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Abd / SS 2 > Module 7 : Trauma > Flashcards

Module 7 : Trauma Flashcards

1
Q

what is the clinical presentation of patients with trauma

A
  • dependent on severity, area, time line
  • hemodynamically unstable (shock)
  • pain and tenderness over area
  • rigid abdomen
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2
Q

what is a correlating lab test

A
  • hematocrit
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3
Q

what is hematocrit

A
  • volume of red blood cells in whole blood sample

- loss of blood causes a low hematocrit

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4
Q

what is the primary modality to see bleeds

A

CT

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5
Q

how does timing affect US look of hemorrhage or hematoma

A
  • acute = echogenic (debris)
  • within 1st week = decreased in echogenicity
  • 2-3 weeks post trauma = less defined
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6
Q

what is the treatment for trauma

A
  • hepatic, renal, splenic trauma managed conservatively in hemodynamically stable patients
  • ureteric trauma = nephrostomy stents
  • surgical repair
  • paracentisis
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7
Q

is the liver susceptible to hemorrhage what lobe most affected

A
  • yes

- right posterior segment

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8
Q

how is liver trauma treated

A
  • conservatively is not in shock
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9
Q

what are 5 findings of liver trauma

A
  • perivascular laceration
  • sub capsular and pericapsular bleed
  • isolated hematoma
  • liver fracture
  • hemoperitoneum
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10
Q

what is the most common cause of spleen trauma

A
  • MVA or rib trauma
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11
Q

which organ is most commonly affected by trauma

A
  • spleen
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12
Q

what does the shape of the fluid collection around the spleen tell you

A
  • crescent shape = sub capsular
  • irregular = perisplenic
  • check flanks and morissons pouch
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13
Q

what is the most common cause of biliary tree and pancreas trauma

A
  • percutaneous procedures and liver biopsies
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14
Q

what 5 things usually result form biliary or panc trauma

A
  • hemobilia
  • jaundice
  • pneumobilia
  • biloma
  • pseudocysts
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15
Q

what can kidney trauma be caused by

A
  • blunt or penetrating injury
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16
Q

what might be involved in kidney trauma

A
  • parenchyma or extend into collecting system
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17
Q

what are the 2 types of kidney hematoma

A
  • subcapsular

- intrarenal

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18
Q

what are kidney lacerations

A
  • linear defects
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19
Q

what are perirenal collections

A
  • urinomas

- hematomas

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20
Q

what is 70% of bladder trauma associated with

A
  • pelvic fracture
  • rupture
  • look for large fluid collections
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21
Q

is spontaneous hemorrhage of adrenal common or uncommon

A
  • not common
22
Q

what three things could cause spontaneous hemorrhage of adrenal

A
  • anticoagulation
  • stress
  • blood abnormalities
23
Q

characteristics of post traumatic hemorrhage of adrenal gland

A
  • predominantly in medulla
  • right more than left
  • bright ehcogenic mass more anechoic and smaller over time
24
Q

what does bilateral trauma of adrenal gland put you at risk for

A
  • adrenal insufficiency
25
Q

what is the most common cause of adrenal mass in neonates

A
  • adrenal hemorrhage
26
Q

characteristics of adrenal hemorrhage in infants

A
  • traumatic delivery
  • bilateral
  • decreased hematocrit increased bilirubin
  • jaundice
27
Q

where is hematoma localized to in GI tract

A
  • submucosa
28
Q

where does free fluid collect in peritoneum in supine

A
  • pelvis
  • paracolic gutters
  • free fluid conforms to surrounding organs
29
Q

what are the two types of free fluid in peritoneum

A
  • transudative and exudative
30
Q

what is a FAST scan

A
  • focused assessment with sonography
  • screening for intra abdominal injuries
  • free fluid detection suggests significant injury, patient goes for laparotomy
31
Q

what are 4 traumatic injuries to the retroperitoneum

A
  • hematomas = psoas muscle, perinephric space
  • abscesses = perinephric
  • urinomas = interventional procedures, hypo echoic collection
  • lymphocytes = post surgery, anechoic
32
Q

why do hernias occur

A
  • weakening in the abdominal wall muscles

- viscera protrudes through

33
Q

what are the two types of hernias

A

congenital

- aquired

34
Q

what are the 2 acquired hernias

A
  • gastroschisis

- omphalocele

35
Q

what are the risk factors for getting an acquired hernias

A
  • elderly
  • excessive weight gain or loss
  • surgery
  • pregnancy
  • heavy lifting
  • chronic constipation
  • sudden twists
  • pulls or muscle strains
36
Q

what are the signs and symptoms of hernias

A
  • asymptomatic
  • palpable mass or buldge
  • pain or burning
  • heaviness around scrotum
37
Q

what is a reducible hernia

A

can be pushed back into place

38
Q

what is an incarcerated hernia

A
  • irreducible

- trapped

39
Q

what is a strangulated hernia

A
  • blood supply cut off/tisssue swells

- medical emergency

40
Q

what are 8 locations of hernia

A
  • umbilical
  • epigastric
  • inguinal
  • spigelian
  • lumbar
  • ventral
  • femoral
  • incisional
41
Q

where do epigastric hernias occur

A
  • widest part of the lineament alba
42
Q

what is the most common location of hernias

A
  • inguinal

- if unilateral on the right

43
Q

what are the 2 types of inguinal hernias

A
  • direct

- indirect

44
Q

what is a direct inguinal hernia

A
  • acquired
  • older men
  • due to weakened canal floor
  • medial to inferior epigastric artery
45
Q

what is an indirect inguinal hernia

A
  • congenital
  • most common
  • exits via deep inguinal ring
  • passes through length of canal
46
Q

what is a spigelian hernia

A
  • spontaneous lateral abdominal wall
47
Q

is a lumbar hernia common or uncommon

A
  • uncommon
48
Q

what is a femoral hernia

A
  • groin pain

- mass medial to femoral vein

49
Q

what are the 3 surgical interventions for hernia s

A
  • herniorrhapy = large incision muscle sewn over defects
  • hernioplasty = incision , prosthetic mesh inserted
  • laparoscopic - small incision
50
Q

what are 5 causes of rectus sheath hematoma

A
  • trauma
  • surgery
  • vigorous abdominal contractions
  • intense straining g
  • spontaneous

Abd / SS 2 (7 decks)

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