Abdo and Pelvic Flashcards Preview

2018 VU Trauma > Abdo and Pelvic > Flashcards

Flashcards in Abdo and Pelvic Deck (27)
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1
Q

Sign and symptoms of Diaphragmatic injuries

A
  • Auscultation of bowel sounds in the chest
  • Bowel or visceral herniation, obstruction, strangulation and possible rupture of the stomach and colon
  • Tension pneumothorax
  • Cardiac tamponade
  • Diaphragmatic paralysis
2
Q

Why are liver injuries so serious, its location, common causes and what occurs?

A
  • Upper right Quadrant
  • The liver is the largest organ in the abdomen and as so a rapid and significant amount of blood loss will occur. When the liver is injured blood and bile are caused to escape into the peritoneal cavity.
  • The liver is often injured via the steering wheel and lap belt in MVA.
3
Q

What are signs and symptoms of liver trauma?

A
  • Pain in right upper quadrant
  • Tenderness
  • Rigidity
  • Poor perfusion
4
Q

What are common cause of spleen injuries and are patients generally presenting symptomatically or asymptomatic?

A
  • Common cause of spleen injuries are due to RTA’s, falls, sporting injuries and are primarily caused by blunt trauma. These cause a significant and rapid blood loss.
  • 40% of PT are asymptomatic.
5
Q

What are signs and symptoms of a PT with a spleen injury?

A
  • The PT may present with referred pain in the left shoulder tip as the splenic haematoma causes diaphragm irritation
  • Poor perfusion
6
Q

What traumatic injuries may affect the kidneys?

A
  • The kidneys may be affected by contusions, haemorrhaging that my tamponade, lacerations, contusions and vascular injuries.
7
Q

What is the main cause of Ureters injuries?

A
  • The ureters may generally be injured by penetrating trauma.
8
Q

List some signs and symptoms of a PT with kidney or ureters trauma.

A
  • Haematuria (blood in urine) will be seen in 80% of cases
  • Localised flank / abdominal pain
  • Palpable posterior mass
  • Tenderness in lower ribs, upper L spine and flank
  • Pain in groin, should back and flank
9
Q

Is the pancreas susceptible to injuries, what type of trauma might impact it?

A
  • The pancreas is a solid organ that is rarely injured, however, if injured it may be due to penetrating trauma.
  • Duodenum injury is also associated with pancreatic trauma.
10
Q

How can a GI haemorrhage be confirmed?

A
  • A GI haemorrhage can only be confirmed if there is obvious evidence of bleeding from the mouth of anus.
11
Q

In what forms of trauma are you likely to see small and large intestine injuries in trauma setting?

A
  • Penetrating trauma, RTA and shearing force injuries.
12
Q

What signs and symptoms will a PT with small and large intestine injuries present with?

A
  • Pain
  • Peritoneal contamination
  • Visible GI bleeding
13
Q

What major vessels if lacerated require surgical repair?

A
  • Aorta
  • Inferior vena cava
  • Renal arteries
  • Mesenteric arteries
  • Iliac arteries
14
Q

What signs and symptoms and how can diagnosis be achieved of vessel lacerations?

A
  • Pain and poor perfusion

- These patients can only be diagnosed via ultrasound and exploratory surgery

15
Q

List the signs and symptoms of a traumatic aortic rupture.

A
  • Severe tearing chest pain
  • Cough
  • Dyspnoea
  • Dysphagia
  • Back pain
  • Hoarseness
  • High upper body blood pressure
  • Low lower body blood pressure
16
Q

What may cause an abdominal vessel wall to become weakened?

A
  • Trauma
  • Atherosclerosis
  • Vascular disease
  • Infection
17
Q

What are the four forms of Aneurysms?

A
-	Scallular
o	True aneurysm
-	Fusiform
o	True aneurysm
-	False Aneurysm
-	Dissecting aneurysm
18
Q

What are the signs symptoms and progression of a Ruptured aortic or thoracic aneurysm?

A
  • They progress fast into a PEA arrest, you may see signs early on of PT complaining of severe tearing/ripping pain and present with poor perfusion.
19
Q

What are the signs symptoms and progression of a Dissecting abdominal aortic aneurysm AAA?

A
  • PT will have an acute onset of a severe tearing/ripping pain in the abdomen through to the back.
  • The PT will present with poor perfusion, neurovascular compromise to lower limbs and have a pulsating abdominal mass.
20
Q

What is the paramedic management of a PT having an Aneurysm?

A
  • Prepare for cardiac arrest
  • IV access, preferably x2 large bore – 14g or 16g
  • Withhold fluid unless loss of cardiac output
    o Hypotension is helping to avoid full rupture
  • 2 bags of normal saline ready for arrest ( will essentially be a traumatic arrest)
  • Antiemetic’s
    o Vomiting will increase intra-abdominal pressure.
21
Q

What form of abdominal pain is felt on palpation?

A
  • Parietal pain
22
Q

What form of abdominal pain is felt on release of palpation?

A
  • Visceral pain
23
Q

What are the three types of lateral pelvis compression injuries?

A
-	Type 1
o	Compression of the sacrum
-	Type 2
o	Fracture of the iliac 
-	Type 3
o	Normally when a hemi pelvis is crushed
24
Q

List some details of lateral pelvic# compression

A
  • 50% of pelvic fractures
  • Common pedestrian injury
  • Stable but often high forces
25
Q

List some details of Anterior pelvic# compression

A
  • Accounts for 25% of pelvic fractures
  • Forces can be applied direct to pelvis or indirectly via the lower limbs
  • Produces an open book fracture
  • These are a lower energy force than lateral compression
26
Q

List some details of Vertical shear pelvic #

A
  • Account for 20% off pelvic#

- Usually occur from high falls or MVAs

27
Q

List the 3 classifications of pelvic#

A
  • Stable
    o # does not disrupt the pelvic ring, only has one break point and minor haemorrhage.
  • Unstable
    o # disrupts the pelvic ring, has two or more break points. # ma be within bones or separations between the fibrous joints between bones.
  • Open/closed
    o Closed pelvic # is where the skin over the fracture site is not broken. Open pelvic # or compound fracture, skin over the # site is broken.