Chapter 36: Abdominal and Genitourinary Trauma

Does bright blood in urine suggest bleeding in the upper or lower urinary tract?

Lower (pg 1831)

What is referred to as the "third collision" in MVAs?

Organs shearing or tearing from their points of attachment to the abdominal wall.

What is visceral pain?

Originating from interior organs Aching, Poorly localized, Often accompanied by autonomic responses (vomiting, nausea, pallor, diaphoresis).

What is somatic pain?

Pain originating from muscle, bone, joints, tendons, or blood vessels.

Are most injuries to the stomach a result of blunt or penetrating trauma?

Penetrating. The stomach is rarely injured by blunt force trauma.

What is Kehr sign?

Referred left shoulder pain from a splenic rupture

Is the pancreas intraperitoneal or retroperitoneal?

Retroperitoneal

What quadrant is the liver located in and is it a solid or hollow organ?

Right Upper and Solid

Does an abdominal assessment include an assessment of the back?

Yes. Absolutely.

What is hemoperitoneum?

Accumulation of blood within peritoneal cavity

What is Fournier's gangrene?

An acute necrotic infection of the scrotum; penis; or perineum. It is characterized by scrotum pain and redness with rapid progression to gangrene and sloughing of tissue

What is bile and where is it made and stored?

Bile is a digestive enzyme produced by the liver and it is stored in the gallbladder.

What is the term of ecchymosis of the flanks?

Grey Turner sign

What major vessels are found in the abdomen and are they intraperitoneal or retroperitoneal?

Inferior vena cava (venous) and the Abdominal aorta (arterial) and both are in the retroperitoneal space.

What is peritonitis?

Inflammation of the peritoneum, typically caused by bacterial infection either via the blood or after rupture of an abdominal organ.

What could ecchymosis around the umbilicus be indicative of? What is the name for that sign?

Intra-abdominal hemorrhage. Cullen Sign

Why is the finding of an abdominal wall contusion significant?

It can be indicative of significant blunt force trauma to the abdomen.

What is the highest level of the diaphragm?

It peaks at the 4th intercostal space.

What are the solid organs of the abdomen?

Liver, Spleen, Pancreas, Kidneys

What are the four main organs found in the upper peritoneal cavity?

Liver, Spleen, gallbladder, stomach

What is the most commonly injured organ in blunt abdominal trauma? The second most common?

Spleen is the most common, followed by the liver. (Because they are easily compressed solid organs.)

What are the primary sources of exsanguination in abdominal trauma?

Spleen, liver, and vascular system.

What is the first part of the small intestine?

The duodenum

Trauma to the abdominal wall usually causes injury to what part of the GI tract?

The duodenum. (Due to its location and ligamentous attachment.) It can present as back pain.

What is/does the gallbladder do and where is it located?

The gallbladder is a saclike hollow organ located on the lower surface of the liver (upper right quadrant) that acts as a reservoir for bile.

What is the largest and most vascular organ of the abdominal cavity?

The liver

What are the organs of the retroperitoneal cavity?

The pancreas, vascular structures, part of the small intestine, and the kidneys.

What are the ureters and are they intraperitoneal or retroperitoneal?

They carry urine from the kidneys to the urinary bladder and Retroperitoneal

True or False: An injury to the chest anywhere below the nipples should also be considered an injury to the abdomen?

True

What quadrant is the spleen located in?

left upper quadrant

What are the hollow organs of the abdomen?

stomach, small intestines, large intestines, bladder