Traumatic Abdominal Injuries Flashcards

1
Q

Located below the diaphragm and contains major organs of the digestive, endocrine, urogenital systems and major vessels

A

Abdominal cavity

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2
Q

Abdominal cavity is divided into what two regions?

A

Peritoneal cavity

Retroperitoneal space

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3
Q

“True Abdomen”

  • Solid organs
  • Portions of the large intestine
  • Most of the small intestines
  • Female reproductive organs
A

Peritoneal cavity

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4
Q

Area located behind the peritoneum and contains:

  • Kidneys
  • Ureters
  • Inferior vena cava
  • Aorta
  • Pancreas
  • Much of the duodenum
  • Ascending descending colon and rectum
A

Retroperitoneal

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5
Q

The acids, enzymes and bacteria from the GI tract in an injury can result in:

A

Peritonitis and sepsis

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6
Q

Most commonly injury:

  • Small bowel (50%)
  • Colon (40%)
  • Liver (30%)
  • Abdominal vessels (25%)
A

GSW

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7
Q

___% of GSW will require surgery for definitive intervention

A

85%

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8
Q

__% of stab wounds will require surgery for definitive intervention

A

15%

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9
Q

Injuries most often involved in blunt abdominal trauma include

A
  • Spleen 40-55%
  • Liver 35-45%
  • Small bowel 5-10%
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10
Q

The most reliable indicator of intra-abdominal bleeding is the:

A

Presence of hypovolemic shock from an unexplained source

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11
Q

Indicates sudden force from deceleration (20% chance of intra-abd injury in adults) bowel

A

Seat Belt Sign

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12
Q

Distended abdomen may result from greater than ___ L of blood or a stomach filled with air

A

1.5 L

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13
Q

Historically thought to be a strong indicator of peritonitis. Controversial – performed by deeply palpating then quickly releasing. If more pain is felt when releasing then this is a positive test.

A

Rebound tenderness

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14
Q

Auscultation

Hemorrhage or spillage of contents may result in:

A

Ileus (cessation of peristalsis)

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15
Q

Bowel sounds are heard over the thorax

A

Diaphragmatic injury

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16
Q

Significant tenderness to percussion or pain with coughing is a strong indicator for:

A

Peritonitis

17
Q

Primary bedside modality to assess for intra-abdominal injury

Reliable, quick, repeatable, sensitive

A

FAST exams

18
Q

Image acquisition for FAST exam

A

RUQ, LUQ, pelvic, pericardial

19
Q

FAST exam

Can help with the subxiphoid view

A

Bending the knees

20
Q

FAST

Cardiac view is a secondary option if unable to get the subxiphoid view

A

PSLA

21
Q

Probe for FAST exam

A

Curvilinear

Phased-array

22
Q

FAST

Scan planes for RUQ and LUQ

A

Sagittal

23
Q

FAST

Scan planes for pelvic

A

Transverse and sagittal

24
Q

FAST

Scan planes for subxiphoid or PSLA

A

Cardiac

25
Q

FAST

In the RUQ visualize 4 areas

A

Morison’s Pouch, inferior tip of the liver, R hemothorax, subdiaphragmatic space

26
Q

FAST

In the LUQ, visualize 4 areas:

A

Splenorenal recess, inferior tip of the spleen, L hemithorax, subdiaphragmatic space

27
Q

Liver, kidney, diaphragm, Morison’s pouch, hemithorax (mirror image), inferior tip of the liver, subdiaphragmatic space

A

RUQ

28
Q

Liver, kidney, diaphragm, Morison’s pouch, hemithorax (mirror image), inferior tip of the liver, subdiaphragmatic space

A

LUQ

29
Q

Normal anatomy (FAST)

Posterior to the bladder (men) and Pouch of Douglas (women)

A

Pelvic

30
Q

FAST

Appearance of old blood

A

More echogenic

31
Q

Target goal in the absence of TBI is systolic of:

A

80-90mmHg

32
Q

TBI systolic minimum is:

A

90mmHg

33
Q

Eviscerated bowel treatment

A

Treatment should focus on protecting the protruding segment and provide moist environment

Clean or sterile dressing moistened with saline

  • Periodically re-moisten
  • Initial dressing may be covered with large, dry dressing to keep warm