TRAUMATIC ABDOMINAL INJURIES Flashcards
What is located below the diaphragm and contains major organs of the digestive, endocrine, urogenital systems and major vessels?
Abdominal Cavity
What 2 regions are the abdominal cavity divided into based on relation to the peritoneum?
- Peritoneal cavity “true abdomen”
2. Retroperitoneal space
What region of the abdominal cavity contains solid organs, portions of the large intestines, most of the small intestines, and the female reproductive organs?
Peritoneal cavity
What is the area located behind the peritoneum and contains the kidneys, ureters, inferior vena cava, aorta, pancreas, much of duodenum, ascending descending colon and rectum?
Retroperitoneal Space
Loss of blood in the abdominal cavity is a primary cause of what?
Hemorrhagic shock
The acids, enzymes, and bacteria from the GI tract results in what?
Sepsis and Peritonitis
Gunshot wounds to the abdomen most commonly injure what?
- Small bowel (50%)
- Colon (40%)
- Liver (30%)
- Abdominal Vessels (25%)
___% of GSW to the abdomen will require surgery for definitive intervention versus ___% of stab wounds
- 85%
2. 15%
What are some common causes of blunt trauma to the abdomen?
- Deceleration forces or compression when involved in MVC
- Struck by a vehicle
- Falling from a significant height
Compression of a solid structure may lead to splitting of its structure (hepatic laceration) versus compression to a hollow structure that may cause what?
Rupture
Injuries most commonly involved in abdominal trauma include what?
- Spleen 40-55%
- Liver 35-45%
- Small bowel 5-10%
Mild compensated shock will show what?
mild increase in ventilation rate
Severe hemorrhagic shock will show what?
Marked tachypnea
Injury to what will often manifest with breathing aberrations with contents herniating into the chest cavity and bowel sounds may be heard over the thorax?
Diaphragm
The most reliable indicator of intra-abdominal bleeding is the presence of what?
Hypovolemic shock from an unexplained source
What sign indicated a sudden force from deceleration and a 20% chance of intra-abdominal injuries in adults (bowel)?
Seat belt sign
Distended abdomen may result from greater than ____L of blood or a stomach filled with air
1.5L
What is 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 it is a positive test?
Rebound tenderness
Auscultation
Hemorrhage or spillage of contents may result in what?
Ileus (cessation of peristalsis)
What should be considered if bowel sounds are heard over the thorax?
Diaphragmatic injury
Significant tenderness to percussion or pain with coughing is a strong indicator for what?
Peritonitis
What is often the definitive treatment for patients that have sustained abdominal injuries?
Surgical Intervention
What exams have become the primary bed side modality to assess for intra-abdominal injury?
FAST exams
What is the image acquisition for the FAST exam?
RUQ, LUQ, pelvic, pericardial
