Chapter 30 Abdominal and Genitourinary Injuries

Suspect a possible injury of the urinary bladder in all of the following findings EXCEPT: A.) Bruising to the left upper quadrant B.) Blood at the urethral opening C.) Blood at the tip of the penis or a stain on the patient's underwear D.) Physical signs or trauma on the lower abdomen, pelvis, or perineum

A.) Bruising to the left upper quadrant

Because solid organs have a rich supply of blood, any injury can result in major: A.) Hemorrhaging B.) Damage C.) Pain D.) Guarding

A.) Hemorrhaging

The solid organs of the urinary system include the: A.) Kidneys B.) Ureters C.) Bladder D.) Urethra

A.) Kidneys

The largest organ in the abdomen is the: A.) Liver B.) Spleen C.) Pancreas D.) Kidneys

A.) Liver

Patients with open abdominal injuries often complain of: A.) Pain B.) Nausea C.) Vomiting D.) Dyspnea

A.) Pain

The major complaint of patients with abdominal injury is: A.) Pain B.) Tachycardia C.) Rigidity D.) Swelling

A.) Pain

The abdomen is divided into four: A.) Quadrants B.) Planes C.) Sections D.) Angles

A.) Quadrants

Peritoneal cavity

Abdominal cavity

In case of sexual assault, which of the following is TRUE: A.) You should always examine the genitalia for any sign of injury B.) Advise the patient not to wash, urinate, or defecate C.) In addition to recording the facts, it is important to include your personal thoughts D.) You should use plastic bags when collecting items such as clothes

B.) Advise the patient not to wash, urinate, or defecate

When treating a patient with an amputation of the penile shaft, your top priority is: A.) Locating the amputated part B.) Controlling bleeding C.) Keeping the remaining tissue dry D.) Delaying transport until bleeding is controlled

B.) Controlling bleeding

Late signs of abdominal injury include all of the following EXCEPT: A.) Distention B.) Increased blood pressure C.) Change in mental status D.) Pale, cool, moist skin

B.) Increased blood pressure

In any case of trauma to a female patient, you should always determine if the patient: A.) Is on birth control B.) Is pregnant C.) Is currently menstruating D.) Has a history of ovarian cysts

B.) Is pregnant

You respond to an 18-year-old high school football player who was hit in the right flank with a helmet several hours ago. He is complaining of pain in the area. He is alert and oriented. His airway is open, and his respirations are within normal limits. His pulse is rapid and regular. He has a radial pulse. He tells you that he is noticing blood in his urine. Based on this information, the patient is likely to have an injury to the: A.) Liver B.) Kidney C.) Gallbladder D.) Appendix

B.) Kidney

Which of the following is NOT a hollow organ of the abdomen? A.) Stomach B.) Liver C.) Bladder D.) Urters

B.) Liver

Your primary concern when dealing with an unresponsive patient with an open abdominal injury is: A.) Covering the wound with a moist dressing B.) Maintaining the airway C.) Controlling the bleeding D.) Monitoring vital signs

B.) Maintaining the airway

Late signs of peritonitis may include: A.) A soft abdomen B.) Nausea C.) Normal bowel sounds D.) Diarrhea

B.) Nausea

Blunt abdominal injuries may result from: A.) A stab wound B.) Seat belts C.) A gunshot wound D.) An impaled object

B.) Seat belts

A very common early sign of a significant abdominal injury is: A.) Pain B.) Tachycardia C.) Rigidity D.) Distention

B.) Tachycardia

Any air in the peritoneal cavity seeks the most ____________ space or void; thus, the location of the air can change with positioning of the patient. A.) inferior B.) superior C.) distal D.) proximal

B.) superior

Hermaturia

Blood in the urine

_________________ takes place in the solid organs. A.) Digestion B.) Excretion C.) Energy production D.) Absorption

C.) Energy production

Which of the following is NOT a solid organ of the abdomen? A.) Liver B.) Spleen C.) Gallbladder D.) Pancreas

C.) Gallbladder

You are dispatched to a motor vehicle collision. Your patient is a 42-year-old restrained woman. The air bag deployed, and the woman has abrasions on her face. She is complaining of pain to both her chest and abdomen. Her airway is open and respirations are within normal limits. Her pulse is a little rapid but strong and regular. She has distal pulses. In assessing the patient, which of the following statements is NOT true? A.) Bowel sounds may help confirm findings B.) Palpation is typically performed first with light touch C.) If light touch elicits pain, perform deep palpation to assess further injury D.) If you find an entry wound, you should always assess for an exit wound

C.) If light touch elicits pain, perform deep palpation to assess further injury

Signs of injury to the kidney may include any of the following EXCEPT: A.) Bruises or lacerations on the overlying skin B.) Shock C.) Increased urgency of urination D.) Hematuria

C.) Increased urgency of urination

Open abdominal injuries are also known as: A.) Blunt injuries B.) Eviscerations C.) Penetrating injuries D.) Peritoneal injuries

C.) Penetrating injuries

All of the following male genitalia lie outside the pelvic cavity EXCEPT: A.) The urethra B.) The penis C.) The seminal vesicles D.) The testes

C.) The seminal vesicles

The ___________ is often injured during motor vehicle collisions, especially in the cases of improperly placed seat belts or impact from the steering wheel, falls from heights or onto sharp objects, and bicycle and motocycle crashes where the patient hits the handlebars on impact. A.) pancreas B.) heart C.) spleen D.) liver

C.) spleen

Gaurding

Contracting the stomach muscles to minimize the pain

Suspect kidney damage if the patient has a history or physical evidence of all of the following EXCEPT: A.) An abrasion, laceration, or contusion in the flank B.) A penetrating wound in the region of the lower rib cage or the upper abdomen C.) Fractures on either side of the lower rib cage D.) A hematoma in the umbilical region

D.) A hematoma in the umbilical region

When performing a history on a patient with abdominal trauma, all of the following questions would be appropriate regarding trauma EXCEPT: A.) Is there any blood in your stool? B.) Does your pain go anywhere? C.) Do you have any nausea, vomiting, or diarrhea? D.) Are you having trouble with your hearing?

D.) Are you having trouble with your hearing?

When treating a patient with an evisceration, you should: A.) Attempt to replace the abdominal contents B.) Cover the protruding organs with a dry, sterile dressing C.) Cover the protruding organs with moist, adherent dressings D.) Cover the protruding contents with moist, sterile gauze compresses

D.) Cover the protruding contents with moist, sterile gauze compresses

You are called to the local bar where a fight has taken place. The police department tells you that you have a 36-year-old man who has been stabbed twice in the abdomen. On arrival, the patient is alert and oriented. His airway is open. His respirations are at 24 breaths/min; pulse is rapid, regular, and weak. He has distal pulses. With the penetrating trauma, you should assume that the object has done all of the following EXCEPT: A.) Has penetrated the peritoneum B.) Has entered the abdominal cavity C.) Has possibly injured one or more organs D.) Has damaged only the skin

D.) Has damaged only the skin

The first signs of peritonitis include all of the following EXCEPT: A.) Severe abdominal pain B.) Tenderness C.) Muscular spasm D.) Nausea

D.) Nausea

If the seat belt lies too high it can do all of the following EXCEPT: A.) Squeeze abdominal organs B.) Compress the great vessels C.) Fracture the lumbar spine D.) Rupture the appendix

D.) Rupture the appendix

All of the following systems contains organs that make up the contents of the abdominal cavity EXCEPT: A.) The digestive system B.) The urinary system C.) The genitourinary system D.) The limbic system

D.) The limbic system

Eviscerated organs should be covered with a dry dressing. True or False

False

Hollow organs will bleed profusely if injured. True or False

False

Injuries to the kidneys usually occur in isolation. True or False

False

Patients with abdominal injuries should be kept supine with the head elevated. True or False

False

The abdomen is divided into two quadrants. True or False

False

Open abdominal injury

Injury in which a foreign objects enters the abdomen and opens the peritoneal cavity to the outside

Solid organs

Liver, pancreas, spleen

Closed abdominal injury

Soft-tissue damage inside the body, but the skin remains intact

Hollow organs

Stomach, small intestine, ureters

Evisceration

The displacement of organs outside of the body.

Flank

The posterior region below the margin of the lower rib cage.

One of the most common signs of a significant abdominal injury is an elevated pulse rate. True or False

True

Patients with peritonitis will want to lie still with their legs drawn up. True or False

True

Peritoneal irritation is in response to hollow organ injury. True or False

True

Peritonitis is an inflammation of the peritoneum. True or False

True

Swelling may involve the entire abdomen and indicates significant intra-abdominal injury. True or False

True

Closed abdominal injuries are also known as ________________ _________________.

blunt injuries

An open wound that allows internal organs or fat to protrude through the wound is called _________________.

evisceration

The region below the rib cage and above the hip is called the _________.

flank

A penetrating wound that reaches the kidneys almost always involves ______________ ________________.

other organs

Open abdominal injuries are also known as _____________ ________________.

penetrating injuries

Blood may irritate the ______________ ________________ and cause the patient to report abdominal pain.

peritoneal cavity

When ruptured, the organs of the abdominal cavity can split their contents into the peritoneal cavity, causing an intense inflammatory reaction called __________________.

peritonitis

Kidneys are located in the _____________ space.

retroperitoneal

Severe bleeding may occur with injury to ______________ organs.

solid

The _____________ system is responsible for filtering waste.

urinary