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12 Cards in this Set
- Front
- Back
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Majority of uretral inuries
bladder injuries occur with |
penetrating trauma
pelvic fracture |
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PE
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Rectal exam - sphincter tone, position of the prostate gland, presence of blood
-if the prostate - missing, riding high or feels boggy - disruption of the membranoud urethra until proven otherwise. |
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UA
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Lab - no direct relationship between presence/absence or degree of micro hematuria and the severity of the injury.
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Contrast enhanced CT
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Contusion, lacerations, hematomas, perfusion abnormalitieis, early contrast extravasation (consistent with ongoing hemorrahge, cannot be detected until tile contrast enhanced urine is excreted 10 minutes)
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Ureter Injuries
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isolated ureteral injury is rare in trauma - wll protected in the retroperitoneuam
80% - form surg or iatragenic Exteram trauma - penetrating Cause gross or micro hematuria, (absence does not r/o uretral injury) Tx: surgery |
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Bladder injuries
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Most from pelvic fractures, will have gross hematuria,
Retrograd cystogram - gold standard. Tx: surg |
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Urethral
Posterior Anterior |
Post - membranou, prostatic urethra
Anterior - penetrating trauma - usu from penic, femal in pelvic fx |
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Dx Urethral injuries
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retrograde urethrogram
Performing a retrograde urethrogram before completing a CT of the abdomen and pelvis to evaluate for other life threatening injuries can interfere with CT diagnosis and embolization treatment of pelvic arterial extravasation from pelvic fracture |
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Tx urethral
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Male - suprapubic cath placement - surgery a couple of weeks later
Femlaes its complicated. |
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Strotal injury
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penetrating, trauma, burns, avulsion, zipper
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Penile fracture
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rupture of the corpus cavernosum - forcibly ben in sex, hear crack followed by peinle pain, swelling, discoloiration and visible defomity
ampution are usu self-inflicted |
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Self inflicted
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vacuum - hurt glans penis and urethra, debridement of devitilized tissue and reconstruction
rings bits, gunshot |
