Chapter 31 Abdominal and Genitourinary Injuries

Following a motorcycle accident in which a patient collided with a tree and sustained multiple injuries, you notice the presence of blood at the urethral opening. What does this suggest?

A rupture bladder

All of the following are common associated complaints with genitourinary injuries, EXCEPT:

Abdominal tenderness

Abdominal distention or swelling can sometimes be the result of_____ from the bowel or infection.

Air

If the patient who was raped or assaulted will tolerate being wrapped in a sterile burn sheet, what might the investigators find left behind from the alleged offender? Fiber Hair Fluid

All of these answers are correct.

When treating a trauma patient with an abdominal injury, what should you do if you suspect shock? Skin color Temperature Pulse

All of these answers are correct.

Which organs are at risk of injury from falls, particularly in geriatric patients?

Aorta, Spleen, and Liver

What is another name for the distal end of the descending colon?

Appendix

Other than applying a moist, sterile dressing covered with a dry dressing to treat an abdominal evisceration, an alternative form of management may include:

Applying an occlusive dressing, secured by trauma dressings.

The term hematuria is defined as:

Blood in the urine.

When treating a patient whose foreskin has gotten caught in more than a few teeth of a zipper, you should?

Cut the zipper out of the pants.

Which of the following symptoms is NOT one of the first signs of peritonitis?

Diarrhea

What is the most common mechanism of injury in geriatric patients?

Falls

When a patient either consciously or unintentionally stiffens the muscles of the surface of the abdomen in response to abdominal pain, it's called:

Guarding

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?

Have you experienced recent abdominal trauma?

Which of the following is NOT something you should do when treating injuries involving external male genitalia?

If possible, remove impaled instruments or foreign bodies from the urethra.

Which of the following statements regarding rebound tenderness is correct?

It is often discovered when the patient is jarred or moved suddenly.

A 16-year-old boy was playing football and was struck in the left flank during a tackle. His vitals signs are stable, however, he is in severe pain. You should be MOST concerned that he has injured his:

Kidney

Which of the following organs is a solid organ?

Kidney

You are transporting a patient with possible peritonitis following trauma to the abdomen. Which position will he MOST likely prefer to assume?

Legs drawn up

Which of the following organs would be the MOST likely to bleed profusely if severely injured?

Liver

During the secondary assessment of a patient with a genitourinary injury, if there is significant trauma, what should you do FIRST?

Look for DCAP-BTLS

How should you place a woman who his in her third trimester of pregnancy on a backboard/

On her left side

During the second assessment in a patient with spinal injury, what can you do to help alleviate tension on the abdominal wall?

Place blankets and pillow under his or her knees.

You are called to respond to a rape at a local mall parking lot. Which of the following would NOT be proper treatment in dealing with this situation?

Place the evidence in a plastic bag.

The uterus, ovaries, and fallopian tubes are:

Rarely damaged

A common finding during assessment of patients with an injured liver is:

Referred pain to the right shoulder.

Which two bodily functions are controlled by the genitourinary system?

Reproduction and waste discharge.

In which position should a patient who has sustained a blunt abdominal injury be placed on the backboard?

Supine

What is a very common early sign of a significant abdominal injury?

Tachycardia

In the second and third trimesters of pregnancy, the incidence of injury to the_____ is increased by displacement of the uterus.

Urinary bladder

Which of the following organs is at MOST risk for injury as the result of a pelvic fracture?

Urinary bladder

Which of the following statements regarding trauma during pregnancy is correct?

Uterine trauma is likely to cause shock in the pregnant patient.

Which of the following parts of the female genitalia is NOT contained within the pelvis?

Vulva

Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of:

a poorly placed lap belt.

An unresponsive trauma patient has a large open abdominal wound with massive external bleeding. You should:

apply direct pressure to the wound.

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.

When documenting a call involving a female patient who was sexually assaulted, the EMT should:

avoid speculation and document only factual data.

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.

The temporary wound channel caused by high-velocity weapons is called _______.

cavitation

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:

cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage.

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:

giving him small sips of plain water.

A sign of kidney damage following blunt trauma is:

hematuria.

Damage to solid organs typically leads to _______.

hemorrhage

Abdominal rigidity and periumbilical bruising are signs of _______.

internal bleeding

Management of evisceration injuries includes _______.

keeping the injury moist and warm

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:

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.

What percentage of all trauma patients have some form of genitourinary injury?

10%

According to the US Department of Justice's National Crime Victimization Survey, there are_____ victims of rape and sexual assault each year.

293,066

Most of the ________ system lies behind the digestive tract.

urinary