Chapter 37 Flashcards
Which of the following is a function of the pancreas?
• Secretion of insulin
• Glucose secretion
• Clotting factor production
• Reservoir for bile
Secretion of insulin
Which of the following factors primarily contributes to the extent of injury from a gunshot wound to the abdomen?
• Trajectory of the bullet
• Physical fitness of the patient
• Length of the gun barrel
• Size of the patient
Trajectory of the bullet.
A 24-year-old male intentionally placed a commercially manufactured constricting object around the base of his penis. He complains of moderate pain, and assessment of his penis reveals that it is cyanotic. You should:
• make one attempt to cut the constricting object away from his penis.
• apply ice to the area to reduce any swelling and then remove the object.
• administer a narcotic analgesic prior to removing the constricting object.
• transport him to the hospital and provide emotional support en route.
transport him to the hospital and provide emotional support en route.
A 39-year-old woman sustained an abdominal evisceration after she was cut in the abdomen with a large knife. The patient is semiconscious and is breathing shallowly. You should:
• assist ventilations with a bag-mask device; cover the exposed bowel with moist, sterile dressings and protect them from injury; transport at once; and initiate IV therapy en route.
• administer oxygen via nonrebreathing mask; cover the exposed bowel with dry, sterile dressings; start an IV and give a 500-mL fluid bolus; and transport to a trauma center.
• insert an oral airway, provide ventilatory assistance, cover the exposed bowel with aluminum foil, begin transport, and start two large-bore IV lines with normal saline en route.
• perform intubation to protect her airway; cover the exposed bowel with moist, sterile dressings; start an IV and give analgesia; and transport to a trauma center with fluid boluses en route.
assist ventilations with a bag-mask device; cover the exposed bowel with moist, sterile dressings and protect them from injury; transport at once; and initiate IV therapy en route.
The periumbilical area refers to the:
• area lateral to the umbilicus.
• external umbilical orifice.
• space behind the navel.
• area around the umbilicus.
Area around the umbilicus.
Gross hematuria and suprapubic pain following a pelvic injury is most indicative of injury to the:
• ureters.
• urethra.
• bladder.
• kidney.
Bladder.
Fractures of the lower rib cage should make you most suspicious for injuries to the:
• ascending aorta.
• kidneys or pancreas.
• urinary bladder.
• liver or spleen.
Liver or spleen.
When assessing a patient with abdominal trauma for distention, you should recall that:
• a distended abdomen is one of the earliest clinical findings in patients with abdominal trauma.
• abdominal distention is usually caused by muscle tensing rather than intra-abdominal bleeding.
• because distention is a late sign of intra-abdominal bleeding, it should not be assessed for in the field.
• a significant amount of blood accumulation in the abdominal cavity is required to produce distention.
A significant amount of blood volume in the abdominal cavity is required to produce distension
Which of the following factors can decrease the potential damage caused by trauma to the abdomen?
• Toned abdominal muscles and an empty bladder
• Abdominal muscle tensing at the time of impact
• Air bags and being younger than 44 years old
• A seat belt that is worn above the iliac crests
Tones abdominal muscles and an empty bladder
Because of its anatomic position in the retroperitoneum, it typically takes high-energy force to damage the:
• liver.
• stomach.
• pancreas.
• spleen.
Pancreas
The major complication associated with injury of a hollow organ is:
- immediate death secondary to a massive infection.
- peritonitis caused by rupture and spillage of toxins.
- massive internal hemorrhage and profound shock.
- delayed treatment due to the absence of external signs.
Peritonitis caused by rupture and spillage of toxins
The upper peritoneal cavity includes the:
- pancreas.
- spleen.
- bladder.
- sigmoid colon.
Spleen
A 17-year-old high school football player was struck in the abdomen by another player during a tackle. Your assessment reveals signs of shock and pain to the patient’s left shoulder, which is unremarkable for trauma. Examination of the patient’s abdomen is also unremarkable for obvious injury. Based on your assessment findings and the patient’s clinical presentation, you should suspect:
- an injury to the spleen.
- a lacerated liver.
- acute peritonitis.
- retroperitoneal bleeding
An injury to the spleen
Which of the following organs or structures lies in the retroperitoneal space?
- Transverse colon
- Ascending colon
- Pancreas
- Spleen
Pancreas
During the third collision in a motor vehicle crash:
- hollow abdominal organs rupture upon impact.
- rapid deceleration propels an unrestrained person forward.
- the person’s abdomen collides with the steering wheel.
- abdominal organs shear from their points of attachment.
Abdominal organs shear from their points of attachment
