Abdominal and Genitourinary Injuries Chapter: 30
blunt injury to the kidney
A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be MOST suspicious for:
break in the continuity of the bone
A fracture is MOST accurately defined as a(n):
cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage
A man has a large laceration across his lower abdominal wall and a loop of bowel is protruding from the wound. He is conscious and alert and there is minimal bleeding from the wound. You should:
The Mesentery is?
A membranous fold that attaches the intestines to the walls of the body
distal humerus
A supracondylar or intercondylar fracture is also known as a fracture of the
Your patient has his penis caught in his zipper. What do you need to do to relieve pressure?
A. Pull the pants off the patient B. Force the zipper open C. Remove the foreskin D. Cut the zipper out of the pants answer is D
You have a patient with suspected kidney injury but no spinal injury. How should he be positioned?
A. Supine B. Prone C. Lateral recumbent D. Position of comfort answer is D
You have a male patient who has no immediate life threat, but does have bleeding genitalia. You should bandage with a?
A. dry dressing B. moist dressing C. occlusive dressing D. adhesive dressing answer is B
If you are treating a patient with an abdominal evisceration, you should use a?
A. moist, sterile dressing B. dry, sterile dressing C. adhesive dressing D. triangular bandage answer is A
Whenever possible, you should always provide the sexual assault patient with
A. police escort B. rape crisis intervention C. an attendant of the same gender D. name of the assailant answer is C
Can organs from the chest enter the abdomen bad vise versa
Abdomen to chest only
In case of sexual assault, which of the following is true?
Advise the patient not to wash, urinate or defecate
How much blood can abdominal cavity hold?
All of it
open abdominal injury
An injury in which there is a break in the surface of the skin or mucous membrane, exposing deeper tissue to potential contamination.
closed abdominal injury
An injury in which there is soft-tissue damage inside the body but the skin remains intact.
the overlying skin is no longer in tact
An open fracture is MOST accurately defined as a fracture in which:
apply direct pressure to the wound
An unresponsive trauma patient has a large open abdominal wound with massive external bleeding. You should
Where should the seat belt be worn
Below the iliac crest
Rebound tenderness is know as?
Blumberg sign
What is only definite sign of bleeding in the abdomen
Bruising around the umbilicus
Cullen sign
Bruising or ecchymosis around the umbilicus, which indicates bleeding in the abdomen.
apply gentle manual traction in line with the limb and reassess for a pulse.
During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes. You should
. stabilize the pelvis with a pelvic binder and protect the spine.
During your secondary assessment of a 30-year-old male who fell 25 feet, you note crepitus when palpating his pelvis. Your partner advises you that the patient's blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, you should:
A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his heart rate is elevated. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be MOST pertinent to ask him?
Have you experienced recent abdominal trauma?
Ligamentiumarterious
Holds aorta in place
Peritonitis, an intense inflammatory reaction of the abdominal cavity, usually occurs when?
Hollow abdominal organs are damaged and spill their contents
What type of organs are most affected by cavitation fron gun shot
Hollow organs
the patient is clinically unstable
In general, musculoskeletal injuries should be splinted before moving the patient unless:
If resistance is encountered or the patient experiences severe pain
In which of the following situations should the EMT splint an injured limb in the position of deformity?
peritonitis
Inflammation of the peritoneum
IAP
Inspection, auscultation, palpating in that order
Following blunt abdominal trauma, a 30-year-old male complains of referred pain to the left shoulder. This finding is called the:
Kehr sign.
Which of the following statements regarding abdominal trauma is correct?
The absence of abdominal pain does not rule out intra-abdominal bleeding.
evisceration
The displacement of organs outside of the body. An injury that goes all the way through the peritoneum and now the bowel protrudes outside that body
bones and voluntary muscles of the body
The musculoskeletal system refers to the
flank
The posterior region below the margin of the lower rib cage
Which of the following statements regarding abdominal eviscerations is correct?
The protruding organs should be kept warm and moist.
A. Compartment syndrome typically develops within 6 to 12 hours after an injury
Which of the following statements regarding compartment syndrome is correct? A. Compartment syndrome typically develops within 6 to 12 hours after an injury B. In most cases, compartment syndrome develops within a few minutes after an injury. C. Compartment syndrome occurs because of increased pressure within the bone cavity. D. Most cases of compartment syndrome occur following a severe fracture of the pelvis
It is often discovered when the patient is jarred or moved suddenly.
Which of the following statements regarding rebound tenderness is correct? It should be assessed for by vigorously palpating the abdomen. Rebound tenderness is a specific sign found with a spleen injury. It is often discovered when the patient is jarred or moved suddenly. The absence of rebound tenderness rules out intra-abdominal injury.
Uterine trauma is likely to cause shock in the pregnant patient.
Which of the following statements regarding trauma during pregnancy is correct? Uterine trauma in the pregnant patient rarely leads to severe bleeding. Uterine trauma is likely to cause shock in the pregnant patient. Uterine blood supply is greatly reduced during pregnancy. The uterus serves as a reservoir for blood supply during pregnancy.
lift the airbag and look for deformity to the steering wheel
While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should:
area of soft-tissue damage surrounding the injury.
With regard to musculoskeletal injuries, the zone of injury is defined as the:
law enforcement is at the scene
You are dispatched to a residence for a young female who was kicked in the abdomen. While en route to the scene, you should ask the dispatcher if:
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:
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:
Suspect kidney damage if the patient has a history or physical evidence of?
an abrasion, laceration, or contusion to the flank area. a penetrating wound in the region of the lower rib cage or upper abdomen. fracture on either side of the lower rib cage
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.
A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should:
assume that the arrow injured an internal organ.
Skeletal or voluntary muscle
attaches to bone and forms the major muscle mass of the body. this muscle contains veins, arteries and nerves
When documenting a call involving a female patient who was sexually assaulted, the EMT should
avoid speculation and document only factual data.
When documenting a call involving a female patient who was sexually assaulted, the EMT should:
avoid speculation and document only factual data.
When worn properly, a seatbelt should lie:
below the anterior superior iliac spines of the pelvis and against the hip joints.
A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be MOST suspicious for:
blunt injury to the kidney.
Cullen sign suggest
bruises around the umbilicus
Signs of injury to the kidney include?
bruises or lacerations on the overlying skin shock hematuria
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 amputation of the penile shaft, your top priority is?
controlling bleeding
When treating a patient with an evisceration, you should?
cover the protruding contents with moist, sterile gauze compresses
Placing a pregnant patient in the supine position during the 3rd trimester of pregnancy may?
decrease the amount of blood that returns to the heart
Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured?
diaphragm
Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured:
diaphragm.
The accumulation of blood in the abdominal cavity will MOST likely cause?
distention
Late signs of abdominal injury include all of the following
distention change in mental status pale, cool, moist skin
Accumulation of blood in the abdominal cavity will MOST likely cause:
distention.
______ takes place in the solid organs
energy production
This system control both the reproductive functions and the waste discharge system
genitourinary system
Contraction or tensing of the abdominal muscles in an effort to ease pain is called:
guarding
Air bags, in conjunction with properly worn seatbelts, are MOST beneficial when a person is involved in a:
head-on crash
A sign of kidney damage following blunt trauma is:
hematuria
Common finding of of an injured kidney?
hematuria
Because solid organs have rich supply of blood, any injury can result in major:
hemorrhaging
Peritonitis, an intense inflammatory reaction of the abdominal cavity, usually occurs when:
hollow abdominal organs are damaged and spill their contents.
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.
urinary
most of the ___ system lies behind the digestive tract
What are the late signs of peritonitis?
nausea diminished bowel sounds bowel stops functioning
How to lay a women down when in later trimesters of pregnancy and why?
on her left side to avoid the large uterus placing pressure on the vena cava
Blunt abdominal injuries may result from?
seatbelts
What is a sign of peritonitis?
severe abdominal pain tenderness muscular spasm
solid organs
solid masses of tissue where much of the chemical work of the body takes place, such as the liver, spleen, pancreas, and the kidneys
List the hollow organs of the abdomen?
stomach intestines ureters colon bladder gallbladder
strain
stretching of the muscle
Hollow organs
structure through which materials pass, such as the stomach, small intestines, large intestines, ureters, and bladder
The most common sign of significant abdominal injury is?
tachycardia
peritoneal cavity
the abdominal cavity
What systems contain organs that make up the contents of the abdominal cavity?
the digestive system the urinary system genitourinary system
Which of the following statement regarding abdominal evisceration is correct
the protruding organs should be kept warm and moist.
cavitation
the temporary wound channel caused by high-velocity weapons is called
A 22-year-old male was punched in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should:
transport him in the position in which you found him.
Which of the following organs is at MOST risk for injury as the result of a pelvic fracture?
urinary bladder
urinary bladder
which of the following organs is at MOST risk for injury as the result of a pelvic fracture
keep her knee flexed and secure it with padded board splints
A 17-year-old female dislocated her patella while playing soccer. Her knee is flexed and she complains of severe pain. You should:
assume that the arrow injured an internal organ
A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should:
stablize her head and perform a primary assessment
A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should:
giving him small sips of plain water.
A 40-year-old male presents with severe abdominal pain following blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, EXCEPT: covering him with a warm blanket. giving him small sips of plain water. promptly transporting to the hospital. administering supplemental oxygen.
control the bleeding and cover the wound with a sterile dressing
A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot. You should:
have you experienced recent abdominal trauma
A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his pulse is rapid. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be MOST pertinent to ask him?
Your primary concern when dealing with an unresponsive patient with an open abdominal injury is?
maintaining the airway
keeping the injury moist and warm
management of esvisceration injuries includes
What are the parts of the small intestine
Doudenum, jejunum, ileum
How to treat an evulsed penis with bleeding
Dry dressing
How long can peritonitis take to set in after an abdominal injury?
12 - 24 hrs
How long to assess bowel sounds
2 minutes
What is the box area that receives an occlusive dressing
Chin to bely button
Palate abdominal cavity in which direction
Clockwise
a poorly placed lap belt
Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of:
The abdominal cavity is made up of?
Contains: stomach, small intestine, most of the large intestine, appendix, liver, gallbladder, pancreas, and spleen
guarding
Contraction the abdominal muscles to minimize the pain of the abdominal movement; a sign of peritonitis
40 year old male with severe abdominal pain following blunt trauma. He is diaphoretic, thirsty and has a weak, rapid pulse. what is your treatment?
Cover with warm blanket administer supplemental O2 promptly transport to the hospital
positive indicators of a fracture
Crepitus and false motion are:
hemorrhage
Damage to solid organs typically leads to _______.
Bruises to the RUQ, LUQ, or flank are know as
Grey Turner sign
Kehr sign
Left shoulder pain caused by blood in the peritoneal cavity
Point of lower peritoneal where the nerves and arteries pass through
Mesentery
How to treat an evulsed penis
Moist dressing
S/S: pain that is tearing and is going from the abdomen posteriorly
abdominal aneurysm
Patient with open abdominal injuries often complain of:
Pain
When a hollow organ is punctured during a penetrating injury to the abdomen?
Peritonitis may not develop for several hour
internal bleeding
abdominal rigidity and periumbilical bruising are signs of
Kher sign
Reffered pain to the left or right shoulder
Direct injury to the gallbladder
S/S: pain just under the margin of the ribs or between the shoulder blade
abdominal aneurysm
S/S: pain that is tearing and is going from the abdomen posteriorly
When documenting a call involving a female patient who was sexually assaulted, theEMT should:
Selected Answer: C. avoid speculation and document only factual data.
tendons
Skeletal muscle is attached to the bone by tough, ropelike, fibrous structures called:
This filters out worn out blood cells
Spleen
delaying transport of a critically injured patient
The MOST significant hazard associated with splinting is:
pelvic fracture with hypotension
Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life?
When to use a dry dressing
To control bleeding
When to use a moist dressing
To cover areas of stripped skin
Bloody meatus indicates what
Trauma to the genitourinary system
Black tarry stole indicates bleeding where
Upper part of GI track
Which of the following organs is at MOST risk for injury as a result of a pelvic fracture?
Urinary Bladder
falls
What is the most common mechanism of injury in geriatric patients?
carefully assess the patient for breathing problems
When caring for a patient with a possible fracture of the scapula, the EMT should:
avoid speculation and document only factual data
When documenting a call involving a female patient who was sexually assaulted, the EMT should
displaced fracture
Which of the following musculoskeletal injuries would MOST likely result in deformity?
proxmial femur
a "Hip" fracture is actually a fracture of the
When used alone, diagonal shoulder safety belts can cause?
a bruised chest a lacerated liver decapitation
joint
a junction where two bones come into contact. stabilize in key areas by ligaments
The mesentery is
a membranous fold that attaches the intestines to the walls of the body
Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of:
a poorly placed lap belt.
hematuria
a sign if kidney damage following blunt trauma is
Suspect a possible injury of the urinary bladder if?
if blood is at the urethral opening. blood at the tip of penis or blood stained underwear. physical signs of trauma on the lower abdomen, pelvis, or perineum.
What do hollow organ injuries cause
infection brought on by leaking of material
What is Kehr sign?
injured liver
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 bag-mask device.
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.
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.
sprain
is a stretching injury to the liagments around a joint
In any case of trauma to a female, you should always determine if the patient?
is pregnant
When performing a history on a patient with abdominal trauma, what questions should you ask?
is there any blood in your stool? does your pain go anywhere? do you have any nausea, vomiting or diarrhea?
In later trimesters of pregnancy why is a women's urinary bladder more susceptible to injury
it is displaced further forward
18 year old football player who was hit in the right flank with a helmet. He's complaining of pain in the area. he has an open airway, normal RR, pulse is rapid and regular. he noticed blood in his urine. based on this info what organ has the patients injured
kidney
The solid organ of the urinary system includes the?
kidney
What are low, medium, and high velocity injuries
knife, shotgun, and rifle
You are dispatched to a residence for a young female who was kicked in the abdomen by her boyfriend. While en route to the scene, you should ask the dispatcher if:
law enforcement is at the scene.
While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should:
lift the air bag and look for deformity to the steering wheel.
The largest organ in the abdomen is the?
liver
Which of the following organs would MOST likely bleed profusely when injured?
liver
List the solid organs of the abdomen?
liver spleen pancreas kidneys
Grey Turner sign suggest injury to the
liver, spleen, kidney
All of the following are hollow abdominal organs, EXCEPT for the:
liver.
Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the:
liver.
The major complaint of patients with abdominal injury is?
pain
Air in the abdominal cavity can cause?
pain infection tissue ischemia/infection
25 year old woman who was restrained in a car crash, complains of abdominal pain. The airway is open, with normal RR, pulse is regular but weak and rapid. You inspect the abdomen for possible bleeding. You would expect to see all the following?
pain or tenderness rigidity distention
Open abdominal injures are also know as?
penetrating injuries
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 abdomen is divided into 4
quadrants
Early bruising following abdominal trauma often manifests as?
red area of skin
Early bruising following abdominal trauma often manifests as:
red areas of skin.
