Chapter 36 Abdominal Trauma - Study Set

Traumatic urinary bladder rupture is seen MOST frequently in patients who are:

Intoxicated

At least two thirds of all abdominal injuries:

Involve blunt trauma

Left shoulder pain that may indicate ruptured spleen.

Kehr's sign

Which of the following organs lies within the retroperitoneal space?

Kidneys

Following blunt force trauma to the lower right rib cage, a 40-year-old man presents with restlessness, tachycardia, and unlabored tachypnea. You should be MOST concerned that he has a:

Liver injury

Fractures of the lower rib cage should make you MOST suspicious for injuries to the:

Liver or spleen

Penetrating abdominal trauma MOST commonly results from:

Low-velocity gunshot or stab wounds

What membranous tissue functions as the point of attachment for the various abdominal organs?

Mesentery

Late signs of peritonitis may include:

Nausea

The first signs of peritonitis include all of the following except:

Nausea

When blood is released into the peritoneal cavity:

Nonspecific signs such as tachycardia and hypotension may occur.

You should suspect a ruptured kidney if a patient presents with flank pain, gross hematuria, and:

Pain with inhalation

Because of its anatomic position in the retroperitoneum, it typically takes high-energy force to damage the:

Pancreas

Intraperitoneal organs include all of the following, EXCEPT the:

Pancreas

Intraabdominal bleeding may produce few signs and symptoms of trauma because:

The intraabdominal cavity can accommodate large amounts of blood.

Which of the following statements regarding the liver is correct?

The liver is a solid organ that lies in the right upper abdominal quadrant and detoxifies the blood.

What do the spleen and liver have in common?

They are both highly vascular and bleed profusely when injured.

Which of the following factors can decrease the potential damage caused by trauma to the abdomen?

Toned abdominal muscles and an empty bladder

A 24-year-old male intentionally placed a commercially manufactured constricting object around the base of his penis. He complains of moderate pain, and assessment of his penis reveals that it is cyanotic. You should:

Transport him to the hospital and provide emotional support en route

What are the two layers that cover the testicles?

Tunica albuginea and tunica vaginalis

Left shoulder pain following injury to the spleen:

Usually does not occur until 1 to 2 hours after the injury

Because of the nature of abdominal trauma in pts, which of the following should be required in your management plan?

Consulting with medical control on analgesia

A 59-year-old construction worker collapsed on the job and fell into a pile of steel rods. Your assessment reveals that he is pulseless and apneic, and has a 12-inch steel rod impaled in his epigastrium. As your partner and an emergency medical responder begin CPR, you should:

Control any external bleeding, stabilize the rod in place with bulky dressings, apply the cardiac monitor, and start at least one large-bore IV line en route to the hospital

A 36-year-old female was sexually assaulted and is experiencing intense pain. Your assessment reveals several open lacerations to her vaginal area and a painful distended abdomen. Her blood pressure is 86/50 mm Hg and her heart rate is 120 beats/min and weak. In addition to administering supplemental oxygen, you should:

Cover her open wounds with sterile dressings, establish at least one large-bore IV, and give a 20-mL/kg fluid bolus.

Which of the following statements regarding stomach injuries is correct?

Rupture of the stomach following blunt trauma is usually associated with a recent meal or inappropriate seat belt use.

A 15-year-old girl was kicked in the left side by a horse. She is AOx4, tachycardic, and present with a bruise over the 10th rib in the anterior axillary line with severe tenderness. You suspect:

Ruptured spleen

Fournier gangrene is a potential complication associated with:

Scrotal lacerations

All of the following male genitalia lie outside the pelvic cavity except:

Seminal vesicles

Which of the following assessment findings is MOST suggestive of intraabdominal hemorrhage?

Signs of shock

Which of the following factors does NOT contribute to the extent of injury from a gunshot wound to the abdomen?

Size of the patient

Localized pain, usually felt deeply, which represent irritation or injury to tissue, causing activation of peripheral nerve tracts.

Somatic pain

Injury resulting from compression or deceleration forces, potentially crushing an organ or causing it to rupture.

Blunt trauma

The diaphragm curves from its point of attachment at the _______ rib and peaks in the center at the _______ intercostal space.

12th; 4th

When assessing a patient with abdominal trauma for distention, you must recall that:

A significant amount of blood volume in the abdominal cavity is required to produce distention.

During the third collision in a motor vehicle crash:

Abdominal organs shear from their points of attachment.

A 17-year-old high school football player was struck in the abdomen by another player during a tackle. Your assessment reveals signs of shock and pain to the patient's left shoulder, which is unremarkable for trauma. Examination of the patient's abdomen is also unremarkable for obvious injury. Based on your assessment findings and the patient's clinical presentation, you should be MOST suspicious of:

An injury to the spleen

Injuries to the vascular structures in the intraperitoneal space:

Are often caused by shearing forces secondary to blunt trauma.

The periumbilical area refers to the:

Area around the umbilicus

A 39-year-old man sustained an abdominal evisceration after he was cut in the abdomen with a machete. The patient is semiconscious and is breathing shallowly. You should:

Assist ventilations with a bag-mask device; cover the exposed bowel with moist, sterile dressings and protect them from injury; transport at once; and initiate IV therapy en route.

The LEAST helpful technique when assessing the patient with abdominal trauma is:

Auscultation

You are caring for a patient who experienced blunt abdominal trauma. The patient is conscious, but restless. His respirations are rapid and shallow and his pulse is rapid and weak. What will maximize this patient's chances of survival?

Basic airway and circulation support at the scene, prompt transport to a trauma center, and IV fluid boluses as needed en route.

Each of the following are considered hollow organs of the abdomen, except:

Bladder

Gross hematuria and suprapubic pain following a pelvic injury is MOST indicative of injury to the:

Bladder

Injuries to the retroperitoneal space may include all of the following except:

Diaphragm

A 50-year-old man was in an MVA, was wearing a lap seat belt. Complains of SOB and abdominal pain. HR 92, RR 36 and shallow, BP 120/80. You suspect:

Diaphragm injury

Anatomically, the abdominal cavity extends from the:

Diaphragm to the pelvis

Air in the abdominal cavity can cause all of the following except:

Diarrhea

Generalized abdominal pain following rupture of a hollow organ is MOST suggestive of:

Diffuse peritoneal contamination

The primary assessment for abdominal injuries should include all of the following except:

Epistaxis

Grey Turner sign is defined as ecchymosis to the _________ and is indicative of _________

Flank; Retroperitoneal bleeding

The abdomen extends superiorly to the level of the:

Fourth intercostal space

A membrane in the abdomen encasing the liver, spleen, diaphragm, stomach and transverse colon.

Peritoneum

The major complication associated with hollow organ injury is:

Peritonitis caused by rupture and spillage of toxins.

You have a patient with suspected kidney injury but no spinal injury. How should he be positioned?

Position of comfort

As contents exit the stomach, they FIRST pass through the:

Pylorus

What type of motor vehicle crash poses the LEAST threat for abdominal trauma if the patient is properly restrained?

Rear-end crash

EMS providers can have the MOST positive impact on mortality and morbidity from abdominal trauma by:

Recognizing the need for rapid transport

Periumbilical ecchymosis is:

Referred to as Cullen sign and may take hours or days to develop following abdominal trauma.

You are dispatched to the parking lot of a shopping mall for an injured person. While en route to the scene, it is MOST important for you to:

Request law enforcement assistance

Which of the following is NOT a function of the pancreas?

Reservoir for bile