Chapter 30- Abdominal And Genitourinary Injuries

Question 1

Hollow organs

Answer 1

Large and small intestines
Ureters
Urinary bladder
Stomach

Structures through which materials pass

Question 2

Peritoneal cavity

Answer 2

Abdominal cavity

Question 3

Peritonitis

Answer 3

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

Question 4

First signs of peritonitis are:

Answer 4

Severe abdominal pain
Tenderness
Muscular spasm

Question 5

Mesentery

Answer 5

A term that refers to any fold or tissue that attaches an organ to the body wall.

Question 6

Solid organs

Answer 6

As their name suggests, organs that are solid masses of tissue

They include

• liver
• spleen
• pancreas
• kidneys

Question 7

Retroperitoneal region

Answer 7

Space behind the peritoneum

Question 8

Organs that lie in the retroperitoneal region

Answer 8

Kidneys
Ureters
Urinary bladder
And majority of the pancreas

Question 9

Closed abdominal injuries

Answer 9

Those in which blunt force trauma, some type of impact to the body, results in injury to the abdomen without breaking the skin

Question 10

Pain in the abdomen can often be deceiving because it is often…

Answer 10

Diffused in nature and may be referred from the site of injury to another location in the body.

Question 11

In patients with liver and spleen injuries, and bleeding into the peritoneal space, where is the pain referred?

Answer 11

To the shoulder

Question 12

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?

Answer 12

An abdominal aneurysm that is dissecting

Question 13

Pain that is following the angle from the lateral hip to the midline of the groin can be a result of damage to the…

Answer 13

Kidneys or the ureters

Question 14

Pain primarily located in the right lower quadrant can indicate what?

Answer 14

An inflamed or ruptured appendix

Question 15

Pain that can be found just under the margin of the ribs on the right side or between the shoulder blades can indicate what?

Answer 15

Injury or inflammation of the gallbladder

Question 16

Guarding

Answer 16

When the patient either consciously or unintentionally stiffens the muscles of the surface of the abdomen

Question 17

Abdominal distinction or swelling that occurs between the diploid process and the groin is often the results of:

Answer 17

Free fluid, blood, or organ contents spilling into the peritoneal cavity.

Question 18

Open abdominal injuries

Answer 18

Those in which a foreign object enters the abdomen and opens the peritoneal cavity to the outside

Also known as penetrating injuries

Question 19

When a patient has sustained a penetrating injury to the abdomen, it is important to attempt to determine what?

Answer 19

The velocity of the object that penetrated the abdominal wall because this can predict the amount of damage to tissue that has occurred

Question 20

There are three levels of velocity that are commonly discussed in traumatic injuries:

Answer 20

• 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)

Question 21

Cavitation

Answer 21

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)

Question 22

Evisceration

Answer 22

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

Question 23

Fascia

Answer 23

Interior covering of the abdomen

Question 24

Flank

Answer 24

The region below the rib cage and above the hip

Question 25

Bruises around the umbilicus can predict what?

Answer 25

Significant internal abdominal bleeding

Question 26

Free air in the peritoneal cavity is abnormal and usually indicates what?

Answer 26

That a hollow organ or loop of bowel has perforated.

Question 27

Rupturing a solid organ can lead to what?

Answer 27

Massive bleeding

Question 28

Hematuria

Answer 28

Blood in the urine

Question 29

What’s a common finding in a injured kidney?

Answer 29

Hematuria

Question 30

Melena

Answer 30

Black tarry stools

Question 31

If there is a penetrating object still in place what do we do?

Answer 31

Apply a stabilizing bandage around it to control external bleeding and to minimize movement of the object.

Question 32

What do you do when you come across an evisceration?

Answer 32

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

Question 33

Injuries on the genitalia should not be given priority over other, more severe wounds, unless…

Answer 33

The rich blood supply causes significant bleeding.

Question 34

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?

Answer 34

Supine position

The patient should be carefully placed on her left side so that the uterus will not lie on the vena cava

Question 35

Assume all women of childbearing age are what?

Answer 35

Possibly pregnant

Question 36

If you encounter a patient with an avulsion of skin of the penis what do you do?

Answer 36

• 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

Question 37

Rectal bleeding can be cause by what?

Answer 37

Sexual assault, rectal foreign bodies, hemorrhoids, colitis, or ulcers of the digestive tract.

Question 38

For a sexual assault case we do not examine the genitalia of a victim unless

Answer 38

Obvious bleeding requires you to apply a dressing

Question 39

For sexual assault/rape cases we

Answer 39

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