. He has lost a significant amount of blood. His airway is open and he is breathing poorly at a rate of 28 breaths per minute. His radial pulse is​ weak, and his skin is cool and pale. What should the EMT do​ first? Question content area bottom Part 1 A. Start positive pressure ventilation B. Cover the intestine with​ saline-soaked gauze C. Check the blood pressure D. Secure the patient to a long spine board

b

Palpation of abdominal pain should​ begin: Question content area bottom Part 1 A. in the left upper quadrant. B. in the quadrant that hurts. C. farthest from the quadrant that hurts. D. immediately.

c

A female patient suffered a straddle injury​ (genitalia trauma) while trying to balance on top of a​ chain-link fence, after she fell with a leg on each side of the fence. At this​ time, you​ would: Question content area bottom Part 1 A. Clean the area with sterile saline and apply direct pressure with a gloved hand while monitoring for ongoing bleeding B. Apply an ice pack wrapped in a towel to the genital area C. Gently put sterile gauze dressings into the opening of the vaginal canal to stop the bleeding D. Place a moist​ compress, such as a moist sanitary​ pad, over the injury to control the bleeding

d

Severe abdominal trauma and blood loss may cause signs and symptoms of​ shock, which​ include: Question content area bottom Part 1 A. hypertension. B. flushed skin. C. a decreased heart rate. D. an increased heart rate.

d

Which is the inferior border of the abdominal​ cavity? Question content area bottom Part 1 A. Small intestine B. Genitalia C. Peritoneal space D. Pelvic ring

d

Which of the following abdominal injuries would be considered the most​ dangerous? Question content area bottom Part 1 A. Gunshot wound B. Impalement C. Stabbing D. Assault with a club

d

You are transporting a male patient with a deep stab wound to the​ groin, with damage also noted to the genitalia following an assault by his girlfriend. The patient is alert and​ oriented, albeit restless. Vital signs on scene were​ pulse, 128​ beats/min; respirations, 20​ breaths/min; blood​ pressure, 108/64​ mmHg; and​ SpO2, 92%. Oxygen is being administered via nasal cannula. Upon​ reassessment, which sign would be most concerning to the​ EMT? Question content area bottom Part 1 A. ​Patient's urge to void B. SpO2 stabilizing at​ 96% despite O2 therapy C. Heart rate of 132​ beats/min D. Blood pressure is now​ 106/88 mmHg

d

visceral peritoneum

inner lining

peritoneum

lining of the abdominal cavity

parietal peritoneum

outer lining

peritoneal space

space between the parietal and visceral peritoneum