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DMST ABD 3 > Trauma > Flashcards

Trauma Flashcards

1
Q

What are etiology of trauma? 4

A
  1. Medical procedures
  2. MVA (motor vehicle accident)
  3. Blunt/penetrating trauma
  4. FAlls
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2
Q

What can we see with trauma? 4

A
  1. Tissue fractures
  2. Lacerations
  3. Capsule tears
  4. Sub-capsular hematoma
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3
Q

Clinical presentation of trauma is dependent on what? 3

A
  1. Severity of trauma
  2. Area damaged
  3. TIme period
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4
Q

What are some clinical presentations of trauma? 3

A
  1. Hemodynamically unstable
  2. Pain
  3. Rigid abdomen
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5
Q

What is a hematocrit?

A

Percentage by volume of packed red blood cells in whole blood

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6
Q

What causes low hematocrits?

A

Loss of blood

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7
Q

What are some imaging modalities for correlating hematocrits?

A

CT is the primary screening test for bleeding

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8
Q

What is a hematoma/hemorrhage?

A

Localized collection of blood

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9
Q

Sonographic appearance of hematomas/ hemorrhage does what with time?

A

Vary

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10
Q

What does hematomas/hemorrhages look like less than 24 hours?

A

Echogenic and acute

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11
Q

What does a hematoma/hemorrhage look like within the first week?

A

Decreases in echogenicity

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12
Q

What does a hematoma/ hemorrhage look like 2-3 week post trauma?

A

Less defined and can be isoechoic to organ tissue

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13
Q

What is the treatment options for hepatic, renal and splenic trauma in hemodynamically stable patients?

A

Managed conservatively in hemodynamically stable patients

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14
Q

What is the treatment option for ureteric trauma?

A

Nephrostomy or stents

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15
Q

What is general treatment option for trauma? 2

A
  1. Possible surgical repair
  2. Paracentesis for fluid drainage
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16
Q

Liver is susceptible to what with trauma?

A

Hemorrhage

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17
Q

Which side of the liver is typically affected by trauma?

A

Right posterior lobe

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18
Q

How is imaging used to diagnose liver trauma? 2

A
  1. Initial assessment with CT
  2. Serial U/S to monitor healing
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19
Q

What are some possible findings of liver trauma? 5

A
  1. Perivascular laceration
  2. Sub capsular and peri capsular bleed
  3. Isolated hematoma
  4. Liver fracture
  5. Hemoperitoneum
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20
Q

What is the most common trauma seen with the spleen?

A

MVA or rib trauma

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21
Q

What is the modality of choice for looking at spleen trauma?

A

CT

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22
Q

In terms of trauma of the spleen what does a intact capsule mean?

A

Subcapsular hematoma

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23
Q

In terms of spleen trauma, what does a capsule tear mean?

A

Hemoperitoneum LUQ

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24
Q

What kind of shapes of fluid collection do we need to look at in terms of spleens?

A
  1. Crescent: Subcapsular
  2. Irregular: Capsule may be torn
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25
Q

If we see a irregualr shape of fluid in the spleen, where should we check?

A

Flanks/ Morison’s pouch

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26
Q

What is the most common trauma of the biliary tree/ pancreas?

A

Percutaneous procedures (post liver biopsy)

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27
Q

What are some signs of biliary tree/pancreas trauma? 5

A
  1. Hemobilia
  2. Jaundice
  3. Pneumobilia
  4. Biloma
  5. Pseudocysts
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28
Q

What causes penumobilia with biliary tree/ pancreas? 3

A
  1. Fistulas
  2. Interventional procedures
  3. Emphysematous cholecystitis
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29
Q

What is the modality of choice to look at urinary tract - kidney trauma?

A

CT BUT U/S to follow up

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30
Q

What usually causes kidney trauma?

A

Blunt or penetrating injury

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31
Q

What is involved in truama of the kidneys?

A

Parenchyma or extending into collecting system

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32
Q

What is seen in the kidney with trauma?3

A
  1. Hematomas
  2. Lacerations
  3. Perirenal collections
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33
Q

What kind of hematomas are seen in the kidney

A

Subcapsular or intrarenal

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34
Q

What are some perirenal collections seen with kidneys? 2

A
  1. Urinomas
  2. Hematomas
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35
Q

70% of bladder trauma is associated with what?

A

Pelvic fracture

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36
Q

What do we see with bladder trauma? 3

A
  1. Possible rupture
  2. Large fluid collections
  3. Urinoma
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37
Q

What kind of trauma do we see with adrenal glands? 2

A
  1. Spontaneous hemorrhage no common
  2. Post traumatic
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38
Q

What leads to spontaneous hemorrhage in the adrenals? 3

A
  1. Anticoaguation therapy
  2. Severe stress
  3. Blood abnormalities
39
Q

With post traumatic of the adrenal glands, what is affected? What does it look like? What happens if it is bilateral?

A
  1. Medulla, right more than left
  2. Echogenic mass that becomes more anechoic and smaller over time
  3. Bilateral leads to adrenal insufficiency
40
Q

Can we see adrenals hemorrhage in infant?

A

Yes, its the most common cause of adrenal mass in neonates

41
Q

When does adrenal hemorrhage usually occur with infants?

A

2-7th day

42
Q

What causes traumatic adrenal hemorrhage in infants? What side does it affect?

A
  1. Traumatic delivery
  2. Bilateral
43
Q

What are signs of adrenal hemorrhage in infants? 3

A
  1. Decreases hematocrit
  2. Jaundice- reabsorption of excess hemoglobin
  3. Increase in bilirubin
44
Q

In supine, free fluid collects where?

A

In pelvis and paracolic gutters

45
Q

How does peritoneum fluids look like?

A

Transudative and exudative fluids which conforms to surrounding structures

46
Q

What does FAST stand for?

A

Focused assessment with sonography trauma

47
Q

What is FAST used for? 2

A
  1. Screening fro intra-abdominal injuries
  2. Free fluid detection from laparotomy
48
Q

What are some things seen as result of trauma in the retroperitoneum? 4

A
  1. Hematomas
  2. Abscesses
  3. Urinomas
  4. Hyphoceles
49
Q

Where are hematomas in the retroperitoneum?

A

Psoas muscle and perineprhic space

50
Q

What is the nature of retroperitoneum abscesses?

A

Perineprhic

51
Q

How would someone get Urinomas in the retroperitoneum? What do these collection look like echogenicity wise? 2

A
  1. Interventional procedures
  2. Hypoechic collections
52
Q

How would someone get lymphoceles in the retroperitoneum? What is the echogenicity? 2

A
  1. Post surgery
  2. Anechoic
53
Q

What is a hernia?

A

Weakening in the abdominal wall muscles, which cause viscera to protrude through

54
Q

How can someone get a hernia?

A

Acquired or congenital

55
Q

What are some Congential hernias? 3

A
  1. Gastroscisis
  2. Omphalocele
  3. Indirect inguinal hernia
56
Q

What are risk factors for acquired hernias? 7

A
  1. Elderly
  2. Excessive weight gain or loss
  3. Surgery
  4. Pregnancy
  5. Heavy lifting
  6. Chronic constipation
  7. Sudden twists, pulls or muscle strains?
57
Q

What are s/s for hernias? 4

A
  1. Asymptomatic
  2. Palpable mass or “bulge”
  3. Pain, burning sensation
  4. Heaviness around scrotum (males)
58
Q

Palpable masses for hernias increase and decrease in what positions?

A
  1. Increase while standing
  2. Decreased in supine
59
Q

What is a reducible hernia?

A

Ability to be pushed back into place

60
Q

What does a incarcerated hernia look like? 2

A
  1. Irreducible
  2. Trapped
61
Q

What is a strangulated hernia? What is the urgency of this type of hernia?

A
  1. Blood supply cut off/ tissue swells
  2. Medical emergency
62
Q

What are locations for hernias? 2

A
  1. Umbilical
  2. Epigastric (Through the linea alba)
63
Q

What are two types of inguinal hernias?

A
  1. Direct
  2. Indirect
64
Q

What is a direct inguinal hernia?

A

Tissue passes through a weakened canal floor

65
Q

Who is affected most with inguinal hernias?

A

Older males

66
Q

How does someone get a direct hernia

A

Acquired

67
Q

What is a indirect hernia?

A

Herniated tissue passes through the deep inguinal ring

68
Q

What is the most common type of inguinal hernia?

A

Indirect

69
Q

How does someone get a indirect hernia?

A

Congenital

70
Q

Both direct and indirect hernias can extend where?

A

Into the scrotum

71
Q

Can u/s differentiate between direct and indirect hernias?

A

No

72
Q

What is a spingelian hernia? And how is it diagnosed ?

A
  1. Spontaneous/ Lateral wall
  2. CT diagnosed most of the time
73
Q

How common is lumbar hernias?

A

Uncommon and acquired

74
Q

Lumbar hernias are asymptomatic or symptomatic?

A

Asymptomatic

75
Q

Who is affected with Lumbar hernias? And why?

A

Females due to wider pelvis

76
Q

How is lumbar hernias diagnosed?

A

CT

77
Q

What are ventral hernias? What are two examples?

A

Congenital ventricle hernias: Omphalocele, gastroschisis

78
Q

What does a femoral hernia look like?

A

Mass medial to femoral vein

79
Q

What are femoral hernia s/s?

A
  1. Groin pain
  2. +/- Palpable mass
80
Q

How does someone get a incisional hernial?

A

Post surgical

81
Q

What are s/s of incisional hernias?

A

Pain and palpable masses

82
Q

When scanning for a hernia what type of tranducer would we use?

A

High frequency transducer

83
Q

What does a patient need to do for a hernia exam?

A

Valsalva

84
Q

What do we need to do in terms of a U/S exam for documentation? 2

A
  1. 2 planes
  2. Document size, changes with pressure
85
Q

What does a hernia generally look like on U/S?

A

Interruption of peritoneal line

86
Q

What do we need to look for with hernias on u/s?

A

Look for peristalsis, fat or fluid

87
Q

What are criteria’s for hernias with u/s? 4

A
  1. Abdominal wall defect
  2. Presence of bowel loops or fat
  3. Increase in mass size with valsalva
  4. Decrease in mass size with transducer pressure
88
Q

What are three surgical intervention for hernias?

A
  1. Herniorrhaphy
  2. Hernioplasty
  3. Laparoscopic method
89
Q

What is a herniorrhaphy? 2

A
  1. Large incisions
  2. Muscle sewn over defect
90
Q

What is a hernioplasty?

A

Incision/ prosthetic mesh inserted

91
Q

What is a laparoscopic method for hernias?

A

Tiny incisions

92
Q

What are complications for surgical interventions for hernias? 4

A
  1. Infection
  2. Hematoma
  3. Epididymitis
  4. Ischemic Orchitis
93
Q

What are rectus sheath hematoma causes? 5

A
  1. Trauma
  2. Surgery
  3. Vigorous abdominal contractions
  4. Intense straining
  5. Spontaneous
94
Q

How can someone get spontaneous rectus sheath hematomas?

A

Anticoagulation therapy

DMST ABD 3 (11 decks)

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