Chapter 30- Abdominal And Genitourinary Injuries Flashcards
Hollow organs
Large and small intestines
Ureters
Urinary bladder
Stomach
Structures through which materials pass
Peritoneal cavity
Abdominal cavity
Peritonitis
Infection that happens When the lining of the peritoneal cavity (peritoneum) becomes inflamed and painful usually from organs spilling their contents into the peritoneal cavity
First signs of peritonitis are:
Severe abdominal pain
Tenderness
Muscular spasm
Mesentery
A term that refers to any fold or tissue that attaches an organ to the body wall.
Solid organs
As their name suggests, organs that are solid masses of tissue
They include
- liver
- spleen
- pancreas
- kidneys
Retroperitoneal region
Space behind the peritoneum
Organs that lie in the retroperitoneal region
Kidneys
Ureters
Urinary bladder
And majority of the pancreas
Closed abdominal injuries
Those in which blunt force trauma, some type of impact to the body, results in injury to the abdomen without breaking the skin
Pain in the abdomen can often be deceiving because it is often…
Diffused in nature and may be referred from the site of injury to another location in the body.
In patients with liver and spleen injuries, and bleeding into the peritoneal space, where is the pain referred?
To the shoulder
If a patient reports pain that is tearing and describes it as going from the abdomen posteriorly, he or she is often describing symptoms of what?
An abdominal aneurysm that is dissecting
Pain that is following the angle from the lateral hip to the midline of the groin can be a result of damage to the…
Kidneys or the ureters
Pain primarily located in the right lower quadrant can indicate what?
An inflamed or ruptured appendix
Pain that can be found just under the margin of the ribs on the right side or between the shoulder blades can indicate what?
Injury or inflammation of the gallbladder
Guarding
When the patient either consciously or unintentionally stiffens the muscles of the surface of the abdomen
Abdominal distinction or swelling that occurs between the diploid process and the groin is often the results of:
Free fluid, blood, or organ contents spilling into the peritoneal cavity.
Open abdominal injuries
Those in which a foreign object enters the abdomen and opens the peritoneal cavity to the outside
Also known as penetrating injuries
When a patient has sustained a penetrating injury to the abdomen, it is important to attempt to determine what?
The velocity of the object that penetrated the abdominal wall because this can predict the amount of damage to tissue that has occurred
There are three levels of velocity that are commonly discussed in traumatic injuries:
- Low-velocity injuries (caused by handheld objects such as knives
- medium-velocity penetrating wounds (caused by smaller caliber handguns and shotguns
—High-velocity injuries (caused by larger weapons such as high powered rifles and higher powered handguns)
Cavitation
A cavity that forms as a pressure wave from the projectile is transferred to the tissues (like a bullet going through the body producing this cavity)
Evisceration
An open abdominal injury that goes through the skin and muscle layer and through the fascia or the interior covering of the abdomen, such that organs now protrude from the peritoneum
Fascia
Interior covering of the abdomen
Flank
The region below the rib cage and above the hip
Bruises around the umbilicus can predict what?
Significant internal abdominal bleeding
Free air in the peritoneal cavity is abnormal and usually indicates what?
That a hollow organ or loop of bowel has perforated.
Rupturing a solid organ can lead to what?
Massive bleeding
Hematuria
Blood in the urine
What’s a common finding in a injured kidney?
Hematuria
Melena
Black tarry stools
If there is a penetrating object still in place what do we do?
Apply a stabilizing bandage around it to control external bleeding and to minimize movement of the object.
What do you do when you come across an evisceration?
Cover it with sterile dressings moistened with sterile saline solution and secure with a bandage and tape
Treat the patient for shock by keeping them warm, put in a supine position, provide high flow oxygen, and transport
Injuries on the genitalia should not be given priority over other, more severe wounds, unless…
The rich blood supply causes significant bleeding.
In the third trimester of pregnancy the uterus is large and may obstruct the vena cava, leading to a decrease in the amount of blood returning to the heart if the patient is placed in what position? How can we fix this problem?
Supine position
The patient should be carefully placed on her left side so that the uterus will not lie on the vena cava
Assume all women of childbearing age are what?
Possibly pregnant
If you encounter a patient with an avulsion of skin of the penis what do you do?
- wrap the penis in a soft, sterile dressing moistened with sterile saline solution
- rapidly transport the patient
- use direct pressure to control any bleeding
- do not delay transport to save avulsion skin
Rectal bleeding can be cause by what?
Sexual assault, rectal foreign bodies, hemorrhoids, colitis, or ulcers of the digestive tract.
For a sexual assault case we do not examine the genitalia of a victim unless
Obvious bleeding requires you to apply a dressing
For sexual assault/rape cases we
Advise the patient not to wash, bathe, shower, douche, urinate, or defecate until after a physician has examined him or her. This will help preserve any evidence of a crime.
If oral penetration has occurred, advise the patient not to eat, drink, brush teeth, or use mouthwash until she has been examined
