Trauma

Question 1

Describe what things related to trauma we can see sonographically:

Answer 1

Tissue fractures, lacerations, capsule tears, subcapsular hematomas

Question 2

What is a hematoma?

Answer 2

Localized mass of extravasated blood that is confined within an organ, tissue, or space

Question 3

What is a seroma?

Answer 3

A mass caused by the localized accumulation of serum within a tissue or organ

Question 4

What is a subcapsular hematoma?

Answer 4

A hematoma located in the subcapsular space of an organ

Question 5

What is a lymphocele?

Answer 5

A cystic collection containing lymph, often seen after surgical procedures

Question 6

What is a urinoma?

Answer 6

A cystic collection of extravasated urine

Question 7

What is a pseudocyst?

Answer 7

Walled off fluid collection that forms in response to extravasated enzymes

Question 8

What is a renal laceration?

Answer 8

Tearing of the renal tissues

Question 9

What is hemobilia?

Answer 9

Presence of blood in the biliary tree

Question 10

What is a biloma?

Answer 10

Encapsulated collection of bile in the peritoneal cavity

Question 11

What is pneumobilia?

Answer 11

Air within the biliary tree

Question 12

What is a bezoar?

Answer 12

Mass of foreign material

Question 13

What is the clinical presentation of trauma dependent on?

Answer 13

Severity of trauma, area damaged, and time period

Question 14

Describe the acute appearance of a hematoma (<24 hours):

Answer 14

Echogenic

Question 15

Describe the appearance of a hematoma within one week:

Answer 15

Decrease in echogenicity

Question 16

Describe the appearance of a hematoma 2-3 weeks post trauma:

Answer 16

Less defined (becomes more isoechoic)

Question 17

What is the most common site of hepatic injury in the liver?

Answer 17

Right posterior segment

Question 18

What is perivascular laceration?

Answer 18

Laceration that parallels the vessels

Question 19

What is a liver fracture?

Answer 19

Laceration extending between 2 visceral surfaces

Question 20

What are the most common causes of trauma to the spleen?

Answer 20

MVA or rib trauma

Question 21

How can you determine whether the capsule is in tact or broken?

Answer 21

If the fluid conforms to the shape, subcapsular. If irregular, hemoperitoneum

Question 22

What are the most common causes of biliary tree and pancreas trauma?

Answer 22

Percutaneous procedures, liver biopsies

Question 23

What may biliary tree and pancreas trauma result in?

Answer 23

Hemobilia, jaundice, pneumobilia, biloma, or pseudocysts

Question 24

How do lacerations appear sonographically?

Answer 24

Linear defect

Question 25

70% of bladder trauma is associated with what?

Answer 25

Pelvic fracture

Question 26

What are the two types of adrenal gland trauma?

Answer 26

Spontaneous and post-traumatic hemorrhage

Question 27

What would spontaneous hemorrhage of the adrenal glands be caused by?

Answer 27

Anticoagulation therapy, severe stress, blood abnormalities

Question 28

Where would post-traumatic hemorrhage of the adrenal glands be seen?

Answer 28

Predominantly in the medulla

Question 29

Which adrenal is affected more often by post traumatic hemorrhage?

Answer 29

Right

Question 30

What is the most common cause of adrenal mass in neonates?

Answer 30

Post traumatic hemorrhage

Question 31

What does FAST stand for?

Answer 31

Focused Assessment with Sonography for Trauma

Question 32

In the retroperitoneum, hematomas may be residing in where?

Answer 32

Psoas muscle and perinephric space

Question 33

In the retroperitoneum, abscesses may be residing in where?

Answer 33

Perinephric space

Question 34

In the retroperitoneum, urinomas may appear as what?

Answer 34

Anechoic collection

Question 35

Hernias occur due to what?

Answer 35

Weakening in the abdominal wall muscles, viscera protrudes through

Question 36

What are risk factors for an acquired hernia?

Answer 36

Increased age

Question 37

What is a reducible hernia?

Answer 37

Can be pushed back into place

Question 38

What is an incarcerated hernia?

Answer 38

Irreducible, trapped

Question 39

What is a strangulated hernia?

Answer 39

Blood supply cut off/tissue swells, medical emergency

Question 40

What is the most common form of hernia?

Answer 40

Inguinal

Question 41

Who gets a direct inguinal hernia?

Answer 41

Older men (acquired)

Question 42

Who gets an indirect inguinal hernia?

Answer 42

Young men (congenital)

Question 43

List the types of hernias: (8)

Answer 43

- Umbilical - Epigastric (widest part of the linea alba) - Inguinal (direct and indirect) - Spigelian (lat abd wall) - Lumbar - Ventral - Femoral - Incision

Question 44

Describe hemiorrhaphy in regards to hernia treatment:

Answer 44

Large incision, muscle sewn over defect

Question 45

Describe hernioplasty in regards to hernia treatment:

Answer 45

Incision, prosthetic mesh inserted

Question 46

Describe laproscopic method in regards to hernia treatment:

Answer 46

Small incision

Question 47

How does a rectus sheath hematoma appear sonographicallly?

Answer 47

Complex fluid collection in region of rectus abdominal muscles

Question 48

What is the classic triad of Trauma?

Answer 48

1. Hemodynamic instability (shock) 2. Pain and tenderness 3. Rigid abdomen

Question 49

What lab test indicates trauma?

Answer 49

Low hematocrit (low RBC volume)

Question 50

What is the primary method of imaging to detect a bleed?

Answer 50

CT