chapter 8 - abdominal and pelvic trauma

Question 1

Abdominal solid organs

Answer 1

Includes; liver, spleen, kidney and pancreas

Question 2

Liver (the basics)

Answer 2

• Heavist of the organs
• Only one connected to the anterior abdominal wall <falciform></falciform>
• Divided into right and left lobes
• highly vascular organ

Rich blood supply from both the hepatic artery and the portal vein.

HEPATIC ARTERY> provides oxygen-rich blood @ the rate of 400 to 500 ml/minute. this is 25% of the total cardiac output

HEPATIC VEIN > deoxygenated blood

Question 3

Spleen

Answer 3

fist sided

> upper L) quad
filters and cleans the blood and serves as a reservoir. (300 ml of blood)

A drop in BP causes the synethic nervous system to stimulate contsrition of the spelic snuueses, this triggers the spleen to expel as much as 200 ml of blood into the venous circulation to try and restore blood volume.

Question 4

Liver (metabolism)

Answer 4

Metabolism; carbohydrates, fats, proteins and glucose conversion and release are regulated by the liver.

Also synthesis of fats from carbohydrates and proteins that have been broken down into amino acids. Bile is excreted from organic waste in the liver

> liver also synthesizes PT, fibrinogen and clotting factors.
vitamin K absorption is dependent on the liver producing adequate amounts of bile

Question 5

Abdominal hollow organs

Answer 5

Gallbladder stomach, small and large bowel

Question 6

Gallbladder

Answer 6

Stores bile and forces it into the duodenum after 30 minutes of eating.

Question 7

Small bowel

Answer 7

duodum, jejumum, illeium

Question 8

wall of the small bowel

Answer 8

mucosa, submucosa, musclarsis, serosa

Question 9

large bowel

Answer 9

cecum, colon, rectum and anal canal

Question 10

Pelvis organs

Answer 10

bladder, ureters, urethra and reproductive organs (ovaries, fallopian tubes, uterus, vagina).

Question 11

Renal injuries - signs

Answer 11

• hematuria
• flank tenderness
• rising BUN and creatine

Question 12

What else can you use as a pelvis binder

Answer 12

• towel

Question 13

Pancraese injuries - bloods

Answer 13

Amalyse levels - elevated

Question 14

General interventions for patients w abdominal and pelvis trauma

Answer 14

• Give 1 L of crystalloids and if no improvement consider blood
• IDC
• If rebound tenderness; stop as this may indicate operational irritation and lead to avoidable pain

Question 15

Labs in abdo trauma

Answer 15

• decrease in hemoglobin (Hgb) and hematocrit (Hct) will be noted in the presence of continued bleeding
• K level may increase with blood transfusion as there is a higher concentration of K in banked blood
• blood urea nitrogen (BUN) and craetine will rise in patients with poor renal perfusion.

Question 16

R) sided rib fractures - suspect

Answer 16

Liver injury

Question 17

A sudden increase in intraabdominal pressure would affect what organs?

Answer 17

stomach, large bowel, uterus and bladder

Question 18

signs of injury to the hollow organs

Answer 18

delayed signs (slow leakage)
*fever
* leukolysitis
* increasing abdo pain

Question 19

Retropetrinal organs ?

Answer 19

kidney and pancreases