Lecture 32 -- Abdominal and Genitourinary Injuries

Which of the following is true about injuries to the kidneys? Injuries are unusual because the kidneys are well protected. A penetrating wound that reaches the kidneys almost always involves other organs. An indication of kidney injury is bruising to the left upper quadrant. A sign of kidney damage is hematuria.

A sign of kidney damage is hematuria. A penetrating wound that reaches the kidneys almost always involves other organs.

Which of the following mechanisms of injury would MOST likely cause a shearing injury of the bladder from the urethra in a male? A. Motorcycle crash B. Blunt trauma to the flank C. Fall from a significant height D. Rear-end motor-vehicle crash

A. Motorcycle crash

While transporting a pregnant trauma patient who is immobilized on a backboard, you note a sudden decrease in her blood pressure and a decrease in her mental status. You should: A. tilt the backboard to the left. B. infuse 20 mL/kg of normal saline. C. elevate the foot of the backboard. D. apply and fully inflate the PASG.

A. tilt the backboard to the left.

When worn properly, a seat belt lies below the_________________ and against the hip joints. Posterior inferior iliac spines of the pelvis Anterior inferior iliac spines of the pelvis Posterior superior iliac spines of the pelvis Anterior superior iliac spines of the pelvis

Anterior superior iliac spines of the pelvis

Signs of a ruptured urinary bladder include all of the following, EXCEPT: A. hematuria B. hematemesis. C. perineal bruising. D. urethral bleeding.

B. hematemesis.

Diffuse (global) swelling of the abdomen is MOST suggestive of: A. acute bowel obstruction. B. intraabdominal bleeding. C. peritoneal inflammation. D. perforation of the liver

B. intraabdominal bleeding.

Which of the following statements regarding trauma to the kidneys is correct? A. Injuries confined to the kidneys are common following blunt force trauma. B. You should suspect a ruptured aorta when the MOI suggests kidney injury C. Kidney injury is usually associated with injury to other abdominal organs. D. The kidneys are well protected in the abdomen and rarely sustain injury.

C. Kidney injury is usually associated with injury to other abdominal organs.

Which of the following is the MOST reliable means of assessing the potential for abdominal injuries following a motor-vehicle crash? A. Asking the patient if he or she was wearing a seatbelt B. Noting the position of the restraint system on the patient C. Lifting a deployed airbag and assessing the steering wheel D. Determining whether or not the airbag deployed on impact

C. Lifting a deployed airbag and assessing the steering wheel

Priority management for a patient with an amputated penis and stable vital signs includes: A. locating the amputated part. B. rapid transport to a trauma center. C. controlling any active hemorrhage. D. placing moist dressings on the wound.

C. controlling any active hemorrhage.

After applying supplemental oxygen to a patient with blunt abdominal trauma, you should: A. fully extend the patient's legs. B. vigorously palpate the abdomen. C. obtain a set of baseline vital signs. D. start an IV and give a fluid bolus.

C. obtain a set of baseline vital signs.

When assessing a patient who experienced blunt abdominal trauma, you note bruising around the umbilicus. This is called ____________ sign and indicates: A. Kehr sign; ruptured hollow organs. B. Grey Turner sign; injury to the liver. C. Murphy sign; gallbladder rupture. D. Cullen sign; significant internal bleeding.

D. Cullen sign; significant internal bleeding.

In an injury to which organ would you see a scaphoid abdomen? Diaphragm Kidney Liver Spleen

Diaphragm

You are assessing a patient who reports pain that is tearing and describes it as going from the abdomen posteriorly. What should you suspect? Dissecting abdominal aneurysm Kidney damage Ruptured appendix Gallbladder inflammation

Dissecting abdominal aneurysm

Which position does a person with peritonitis usually prefer? Supine with the legs outward Fetal position with legs drawn in toward the chest Prone Variable according to each patient

Fetal position with legs drawn in toward the chest

Which of the following signs would indicate that an injury to the kidney has occurred? Hemoptysis Hematuria Hematoma Hematemesis

Hematuria

Which of the following is true about visceral pain? It comes from skin and muscle, as well as joints, ligaments, and tendons. It is usually accompanied by bleeding, swelling, and cramping. It can radiate to other locations such as the back and chest. It comes from organs inside the body with injury or illness.

It can radiate to other locations such as the back and chest. It comes from organs inside the body with injury or illness.

Bruising over the right upper quadrant could indicate injury to which of the following? Liver Colon Kidney Appendix

Liver

Which of the following abdominal organs would cause the MOST profuse bleeding when severely injured? A. Liver B. Spleen C. Pancreas D. Kidneys

Liver

You should have an index of suspicion that a patient with pain referred to the right shoulder has an injury to which organ? Bladder Intestine Kidney Liver

Liver

Which of the following are considered solid organs? Liver and intestines Kidneys and bladder Spleen and stomach Pancreas and spleen

Pancreas and spleed

When abdominal organs are ruptured or lacerated, these organs spill their contents into the abdominal cavity, causing which inflammatory reaction? Peritonitis Pneumonitis Pneumothorax Pneumomediastinum

Peritonitis

Which of the following is an indication of a spleen injury? Referred right shoulder pain Referred left shoulder pain Radiating pain from left upper quadrant down through the flank Hematuria

Referred left shoulder pain

Which of the following statements is true? Low-velocity injuries produce extensive temporary wound channels. There are four levels of velocity. The higher the velocity of a projectile, the larger the cavity it produces. The velocity of an object is not a critical determination in your assessment.

The higher the velocity of a projectile, the larger the cavity it produces.