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Semchir > T.abd > Flashcards

T.abd Flashcards

1
Q

CLASIFICARE

A

Contuzii

Plagi

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2
Q

CONTUZII
etiopatogenie
mecanism de actiune
factori favorizanti:????

factori determinanti:
???

A

factori favorizanti:
anatomici
fiziologici
patologici

factori determinanti:
topografie + directie
suprafata
viteza

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3
Q

SIMPTOMELE

A 
leziune parietala
	Sindromul Morel – Lavalle
         musculatura
         a . epigastrica
         hernia (evisceratia) 
          traumatica

leziuni viscere cavitare
peritonita
leziuni viscere parenchimatoase
leziuni viscerale in politraumatisme - ierarhizare

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4
Q

DIAGNOSTIC PARACLINIC

A 
Rx abdominala simpla + toracica !!!
Ecografie 3.5 / 7.5 MHz
Laparoscopia diagnostica/terapeutica
CT
Cistografie – urografie
Angiografie selectiva
Punctia abdominala
simpla ( 0.5 l sange  necoagulabil)
sensibilizata (cu 10-20 ml ser)
lavaj – NU !!
Biologic
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5
Q

PLAGI ABDOMINALE

A 
nepenetrante
penetrante
               orificiu de intrare - iesire
               scurgeri
               viscere

!!EXPLORARE CHIRURGICALA!!

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6
Q

STOMAC

DUODEN

A

plin
plagi – abdominale
plagi toracoabdominale
ulcer perforat

DUODEN
       diagnostic dificil
       preoperator
       intraoperator
       punere in repaos
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7
Q

JEJUN-ILEON

COLON-RECT

A

JEJUN-ILEON
frecvent multiple
explorare – sutura

COLON-RECT
iatrogen
insuflare
sutura  colostomie
exteriorizare
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8
Q

VEZICA URINARA

A 
VEZICA URINARA
intraperitoneala
extraperitoneala
anurie  hematurie
sondaj - lavaj  (nu se intoarce lichidul)
cistografie
sutura + sonda (7-10 zile)
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9
Q

FICAT

clasificare
semne clinice
tratament

A 
FICAT
CLASIFICARE: Contuzii / plagi
hematom subcapsular
leziune capsula
leziune profunda
SEMNE CLINICE: Triada 
bradicardie paradoxala la bolnav socat
hipotensiune
icter
Hemobilia OWEN
durere
HDS-melena
icter obstructiv

TRATAMENT: Sutura / Rezectie hepatica / Embolizari

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10
Q

SPLINA

RUPTURI
DUPA TRAUMATISM TORACO-ABD

A 
SPLINA
RUPTURI - intr-un timp
                 - în 2 timpi
 Dupa traumatism toraco-abdominal:
capsula fisurata
decapsulare
profunda
profunda cu interesare hil
multifragmentara sau hilara grava
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11
Q

SPLINA

FUNCTIE

EFET. SPLENECTOMIEI

A 
SPLINA
FUNCTIE:
rezervor
hematopoieza
imunologica
metabolica – fier, bilirubina

EFECTELE SPLENECTOMIEI:
sangvine – plachete / eritrocite
imunologice – Ig M, complement
vasculare - AVC, coronare

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12
Q

TRATAMENT SPLINA

  1. CONSERVARE SPLINA
  2. SPLENECTOMIE
A

TRATAMENT:

  1. CONSERVARE SPLINA
    a) nechirurgicala: abstentie interventionala / embolizare

b) chirurgicala miniinvaziva: tamponada/contentie/adezivi tisulari
c) Chirurgicala: sutura/splenectomia partiala/tamponada/laser/ligatura a. splenice/autotransplantul
2. SPLENECTOMIA : hemostatica cu rol vital !!

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13
Q

PANCREAS

TRATAMENT

A

PANCREAS
rar izolate
pancreatita acuta

       TRATAMENT : 
                        explorare
                        drenaj
                        anastomoze
                        Pancreatectomie caudala
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14
Q

RINICHI

Semne clinice
Examinari paraclinice
Tratament

A

RINICHI
Semne clinice: durere
hematurie

Examinari paraclinice: urografie – difuziune
ecografie

Tratament: abstentie
                    sutura
                    nefrectomie dupa urografie
VASE MARI
la traumatisme arteriale
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15
Q

MEZOURI

Mecanisme
Tratament

HEMORAGIE RETROPERITONEALA

A

MEZOURI
Mecanisme: Perpendicular / Paralel

Tratament: sutura / rezectie
hemostaza

HEMORAGIE RETROPERITONEALA
organe retroperitoneale
coloana
bazin
vase mari 
                         !!! ŞOC !!!
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16
Q

PRINCIPII GENERALE DE TRATAMENT

IN TRAUMATISMELE ABDOMINALE

A

PRINCIPII GENERALE DE TRATAMENT
IN TRAUMATISMELE ABDOMINALE

cateter de debit venos central	
aport volemic
PVC
aspiratie gastrica
sonda vezicala   > 40 ml / h
EKG - monitor

Semchir (7 decks)

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