Abdominal Trauma

Question 1

What might damage to hollow organs result in?

Answer 1

Hemorrhage and spillage of their contents into the retroperitoneal, peritoneal, or pelvic spaces

Question 2

___ organs such as the spleen, liver, pancreas, and kidneys are also subject to ___ and ___ trauma.

Answer 2

Solid ; blunt ; penetrating

Question 3

What is evisceration?

Answer 3

Protrusion of organs from a wound

Question 4

What is hematochezia?

Answer 4

Blood in the stool

Question 5

What is hematemesis?

Answer 5

Vomiting of blood

Question 6

What is hematuria?

Answer 6

Blood in the urine

Question 7

___ organs like the stomach, small bowel, large bowel, rectum, urinary bladder, gallbladder, and pregnant uterus may rupture with compression from ___ forces, especially if the organ is full and ___.

Answer 7

hollow ; blunt ; distended

Question 8

How is the liverr restrained from forward motion?

Answer 8

By the ligamentum teres

Question 9

What happens to the liver during sever deceleration?

Answer 9

Weight of the liver forces it into the ligament, causing shear forces, laceration, and hemorrhage

Question 10

What is peritonitis and the two cause mechanisms?

Answer 10

It is the inflammation of the peritoneum and is caused by chemical and bacterial irritation.

Question 11

What is bacterial peritonitis?

Answer 11

Irritation due to infection, which is often released into the space by a torn bowel or open wound

Question 12

What is chemical peritonitis?

Answer 12

Occurs more quickly because of caustic nature of digestive enzymes and acids (from stomach or duodenum), and (to a lesser degree) urine quickly irritate the peritoneum and induce the inflammatory response

Question 13

What are the S/S of peritonitis?

Answer 13

• Progressive
• Usually begins with a slight tenderness at location of injury
• Overtime, the area of inflammation expands as does the area of tenderness

Question 14

What is rebound tenderness?

Answer 14

Pain on release of examiner’s hands, allowing the patient’s abdominal wall to return to its normal position; associated with peritoneal irritation

Question 15

What is guarding?

Answer 15

Protective tensing of the abdomen muscles by a patient suffering abdominal pain; may be voluntary or involuntary response

Question 16

When is the greatest risk for injury during pregnancy?

Answer 16

3rd trimester

Question 17

Whilea pregnant mother is somewhat protected from hypovolemia, the __ is not so protected.

Answer 17

Fetus

Question 18

What is abruptio placentae?

Answer 18

Condition in which the placenta separates from the uterine wall

Question 19

T or F. The internal damage correlates well to the appearance of the entrance or exit wound.

Answer 19

False - it does not; many factors can impact the internal damage (i.e. bouncing off a bone) because of the energy exchange characteristics

Question 20

The abdomen may contain up to ___ liters of blood before distention becomes noticeable.

Answer 20

1.5

Question 21

Abnormal pulsations in the abdomen suggest ___ injury.

Answer 21

arterial

Question 22

___ for bowel sounds is not recommended during assessment of the ___ trauma patient.

Answer 22

Auscultation ; abdominal

Question 23

Why are pregnant women more likely to have delayed S/S of hypovolemia?

Answer 23

Because maternal blood volume increases by up to 45% in the third trimester, so blood loss an exceed 30% before S/S reveal themselves

Question 24

How should you care for abdominal trauma in pregnant women?

Answer 24

• Watch for earliest signs of shock

- Place on left side to prevent compression of the inferior vena cava

Question 25

The normal uterus will be ___ and ___ to palpation. It will be palpable above the ___ ___ after the first ___ weeks of pregnancy and progress upward in the abdominal cavity until it reaches the ___ ___ at about ___ weeks.

Answer 25

firm ; round ; iliac crests ; 12 ; costal border ; 32

Question 26

Do not identify ___ and ___ wounds in your written reports because they might confound the crime investigation.

Answer 26

entrance ; exit

Question 27

What should you be prepared to do for any S/S of shock that develop and systolic BP drops below 80 mmHg?

Answer 27

Administer repeated fluid boluses

Question 28

Prehopital infusion is usually limited to ___ mL of fluid.

Answer 28

3,000

Question 29

Unlike other major body containers, the abdomen is bound by ___ rather than skeletal structures.

Answer 29

muscle

Question 30

Blunt trauma to the abdomen causes injury through all f the following mechanisms except:

a. deceleration
b. torque
c. compression
d. shear

Answer 30

torque

Question 31

Hollow organs like the stomach, bowel, bladder, and pregnant utur may ___ with compression from blunt forces.

Answer 31

rupture

Question 32

Penetrating trauma most frequently involves the ___ and small bowel.

Answer 32

liver

Question 33

A protrusion of organs from a wound is call an:

Answer 33

evisceration

Question 34

Inflammation of the lining of the anterior abdomen, caused by bacterial or chemical irritation, is called:

Answer 34

Peritonitis

Question 35

___ is the number one killer of pregnant females.

Answer 35

trauma

Question 36

Significant blunt or penetrating trauma to the abdomen may cause internal hemorrhage and shock. First S/S of shock include all of the following except:

a. lethargy
b. diminishing level of consciousness
c. decreasing pulse pressure
d. increasing capillary refill time

Answer 36

a. lethargy

Question 37

Palpation of an injured abdominal quadrant is most likely to:

Answer 37

cause guarding

Question 38

It is very important to ensure early fluid resuscitation of the potentially hypotensive pregnant mother. This statement is true because it may take a maternal blood loss of between ___ percent before changes in maternal BP or heart rate are evident.

Answer 38

30 and 35

Question 39

Why is it important for your assessment to determine the mechanism of injury ad region of the abdomen it affects?

Answer 39

S/S of injury are limited, non-specific, and do not often reflect the seriousness of abdominal pathology

Question 40

What is another sign of continuing blood loss from an abdominal hemorrhage?

Answer 40

Aggressive fluid resuscitation that appears ineffective

Question 41

Most vascular trauma is associated with ___ trauma.

Answer 41

penetrating