Trauma Flashcards
Describe what things related to trauma we can see sonographically:
Tissue fractures, lacerations, capsule tears, subcapsular hematomas
What is a hematoma?
Localized mass of extravasated blood that is confined within an organ, tissue, or space
What is a seroma?
A mass caused by the localized accumulation of serum within a tissue or organ
What is a subcapsular hematoma?
A hematoma located in the subcapsular space of an organ
What is a lymphocele?
A cystic collection containing lymph, often seen after surgical procedures
What is a urinoma?
A cystic collection of extravasated urine
What is a pseudocyst?
Walled off fluid collection that forms in response to extravasated enzymes
What is a renal laceration?
Tearing of the renal tissues
What is hemobilia?
Presence of blood in the biliary tree
What is a biloma?
Encapsulated collection of bile in the peritoneal cavity
What is pneumobilia?
Air within the biliary tree
What is a bezoar?
Mass of foreign material
What is the clinical presentation of trauma dependent on?
Severity of trauma, area damaged, and time period
Describe the acute appearance of a hematoma (<24 hours):
Echogenic
Describe the appearance of a hematoma within one week:
Decrease in echogenicity
Describe the appearance of a hematoma 2-3 weeks post trauma:
Less defined (becomes more isoechoic)
What is the most common site of hepatic injury in the liver?
Right posterior segment
What is perivascular laceration?
Laceration that parallels the vessels
What is a liver fracture?
Laceration extending between 2 visceral surfaces
What are the most common causes of trauma to the spleen?
MVA or rib trauma
How can you determine whether the capsule is in tact or broken?
If the fluid conforms to the shape, subcapsular. If irregular, hemoperitoneum
What are the most common causes of biliary tree and pancreas trauma?
Percutaneous procedures, liver biopsies
What may biliary tree and pancreas trauma result in?
Hemobilia, jaundice, pneumobilia, biloma, or pseudocysts
How do lacerations appear sonographically?
Linear defect
70% of bladder trauma is associated with what?
Pelvic fracture
What are the two types of adrenal gland trauma?
Spontaneous and post-traumatic hemorrhage
What would spontaneous hemorrhage of the adrenal glands be caused by?
Anticoagulation therapy, severe stress, blood abnormalities
Where would post-traumatic hemorrhage of the adrenal glands be seen?
Predominantly in the medulla
Which adrenal is affected more often by post traumatic hemorrhage?
Right
What is the most common cause of adrenal mass in neonates?
Post traumatic hemorrhage
What does FAST stand for?
Focused Assessment with Sonography for Trauma
In the retroperitoneum, hematomas may be residing in where?
Psoas muscle and perinephric space
In the retroperitoneum, abscesses may be residing in where?
Perinephric space
In the retroperitoneum, urinomas may appear as what?
Anechoic collection
Hernias occur due to what?
Weakening in the abdominal wall muscles, viscera protrudes through
What are risk factors for an acquired hernia?
Increased age
What is a reducible hernia?
Can be pushed back into place
What is an incarcerated hernia?
Irreducible, trapped
What is a strangulated hernia?
Blood supply cut off/tissue swells, medical emergency
What is the most common form of hernia?
Inguinal
Who gets a direct inguinal hernia?
Older men (acquired)
Who gets an indirect inguinal hernia?
Young men (congenital)
List the types of hernias: (8)
- Umbilical
- Epigastric (widest part of the linea alba)
- Inguinal (direct and indirect)
- Spigelian (lat abd wall)
- Lumbar
- Ventral
- Femoral
- Incision
Describe hemiorrhaphy in regards to hernia treatment:
Large incision, muscle sewn over defect
Describe hernioplasty in regards to hernia treatment:
Incision, prosthetic mesh inserted
Describe laproscopic method in regards to hernia treatment:
Small incision
How does a rectus sheath hematoma appear sonographicallly?
Complex fluid collection in region of rectus abdominal muscles
What is the classic triad of Trauma?
- Hemodynamic instability (shock)
- Pain and tenderness
- Rigid abdomen
What lab test indicates trauma?
Low hematocrit (low RBC volume)
What is the primary method of imaging to detect a bleed?
CT
