Chapter 31: Abdominal & Genitourinary Injuries

Question 1

What organs are found in the right upper quadrant?

Answer 1

Gallbladder, duodenum of intestines, majority of liver, small portion of pancreas

Question 2

What organs are found in the left upper quadrant?

Answer 2

spleen, most of stomach, larger portion of pancreas

Question 3

What organs are found in the right lower quadrant?

Answer 3

portions of large and small intestines- ascending colon and right half of transverse colon, appendix

Question 4

What organs are found in the left lower quadrant?

Answer 4

portions of the large and small intestines– descending colon and left half of transverse colon

Question 5

What is peritonitis?

Answer 5

Inflammation and pain of the lining of the peritoneum due to rupture or laceration of hollow organs

Question 6

What may abdominal distension and rigitiy indicate?

Answer 6

Inflammation or internal bleeding into the cavity

Question 7

What external findings should make you suspect kidney damage?

Answer 7

Abrasion, laceration, or contusion in the flank
Penetrating wound in flank or upper abdomen
Fraction on either side of lower rib cage or of the lower thoracic or upper lumbar vertebrae
Hematoma in flank region

Question 8

What is important to report about the MOI of an abdominal and genitourinary traumatic emergency?

Answer 8

Velocity
Low: hand propelled (ie knives)
Medium: small caliber handguns and shotguns
High: High caliber handgun and rifles

Question 9

What may internal injuries do over time? So what must you do?

Answer 9

Get worse. CRITICAL: Reassess often: Primary, secondary, interventions

Question 10

What is very important with a secondary assessment of a traumatic emergency?

Answer 10

EXPOSE the injury trauma naked
Position of comfort may be lying with knees drawn to chest
Look for entrance and exit wounds

Question 11

What is important about an evisceration?

Answer 11

Do not push on abdomen–visual assessment only. Cut clothes away without pulling

Question 12

What is a cavitation?

Answer 12

Pressure wave from a projectile causing large amount of bleeding

Question 13

What are the aspects of a physical exam of an abdominal genitourinary injury?

Answer 13

Palpate from farthest quadrant
DCAP-BTLS
Head to toe exam
Treat life threats as you find them

Question 14

What is general treatment for an abdominal genitourinary injury?

Answer 14

Call ALS, monitor ABCs and LOC, treat for shock, and rapid transport

Question 15

What is treatment for an open wound abdominal genitourinary injury?

Answer 15

Check for entry and exit wounds, keep organs moist and warm, cover with sterile gauze, secure with a bandage, cover with occlusive dressing if needed

Question 16

What indicates kidney injury?

Answer 16

Abrasion, laceration, contusion on flank
Penetrating wound: flank/upper abdomen
Rib fracture: lower rib cage
Side tackle in foot ball

Question 17

What indicates bladder injuries?

Answer 17

Men: sudden deceleration can sheer urethra from bladder
Women: pregnancy increases potential for injury

Question 18

What is important about external male genitalia trauma?

Answer 18

Soft-tissue wounds, painful, rarely life threatening, distracting injury

Question 19

What is inportant about female genitalia?

Answer 19

Internal organs rarely injured-except uterus when pregnant,
External: Use sanitary pad to stop bleeding
-do not insert anything into vagina
Same gender EMT evaluate if possible
Examine undergarments for blood

Question 20

What is important about assessments of genitourinary injuries?

Answer 20

Patients may provide MOI less embarrassing than actual MOI, vascular areas, if blood present exterior genitals must be inspected, was this a sexual assault, are parents present

Question 21

What are the common complaints of a genitourinary injury?

Answer 21

Nausea, vomiting, diarrhea, blood in urine or vomit, abnormal bowel and bladder habits

Question 22

What is important in an instance of sexual assault?

Answer 22

Emotional support necessary, don’t examine genitalia unless bleeding requires intervention, don’t allow patient to wash, urinate, defecate, eat, drink, mouthwash, brush teeth, handle pt clothing as little as possible`