Abdominal Trauma: Questions and Answers for Medical Students, Exams of Biology

Download Abdominal Trauma: Questions and Answers for Medical Students and more Exams Biology in PDF only on Docsity!

TCRN -Abdominal fully solved

&updated

Solid organs Spleen Liver Pancreas - answer Organs commonly injured by blunt trauma? Duodenum (shearing forces may cause tearing at attachment points of ligament) Similar to tearing or aorta during sudden deceleration - answer Sudden deceleration in a blunt trauma caused movement of abdominal organs and most commonly tears which organ? Driver - liver Passenger - spleen - answer Harness seatbelt? GSW 96-98% likely needing surgery v 30-40% w stab wound GSW greater kinetic energy and destruction of tissue - answer GSW v stab wound - abdominal trauma? Retroperitoneal - answer Where is pancreas located in abdominal cavity? Left

(Liver protects diaphragm on right) - answer Blunt abdominal trauma- which diaphragm more likely to be injured? Liver Size and location Driver /harness - answer Most commonly injured Organ in blunt and penetrating trauma? Abd Blood accumulation in capsular portion of spleen.. it it rupture becomes laceration. Observation - answer Splenic hematoma Delayed presentation due to alkaline contents and does not immediately irritate peritoneum Delayed = septic peritonitis - fever , WBC, jaundice, blockage, 3rd spacing, elev liver enzymes, hypovolemia Referred pain possible V. Stomach w acidic fluid and immediate peritonic signs - answer Duodenal rupture Hollow organ rupture - answer Free air in abdomen? Immediate surgery - answer

Grey-Turner Sign - answer Bruising in flank area due to retroperitoneal bleeding Cullen's sign - answer Ecchymosis around umbilical area and indicates bleeding in peritoneal cavitt Pregnancy, pelvic injuries, previous multiple abdominal surgeries , morbid obesity, liver cirrhosis coagulopathy - answer Contraindications for DPL RBC greater than 100,000 - answer Positive DPL Observation - answer Intervention for grade 1 and 2 liver lac? Liver and bowel injury - answer What causes significant increased risk for post traumatic infection? All but 50 cm (total ~260cm) - answer How much bowel can be respected without compromise? Damage control surgery - answer Profuse liver bleeding during surgery - pack liver bed, us fibrin glue, vein /artery ligation with temporary closure w plan re operation Double barrel traverse colostomy Stool/mucus - answer Fecal diversion following a colon injury Right colon injury Difficult and /primary repair or hemicolectomy - answer Colostomy avoided in what type of injury?

Splenectomy - answer Grade 4 & 5 splenic rupture requires? Splenorrhaphy - answer Surgical repair Of Spleen? Kehr's sign Ballances sign Saegesser's sign - answer Signs of spleen injury Pain radiating to left scapula? Dullness over l flank Pain in neck area due to irritation of phrenic nerve Peritonitis - answer Pain worse with movement and rebound tenderness? Markel test - answer Strike heel with fist. It it illicits abdominal pain , possible indication of peritonitis Abdominal Compartment

Syndrome - answer Causes decreased tidal volume and increased ventilators pressures leading to resp distress and bilateral fluffy infiltrates Bladder pressures can be obtained through Foley catheter Normal 5-7 mmhg Normal in critically ill patients 5-15 mmhg ACS = greater than 20 mmhg - answer ACS monitoring High pressure in abdominal can cause increased ICP Refractory intracranial hypertension can be treated with abdominal decompression o neuromuscular blocking Agents - answer ICP related to ACS Negative pressure dressing - answer Recommended wound covering s/p decompressive abdominal surgery Pneumococcal infections Give pneumovac vaccine before discharge - answer Major potential complication following Splenectomy? Metabolic alkalosis Loss

Of gastric acids increases ph - answer Metabolic abnormality Occurs with draining fistula following Stomach injury? Metabolic acidosis secondary to loss of bicarbonate from pancreatic juices Jujunal neutral little change in acid base balance - answer Duodenal fistulas? Hypocalcemia (Tetany, prolonged QR interval, muscle cramps) Life threatening complication.- torsades - answer Electrolyte abnormality commonly occurs s/p pancreatic injury? Grade 2 - answer Liver laceration 1-3 Cm? Grade 3 - answer Liver laceration greater than 3 Cm Bed rest, limit fluid intake, monitor h&h Repeat CT not recommended - answer Obs spleen lac? Elevated platelet , place on lovenox - answer Post splenectomy labs? Midepigastric abdominal pain

Leukocytosis Elevated amylase - answer Triad s/s pancreatic injury? Hepatic Duodenal Face (salivary gland) Pancreatic NOT SPLEEN - answer Elevated amylase?