Chapter 11: Abdominal Trauma

Question 1

The most frequently injured organ in penetrating trauma

Answer 1

Intestine

Question 2

The most reliable indicator of intra-abdominal bleeding is the presence of

Answer 2

Hypovolemic shock from an unexplained source

Question 3

During the secondary survey the abdomen is examined in greater detail. This examination primarily involves

Answer 3

Inspection and palpation of the abdomen

Question 4

Ecchymosis involving the flanks

Answer 4

Grey-Turner’s sign

Question 5

Ecchymosis around umbilicus

Answer 5

Cullen’s sign

Question 6

The adult peritoneal cavity can hold up to ___ of fluid before showing any signs of distention

Answer 6

1.5 liters

Question 7

The key to survival of the unstable patient with abdominal trauma

Answer 7

Early surgical intervention

Question 8

PASG is contraindicated in patients with

Answer 8

1. Respiratory compromise
2. Evisceration
3. Suspected diaphragmatic rupture
4. Pregnancy
5. Impaled object

Question 9

Target systolic BP in the absence of TBI on abdominal trauma pt

Answer 9

80 to 90 mmHg

MAP = 60-65

Question 10

If bleeding occurs around an impaled object, direct pressure should be applied

Answer 10

Around the object to the wound with the flat of the hand

Question 11

The second trimester of pregnancy lasts until

Answer 11

Ending about week 28

Question 12

The uterus continues to enlarge through the ___ week of pregnancy

Answer 12

38th week

Question 13

Uterus location

Week 12

Week 20

Week 38

Answer 13

12= protected by pelvis

20= top of uterus at umbilicus

38= approaches xiphoid process

Question 14

The mother’s heart rate normally increases throughout pregnancy by ___ to ___ by the third trimester

Answer 14

15 to 20 beats/min above normal

Question 15

By the 10th week of pregnancy, the mothers cardiac output increases by

Answer 15

1 to 1.5 liters/minute

By term= volume increase by 50%

Question 16

The pregnant patient may lose ___% of her blood volume before signs and symptoms of hypovolemia become apparent

Answer 16

30 to 35%

Question 17

Maneuvers used to relieve supine hypotension in pregnant patient

Answer 17

1. Left side
2. If immobilized =4-6 inches of padding under right side LSB
3. Raise right leg to displace if pt cannot be rotated
4. Manually displace to left side

Question 18

Preeclampsia is characterized by

Answer 18

Edema and hypertension

Question 19

Eclampsia is characterized by

Answer 19

Mental status changes and seizures

Question 20

Is the key to survival of the mother and fetus in abdominal trauma

Answer 20

Adequate resuscitation

Question 21

Any evidence of vaginal bleeding or a rigid board like abdomen with external bleeding in the last trimester of pregnancy may indicate

Answer 21

Abruptio placenta or ruptured uterus

Question 22

Injuries to the kidneys, ureters, and bladder most often present with

Answer 22

Hematuria

Question 23

Genitalia bleeding from trauma can be controlled with direct pressure or a pressure dressing. How do you treat in pregnant women?

Answer 23

Dressings should be inserted vaginally or in the urethra to control bleeding

Question 24

If direct pressure is not required to control (genitalia) hemorrhage, these injuries should be covered with

Answer 24

Moist, clean, saline soaked gauze

Question 25

The organs most often injured by the same forces that fracture the ribs are

Answer 25

Liver and spleen