Emergency Care In The Streets: Chapter 24 Abdominal Injuries

Front 1

Abdominal cavity extends from

Back 1

diaphragm to the pelvis.

Hint 1

Notes

Front 2

Peritoneum

Back 2

Membrane that covers the abdominal cavity.

Hint 2

Notes

Front 3

What are the regions of the internal abdomen?

Back 3

Peritoneal space
Retroperitoneal space
Pelvis

Hint 3

Notes

Front 4

What are the most commonly injured organs during blunt trauma?

Back 4

The spleen and liver.
They present with few s/s so you must remember to have a high index of suspicion.

Hint 4

Notes

Front 5

What is the leading cause of unexplained death due to delay in surgical intervention?

Back 5

Unrecognized abdominal trauma

Hint 5

Notes

Front 6

Shearing blunt trauma

Back 6

Caused by continued movement of internal organs as the body stops.
Shearing occurs at the point where they are attached to the abdominal wall.
Organs include: kidney, liver, spleen, and small and large intestines.

Hint 6

Notes

Front 7

Crushing blunt trauma

Back 7

The result of external forces at the time of impact.
Solid organs (kidneys, liver, spleen) are placed under intense, rapid pressure between the external forces (ie. dashboard) and the spinal column, ribs and posterior musculature.

Hint 7

Notes

Front 8

Compression blunt trauma

Back 8

Results from a direct blow to the abdominal region which deforms the hollow organs causing them to rupture.

Hint 8

Notes

Front 9

List MVC patterns

Back 9

Frontal
Lateral
Rear
Rotational
Rollover

Hint 9

Notes

Front 10

List solid organs

Back 10

Liver
Kidney
Spleen
Pancreas
Diaphragm

Hint 10

Notes

Front 11

List hollow organs of abdomen

Back 11

Small/large intestine
Stomach
Bladder

Hint 11

Notes

Front 12

Grey Turner's

Back 12

Ecchymosis of the flanks
Can be delay up to hours to days.

Hint 12

Notes

Front 13

Cullen's Sign

Back 13

Ecchymosis around the umbilicus.
Can be delayed sign for hours to days.

Hint 13

Notes

Front 14

Types of MOI in pelvic fx

Back 14

-Anterior-posterior compression in head-on collisions, causes "open-book" fx.
-Lateral compression in side impacts, less likely to cause an unstable pelvis or life-threatening hemorrhage.
-Vertical shears in falls from heights, can cause internal hemmorrhage, fx and bladder rupture.
-Saddle injuries from falling on objects, fx that bones just below the male of female genetalia.

Hint 14

Notes

Front 15

Notes on injuries to the liver

Back 15

Can release blood and bile into the peritoneal cavity. The blood loss can be massive, causing shock.

Hint 15

Notes

Front 16

Notes on injuries to the kidney

Back 16

Releases blood and urea into the retoperitoneal area. Blood loss not as massive due to smaller space

Hint 16

Notes

Front 17

Notes on injuries to the spleen

Back 17

Can be secondary to both MVC and sport injury trauma. Blood spills into the peritoneum with associated massive blood loss and onset of shock.
Kehr's sign is referred pain to left shoulder and may be the only sign or symptom following the traumatic event

Hint 17

Notes

Front 18

Notes on injuries to the pancrease

Back 18

Very rare, occurs in less than 5% of abdominal injuries as it well protected due to positioning. S/s may take hours to onset.Spillage of enzymes into the peritoneal cavity can cause damage to tissues and abcesses.

Hint 18

Notes

Front 19

Notes on injuries to the diaphragm

Back 19

Will present with ventilatory compromise, and are not isolated injuries. Shearing and tearing are the most common MOI

Hint 19

Notes

Front 20

Notes on injuries to the small/lage intestine

Back 20

Usually secondary to penetrating trauma or sever blunt trauma. Contents (consisting of fecal matter and bacteria) are spilled into the peritoneal cavity causing peritonitis and sepsis if untreated.

Hint 20

Notes

Front 21

Notes on injuries to the stomach

Back 21

Almost always secondary to penetrating trauma unless the stomach is full, then blunt trauma can cause rupture. Contents spillage contains acids that cause tissue damage as well as associated peritonitis and sepsis.

Hint 21

Notes

Front 22

Notes on injuries to the bladder

Back 22

Can be secondary to blunt or penetrating trauma. Extent of injury will depend of severity of trauma and distension of bladder. Usually associated with pelvis fx.

Hint 22

Notes

Front 23

Notes on injuries to the abdominal vascular injuries

Back 23

Descending aorta is found here and can bleed to the limits of the retroperitoneal space within minutes. Inferior vena cava is also located here and can cause the same level of blood loss over a long time period.

Hint 23

Notes

Front 24

Notes on injuries to the duodenal injuries

Back 24

Secondary to high speed deceleration injuries. Contents can spill out, however, onset of symptoms will take some time to present.

Hint 24

Notes

Front 25

retroperitoneal organs

Back 25

Aorta, vena cava, kidneys, pancreas, ureterers, and portions of the duodeenum and large intestive.

Hint 25

24.5

Front 26

intraperitoneal organs

Back 26

Peritoneum, liver, spleen, stomach, small bowel, colon, gallbadder, and in women the reproductive organs.

Hint 26

24.5

Front 27

pelvic organs

Back 27

The rectum, ureters, pelvic vascular plexus, major vascular structures, pelvic skeletal structures, and reproductive organs lie in the pelvis.

Hint 27

24.5

Front 28

know the different statistics of abdominal injuries and the difference between penetrating and blunt trauma

Back 28

About 80% of all significant trauma involves the abdomen.
Two thirds involve blunt trauma most during MVA, resulting mortality of about 5%.

Hint 28

24.7

Front 29

mesentery

Back 29

A membranous double fold of tissue in the abdomen that attaches various organs to the body wall.

Hint 29

24,5

Front 30

The area around the umbilicus is referred to as the ______________ area.

Back 30

periumbilicus

Hint 30

24.5

Front 31

The superior border of the liver can be as high as the patient's ________.

Back 31

nipples

Hint 31

24.10

Front 32

Most injuries to the stomach result from _____________________.

Back 32

penetrating trauma

Hint 32

24.11

Front 33

Hemoperitoneum is best defined as

Back 33

stomach bleeding

Hint 33

24.14