Traumatic Injury to Urinary Tract- Butts

Question 1

Answer 1

kidney laceration

Question 2

removal of kidney

Answer 2

nephrectomy

Question 3

repair of kidney

Answer 3

renorrhaphy

Question 4

3 main options for kidney injuries

Answer 4

1. repair
2. remove
3. do nothing

Question 5

what is the best choice in a person who is hemodynamically stable w/ kidney injury

Answer 5

do nothing

Question 6

3 layers of kidney that can prevent expansion of blood and lead to hematoma and hemostasis:

Answer 6

renal capsule
Gerota’s fascia
Peritoneum

Question 7

is blood supply to the kidney normally distributed

Answer 7

no

Question 8

most vital structures to the kidney are superficial or deep

Answer 8

deep

Question 9

PICO question for kidney injury

Answer 9

surgery or non-operative

Question 10

3 main outcomes if you choose to take a surgical approach

Answer 10

death due to hemorrhage
short term complications
long term complications

Question 11

laceration of kidney that extends from renal cortex into medulla and collecting duct

Answer 11

grade IV laceration

Question 12

proposed by literature, _____% of renal injuries were successfully treated non-operatively

Answer 12

88%

Question 13

what has higher risk of complications

Answer 13

surgery

Question 14

in general, people who are ______ would benefit from surgery

Answer 14

bleeding to death

Question 15

midline incision
pack abdomen
control hemorrhage
control contamination
fix today or tomorrow

Answer 15

5 steps in surgical approach to kidney injury

Question 16

in surgery, L medial visceral rotation is _____ maneuver

Answer 16

Mattox

Question 17

in surgery, R medial visceral rotation is ____ maneuver

Answer 17

Cattell-Braasch

Question 18

proximal control
debridement
hemorrhage control
contamination control
close

Answer 18

steps for renorrhaphy

Question 19

2 adjuncts to closure for kidney injury

Answer 19

use omentum (nature’s band-aid)
hemastatic agents

Question 20

difficult injury to identify

Answer 20

ureter injury

Question 21

what can you use to find ureters if you can’t directly visualize them

Answer 21

methylene blue dye

Question 22

what do you see

Answer 22

R ureter obstruction
(hydronephrosis)

Question 23

which side is abnormal

Answer 23

L side

Question 24

Primary repair
Reimplanation
Ureteroureterostomy
External drainage

Answer 24

options for ureter injury

Question 25

sew ureter back together

Answer 25

primary repair

Question 26

take cut end and sew into bladder

Answer 26

reimplantation (only done when injury to ureter is low and close to bladder)

Question 27

takes L ureter and swings it over to R ureter

Answer 27

Ureteroureterostomy

Question 28

why is it important to have adequate blood supply

Answer 28

healing (brings O2 and WBCs)

Question 29

major blood supply to ureters

Answer 29

renal a testicular/ovarian a. internal iliac a

Question 30

best option for repair

Answer 30

primary repair

Question 31

technique?

Answer 31

Carrel technique

Question 32

repair type?

Answer 32

primary repair

Question 33

repair type?

Answer 33

reimplantation

Question 34

tension put on bladder, not ureter

Answer 34

Psoas Hitch

Question 35

Answer 35

Boari Flap

Question 36

this injury is rare

Answer 36

bladder injury

Question 37

2 types of bladder injuries

Answer 37

intraperitoneal extraperitoneal

Question 38

for this bladder injury, heals on its own and foley catheter is placed

Answer 38

extraperitoneal injury

Question 39

this bladder injury is unlikely to heal b/c high pressure and room for urine to build up

Answer 39

intraperitoneal injury

Question 40

see dome of bladder

Answer 40

intraperitoneal injury

Question 41

bladder injury?

Answer 41

extraperitoneal

Question 42

most bladder injuries heal in____ days

Answer 42

10