Chapter 20 Emergent ABD Procedures

Question 1

Limited exam of the abdomen or pelvis to evaluate for free fluid or pericardial fluid

Answer 1

FAST- focused assessment with sonography for trauma

Question 2

Collection of bloody fluid in the abdomen or pelvis secondary to trauma or surgical procedure

Answer 2

hemoperitoneum

Question 3

Imprisonment or confinement of a part of the bowel; the visceral contents cannot be reduced

Answer 3

incarcerated hernia

Question 4

Procedure used in xray wherein contrast is administered IV to help the tech visualize the urinary system

Answer 4

IV urography

Question 5

Invasive procedure that is used to sample the intraperitoneal space for evidence of damage to viscera and blood vessels

Answer 5

peritoneal lavage

Question 6

Condition seen in a patient with aortic dissection

Answer 6

pseudodissection

Question 7

Capable of being replaced in a normal position; the visceral contents can be returned to normal intraabdominal location

Answer 7

reducible hernia

Question 8

An incarcerated hernia with vascular compromise

Answer 8

strangulated hernia

Question 9

This procedure, called ___, is used to sample the intraperitoneal space for evidence of damage to the viscera and blood vessels.

Answer 9

peritoneal lavage

Question 10

Peritoneal lavage is usually used as a diagnostic technique in certain cases of ___ abdominal trauma.

Answer 10

blunt

Question 11

Peritoneal lavage carries a risk of organ injury and decreases the specificity of subsequent US or CT because of the introduction of ___ fluid and air.

Answer 11

intraperitoneal

Question 12

The ___ scan in the emergency department is a limited exam of the ABD or pelvis to evaluate for free fluid or pericardial fluid.

Answer 12

FAST

Question 13

In the context of traumatic injury, free fluid is usually a result of___ and contributes to the assessment of the circulation.

Answer 13

hemorrhage

Question 14

The FAST scan area of evaluation is widespread, extending from the pericardial sac to the urinary bladder and including the ____ area(including Morison’s pouch), the ___ region (including splenorenal recess), ___ and ___.

Answer 14

perihepatic;parasplenal; paracolic gutters; culdesac

Question 15

Accessibility and ___ of performance are critical in the trauma setting.

Answer 15

speed

Question 16

The goal is to scan the __ quadrants,___ sac, and culdesac for the presence of free fluid or hemoperitoneum.

Answer 16

four, pericardial

Question 17

Hemorrhage in the peritoneal cavity collects in the most ___ areas of the abdomen.

Answer 17

dependent

Question 18

___ lacerations or contusions are more easily detected with ultrasound than are any other visceral abdominal injury.

Answer 18

Liver

Question 19

A brisk intraparenchymal hemorrhage may be identified as an ____ region within the abnormal parenchyma, whereas a global parenchymal injury may project into the liver as a widespread architectural disruption with absence of the normal vascular pattern.

Answer 19

anechoic

Question 20

In female patients of reproductive age with trauma, free fluid isolated to the culdesac is likely ____.

Answer 20

physiologic

Question 21

If the patient is female with symptoms of RUQ pain, fever, and leukocytosis, ____ should be ruled out.

Answer 21

acute cholecystitis

Question 22

The most common cause of acute cholecystitis is ___ with a cystic duct obstruction.

Answer 22

cholelithiasis

Question 23

Midepigastric pain that radiates to the back is characteristic of ___.

Answer 23

acute pancreatitis

Question 24

Sonographic findings in acute pancreatitis show a normal to edematous gland that is somewhat ___ to normal texture.

Answer 24

hypoechoic

Question 25

Flank pain caused by ___ is a common problem in patients presenting to the emergency department.

Answer 25

urolithiasis

Question 26

If the stone completely obstructs the ureter, no ___ will be present.

Answer 26

hematuria

Question 27

When obstruction occurs, US is very effective in demonstrating the secondary sign of ___.

Answer 27

hydronephrosis

Question 28

With the bladder distended, the color Doppler is an excellent tool to image the presence of ureteral jets into the bladder; the transducer should be angled in a ___ presentation through the distended urinary bladder.

Answer 28

cephalic

Question 29

The pulse repetition frequency should be ___ to assess the low velocity of the ureteral jet flow.

Answer 29

decreased

Question 30

A ___ is a condition in which a propagating intramural hematoma actually dissects along the length of the vessel, stripping away the intima and, in some cases, part of the media.

Answer 30

dissecting aortic aneurysm

Question 31

Most aortic dissections will occur at one of three sites. Name them.

Answer 31

root with extension into the arch, level of the left subclavian artery with extension into the descending or abdominal aorta,or at the level of the ascending aorta

Question 32

Most aortic dissections are located in the ___ aorta.

Answer 32

ascending

Question 33

___ hypertension is nearly always associated with aortic dissection.

Answer 33

Systemic

Question 34

The most typical presentation of an aortic dissection is that of a sudden onset of severe, tearing ___ pain radiating to the arms,nack, or back.

Answer 34

chest

Question 35

With appendicitis, the patient will usually have rebound tenderness, ___, associated with peritoneal irritation.

Answer 35

McBurneys sign

Question 36

A ___ forms when the abdominal wall muscles are weakened, which allows the viscera to protrude into the weakened abdominal wall.

Answer 36

hernia

Question 37

Sonography allows visualization of the ___ movement of the bowel during Valsalva maneuvers and determines the presence or absence of vascular flow within the defect.

Answer 37

peristaltic

Question 38

Most paraumbilical hernias contain ___, ___, and ___.

Answer 38

colon, omentum, and fat

Question 39

The patient should be instructed to perform a ___ maneuver to determine the site of wall defect and confirm the presence of the protruding hernia.

Answer 39

Valsalva