Podcast
Questions and Answers
If the abdomen appears larger than normal, this is called:
If the abdomen appears larger than normal, this is called:
Organs that lie dorsal to the peritoneum are called:
Organs that lie dorsal to the peritoneum are called:
The liver, spleen, and pancreas are examples of what type of abdominal organs?
The liver, spleen, and pancreas are examples of what type of abdominal organs?
What is the danger of penetrating trauma to the lower quadrants in a male patient?
What is the danger of penetrating trauma to the lower quadrants in a male patient?
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Blunt abdominal trauma that causes the perforation of a vascular structure in the abdomen may cause:
Blunt abdominal trauma that causes the perforation of a vascular structure in the abdomen may cause:
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What bit of information gathered during the scene size-up will be extremely important in determining the severity of abdominal injuries?
What bit of information gathered during the scene size-up will be extremely important in determining the severity of abdominal injuries?
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Why should the EMT complete a full assessment on any patient with abdominal pain?
Why should the EMT complete a full assessment on any patient with abdominal pain?
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You notice a bluish discoloration around the belly button. What does this finding mean?
You notice a bluish discoloration around the belly button. What does this finding mean?
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A penetrating abdominal injury with severe respiratory distress has MOST likely involved what structure?
A penetrating abdominal injury with severe respiratory distress has MOST likely involved what structure?
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You note that the abdomen is slightly distended, rigid to the touch, with an ecchymotic area surrounding the umbilicus. What does this finding imply?
You note that the abdomen is slightly distended, rigid to the touch, with an ecchymotic area surrounding the umbilicus. What does this finding imply?
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An object impaled in the abdomen should be:
An object impaled in the abdomen should be:
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In addition to the traditional management of a patient with abdominal trauma, what additional consideration should be made for an eight-month-pregnant female with abdominal trauma?
In addition to the traditional management of a patient with abdominal trauma, what additional consideration should be made for an eight-month-pregnant female with abdominal trauma?
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If the patient has sustained an abdominal evisceration, the EMT should:
If the patient has sustained an abdominal evisceration, the EMT should:
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In the treatment of an abdominal evisceration, the EMT should NOT:
In the treatment of an abdominal evisceration, the EMT should NOT:
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Injuries to the genitalia are:
Injuries to the genitalia are:
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If a woman who does NOT believe she is pregnant starts having serious vaginal bleeding after being involved in a high-speed collision, it is MOST likely NOT due to:
If a woman who does NOT believe she is pregnant starts having serious vaginal bleeding after being involved in a high-speed collision, it is MOST likely NOT due to:
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Which of the following structures serves as the division of the thoracic and abdominal cavities? (Select all that apply)
Which of the following structures serves as the division of the thoracic and abdominal cavities? (Select all that apply)
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What should you suspect in a construction worker bleeding from the abdomen with a screwdriver nearby? (Select all that apply)
What should you suspect in a construction worker bleeding from the abdomen with a screwdriver nearby? (Select all that apply)
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Severe abdominal trauma and blood loss may cause signs and symptoms of shock, which include:
Severe abdominal trauma and blood loss may cause signs and symptoms of shock, which include:
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As a review of the anatomy of the abdominal cavity, which of the following is TRUE?
As a review of the anatomy of the abdominal cavity, which of the following is TRUE?
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If a patient has an impaled object in his upper left abdominal quadrant, which organ is likely to have been injured?
If a patient has an impaled object in his upper left abdominal quadrant, which organ is likely to have been injured?
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Which of the following solid organs is offered the BEST protection from blunt trauma?
Which of the following solid organs is offered the BEST protection from blunt trauma?
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How should you treat a patient with a serious bleeding injury to his penis?
How should you treat a patient with a serious bleeding injury to his penis?
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A patient with an abdominal injury will likely want to keep his legs in what position to reduce pain?
A patient with an abdominal injury will likely want to keep his legs in what position to reduce pain?
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An abdominal evisceration should be covered with a moist sterile dressing, followed by:
An abdominal evisceration should be covered with a moist sterile dressing, followed by:
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An abdominal evisceration occurs when:
An abdominal evisceration occurs when:
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A weak or absent radial pulse, pale, moist, cool skin, and an increased heart rate in a patient with an abdominal injury are signs of:
A weak or absent radial pulse, pale, moist, cool skin, and an increased heart rate in a patient with an abdominal injury are signs of:
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Which of the following is TRUE regarding abdominal injury assessment?
Which of the following is TRUE regarding abdominal injury assessment?
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General emergency medical care for the patient with an abdominal injury includes:
General emergency medical care for the patient with an abdominal injury includes:
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Palpation of abdominal pain should begin:
Palpation of abdominal pain should begin:
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Which of the following is the correct definition of Kehr sign?
Which of the following is the correct definition of Kehr sign?
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During your focused history and physical exam of a patient with a suspected abdominal injury:
During your focused history and physical exam of a patient with a suspected abdominal injury:
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If a male patient is kicked in the testicles during a fight, after determining there is NO bleeding the EMT should consider:
If a male patient is kicked in the testicles during a fight, after determining there is NO bleeding the EMT should consider:
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Peritoneal space is potential space:
Peritoneal space is potential space:
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What type of abdominal organ is the vena cava?
What type of abdominal organ is the vena cava?
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Your patient sustained abdominal trauma a day earlier from a dirt bike accident. Given this presentation, what type of abdominal injury has the patient likely sustained?
Your patient sustained abdominal trauma a day earlier from a dirt bike accident. Given this presentation, what type of abdominal injury has the patient likely sustained?
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You are caring for a patient who sustained a GSW injury to the abdomen. Injury to which of the following structures would MOST likely result in acute deterioration and death?
You are caring for a patient who sustained a GSW injury to the abdomen. Injury to which of the following structures would MOST likely result in acute deterioration and death?
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When a patient has a knife impaled in his abdomen, the MOST likely condition to develop will be:
When a patient has a knife impaled in his abdomen, the MOST likely condition to develop will be:
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Why should the EMT complete a full assessment on any patient with abdominal pain?
Why should the EMT complete a full assessment on any patient with abdominal pain?
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Your patient has an abdominal wound that resulted in an evisceration of bowel. How should this be managed?
Your patient has an abdominal wound that resulted in an evisceration of bowel. How should this be managed?
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Injuries to the genitalia are:
Injuries to the genitalia are:
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You have a patient who was trapped beneath a truck along the freeway. What should be your FIRST priority of management?
You have a patient who was trapped beneath a truck along the freeway. What should be your FIRST priority of management?
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Which of the following is an example of a solid organ?
Which of the following is an example of a solid organ?
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Which of the following organs, if injured, would be MOST likely to cause peritonitis?
Which of the following organs, if injured, would be MOST likely to cause peritonitis?
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During a fight with a knife, your teenage patient was stabbed in the lower left abdominal quadrant. What structure is MOST likely injured from the stabbing?
During a fight with a knife, your teenage patient was stabbed in the lower left abdominal quadrant. What structure is MOST likely injured from the stabbing?
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What would be the preferred position in which to place a patient who has an abdominal evisceration?
What would be the preferred position in which to place a patient who has an abdominal evisceration?
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If your patient has vaginal bleeding from an assault, the EMT should do all of the following, EXCEPT:
If your patient has vaginal bleeding from an assault, the EMT should do all of the following, EXCEPT:
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Which of the following abdominal organs would be characterized as being solid despite containing a large amount of blood?
Which of the following abdominal organs would be characterized as being solid despite containing a large amount of blood?
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If a woman was assaulted and has sustained deep lacerations to her genitals the EMT should:
If a woman was assaulted and has sustained deep lacerations to her genitals the EMT should:
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Open wounds to the abdomen may be so large and deep that organs protrude through the wound opening. This is known as a/an:
Open wounds to the abdomen may be so large and deep that organs protrude through the wound opening. This is known as a/an:
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You are caring for a patient who was injured while riding his bike and was struck by a car. Where should the EMT start their assessment?
You are caring for a patient who was injured while riding his bike and was struck by a car. Where should the EMT start their assessment?
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What age bracket of patients is MOST likely to suffer injury to the liver and spleen from blunt abdominal trauma?
What age bracket of patients is MOST likely to suffer injury to the liver and spleen from blunt abdominal trauma?
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When assessing a patient with a large piece of glass sticking out of his abdomen, what should you do?
When assessing a patient with a large piece of glass sticking out of his abdomen, what should you do?
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What is the target pulse oximeter reading when providing oxygen to a patient with abdominal trauma?
What is the target pulse oximeter reading when providing oxygen to a patient with abdominal trauma?
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Which of the following causes immediate, excruciating pain?
Which of the following causes immediate, excruciating pain?
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Internal abdominal injuries can be severe because:
Internal abdominal injuries can be severe because:
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Study Notes
Abdominal Anatomy and Trauma Basics
- The diaphragm separates the thoracic and abdominal cavities, acting as a crucial structural division.
- The abdominal cavity houses vital organs of digestion, urinary, and endocrine systems, protected by muscles, the rib cage, and the pelvic ring.
- The peritoneum and pleura serve as linings but provide minimal structural support to separate the cavities.
Penetrating and Blunt Trauma
- A screwdriver found with a construction worker bleeding from the abdomen suggests a penetration injury.
- Signs of shock from abdominal trauma include increased heart rate and cold, pale skin; these are critical indicators of blood loss.
Anatomy Review
- Solid organs in the abdomen, such as the liver, spleen, pancreas, and kidneys, are highly vascularized and susceptible to severe injury.
- Injury to the small intestine is often suspected if a penetrating object is impaled in the abdomen, specifically in the upper left quadrant.
Treatment Considerations
- Injuries to genitalia should be treated as soft tissue injuries, providing direct pressure for bleeding control and emotional support for the patient.
- An abdominal evisceration requires a moist sterile dressing followed by an occlusive dressing to retain warmth and moisture.
Positioning and Assessment
- Patients with abdominal injuries often find relief in a bent position, which relaxes abdominal muscles and reduces pain.
- In cases of evisceration, place the patient in a supine position with knees flexed unless lower extremity injuries are suspected.
Signs and Symptoms of Internal Injury
- Hypoperfusion signs, including weak pulses and cool skin, are alarming signs of shock that could indicate internal bleeding.
- Discoloration around the umbilicus often indicates internal bleeding; it is a late sign suggesting prolonged hemorrhage.
Unique Injuries and Their Management
- Hollow organ injuries, such as those to the colon, can cause internal spillage and subsequent severe infections.
- The liver is a solid organ with a significant blood supply and is susceptible to rupture from blunt abdominal trauma.
Safety Precautions and Protocols
- Never remove objects embedded in a wound; stabilize them and prioritize airway management in trauma cases.
- Always start patient assessments from the airway, especially in unresponsive patients, before checking specific injuries.
Risks and Complications
- Pediatric patients are more at risk for severe liver or spleen injuries due to their anatomical placement and vulnerability in blunt traumas.
- Penetrating injuries to the penis or lower abdomen in males pose risks of serious complications, including urinary tract infections from bladder damage.
Key Terms
- Evisceration: Protrusion of abdominal contents through an open wound.
- Kehr's Sign: Referred shoulder pain caused by abdominal bleeding, particularly from irritations affecting the diaphragm.
- Distension: Enlargement or swelling of the abdomen, indicating underlying complications.
Emergency Care Protocols
- General treatment involves covering eviscerated tissues with moist dressings and closely monitoring vital signs.
- Patients with significant abdominal trauma should not be placed in prone or lateral positions; supine is preferred.
Protective Structures
- The spleen is one of the best-protected solid organs while the urinary bladder is less protected and at risk in penetrating injuries.
Conclusion
- Understanding the complexities of abdominal and genitourinary trauma equips medical personnel to react swiftly and effectively in emergency situations. Proper assessments, positioning, and treatment protocols are vital for patient survival and recovery.### Mechanism of Injury
- The mechanism of injury is crucial for assessing the severity of abdominal injuries.
- Signs include blunt or penetrating trauma, hemorrhagic shock, rapid shallow respirations, and abdominal pain or rigidity.
- Patients complaining of abdominal pain require thorough examination due to potential serious injuries.
Full Assessment Necessity
- Completing a full assessment on patients with abdominal pain is vital for identifying any additional injuries.
- Patients may overlook other injuries due to severe abdominal pain, risking missing life-threatening conditions.
Bruising Indicators
- Bluish discoloration around the belly button indicates a late sign of intra-abdominal bleeding.
- Inspecting the umbilicus and flank areas for bruising is essential, as it may signify internal bleeding over time.
Respiratory Distress and Diaphragm Injury
- Severe respiratory distress from a penetrating abdominal injury likely indicates diaphragm involvement.
- The diaphragm accounts for 60-70% of breathing effort, making its injury critical.
Abdominal Injury Timeline
- Rigid and distended abdomen with ecchymosis around the umbilicus suggests an abdominal injury that is likely several hours old.
- Cullen's sign is a specific indicator of periumbilical ecchymosis associated with abdominal trauma.
Management of Impaled Objects
- Any object impaled in the abdomen must be stabilized in place rather than removed.
- Removal could exacerbate internal injuries, potentially leading to fatal consequences.
Special Considerations for Pregnant Patients
- Pregnant women with abdominal trauma should be positioned to relieve pressure on the vena cava to avoid hypotension.
- The left lateral recumbent position is recommended to alleviate stress from the uterus.
Evisceration Treatment
- In cases of abdominal evisceration, cover the wound with a moist dressing followed by an occlusive dressing to maintain moisture and warmth.
- Avoid using aluminum foil as it may damage protruding organs.
Handling Evisceration
- Never attempt to return bowel to its original location in cases of abdominal evisceration; this is managed surgically later.
Genitalia Injuries
- Injuries to the genitalia, while often painful and embarrassing, are typically not life-threatening and are primarily soft tissue injuries.
Vaginal Bleeding in Non-Pregnant Women
- In non-pregnant women experiencing serious vaginal bleeding after trauma, a ruptured uterus is unlikely.
- Possible causes include genital trauma, pelvic fractures, and significant internal injuries.
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Description
Test your knowledge on abdominal and genitourinary trauma with these flashcards. This quiz covers key anatomical structures and their functions in the thoracic and abdominal cavities, helping you prepare for EMT scenarios effectively.
