LO3 Abdominal Trauma (Chapter 13)

Question 1

• Intrathoracic abdomen

Answer 1

: the part of the abdomen located under the thin sheet of muscle called the diaphragm an enclosed by the lower ribs

o Contains the liver, gallbladder, spleen, stomach and transverse colon

Question 2

• True abdomen

Answer 2

: part of the abdomen from the lower ribs including the pelvis the large and small intestines a portion of the liver, and the bladder

Question 3

• Retroperitoneal abdomen

Answer 3

the part of the abdomen behind the thoracic and true portions of the abdomen, separated from the other abdominal regions by a membrane

o Includes the kidneys, ureter’s, pancreas, ascending and descending colon, abdominal aorta, and the inferior vena cava

Question 4

• Blunt trauma

Answer 4

is most common mechanism

o mortality rates of 10 to 30%

o maybe from direct pressure of the abdomen against a fixed object with resulting tears or hematoma’s involving the solid organs (spleen,liver,pancreas)

o Patient who has experienced blunt abdominal trauma may have no pain or little external evidence of injury

Question 5

• Diapharamatic rupture

Answer 5

o Abdominal contents will herniate into the chest cavity most commonly on the left side because the liver tends to protect the diaphragm on the right

Question 6

• Blunt trauma or penetrating injuries to the chest below the nipple line

Answer 6

should lead to concern for possibility of both chest and abdominal injuries

Question 7

• Rib fractures

Answer 7

may suggest hepatic, splenic, and diaphragmatic trauma

Question 8

• Splenic injury

Answer 8

may present with referred left posterior shoulder pain

Question 9

• Liver injury

Answer 9

may present with referred right posterior shoulder pain

Question 10

• Cullens sign

Answer 10

Periumbilical bruising suspicion for retroperitoneal hemorrhage

Question 11

• Grey turners sign

Answer 11

a flank haematoma can develop particularly after retroperitoneal injuries significant amount of blood may be lost without any abdominal signs

Question 12

• Unstable pelvis

Answer 12

the pelvic ring must be disrupted into places

Question 13

spinal motion restriction

Answer 13

• Treating trauma to the abdomen or chest with no signs of neurological deficit does not require spinal motion restriction

Question 14

• Once on route

Answer 14

established to large IV lines with normal saline

o if the patient’s blood pressure drops below 90 systolic with signs of shock IV fluid should be titrated to maintain systolic pressure at 80 to 90

• Gently cover any organ or viscera protruding from a wound with mosit gauze with sterile saline or water