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262 - cata > lecture 10: abdominal injuries > Flashcards

lecture 10: abdominal injuries Flashcards

1
Q

what are the boundaries of the abdomen

A

anterior and posterior cavity walls
diaphram
imaginary plane from pubic symp to sacrum

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2
Q

whatr are the 4 quda

A

UR UL

RL LL

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3
Q

the adbdoman contain organs that make up what 3 systems

A

digestive
urinary
genital

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4
Q

what does the RUQ contain

A 
liver 
right kidney 
gall 
colon 
pancrease
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5
Q

what does the LUQ contain

A 
stomach 
left kidnet
speen 
colon 
opacnrease
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6
Q

what does the RLQ cotnain

A 
appexid
colon
small intestint
ureter
major ven and arter for right lef
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7
Q

what does LLQ contain

A

colon
small in terniso r
urerer
maajor artery and vein or left lft

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8
Q

what are the solid organs of the abdomen

A 
Liver
 Spleen
 Pancreas
 Kidneys
 Ovaries
 Adrenal
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9
Q

which is more [prone to injuries

A

solid or

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10
Q

whart are some roles of solid organs

A

-enzyme productioon
blood cleansing
energy production

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11
Q

sicne the solid organs have rich blood supply,,, when there is an injury they are more likely to

A

hemmoraging

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12
Q

what are the hollow organs

A 
 Gallbladder
 Stomach
 Small intestine
 Large intestine
 Bladder
 Bile ducts
 Ureters
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13
Q

which organs will often have delayed SS

A

hollow

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14
Q

what is the liver location and landmark

A

right side

ribs 6-10

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15
Q

what is the gal bladder location and landmark

A

below liver

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16
Q

what is the spleen location and landmark

A

left side

ribs 9-11

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17
Q

what is the pancrease location and landmark

A

inferior posterior to lvier stomach, retroperitoneal

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18
Q

true or false: spleen injuries arent dangerous

A

flase

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19
Q

what is the landmark for the left kidneys

A

t11-l2 vertebreas

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20
Q

what is the landmark for right kidney

A

t12 to l3

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21
Q

hllow organs spill their caustic contents which can result in

A

intra-abdominal hemorrahage
peritonitis
sepsis (toxicity)

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22
Q

what are the intervention steps for someone with a abdominal issue

A

UABC (rule out spinal and concussion)
focussed
VITALS ARE IMPOSTANT

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23
Q

what is a foccused secondary assessment for abdomnial injury

A

hisotry
MOI and IOS
observe and put pillo under knees
4 quad palpation and special test

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24
Q

an athlete with an abdominal injiry will have a… (vitals)

A

rapid pulse
low BP
rapid, shallow breathing

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25
Q

when hisotry taking what is important to consider

A

MOI :penetrating or blunt
Any prveious kidney infection
last intake
hematueria (blood in urine)

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26
Q

if there is plain in upper left quadrant what are you expectig

A

spleen=danger

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27
Q

what is the most commonly effected orgaan of penetratinf trauma

A

liver

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28
Q

what does penetrating trauma result in

A

Uncontrolled hemorrhage
 Organ damage
 Spillage of hollow organ contents
 Irritation and inflammation of abdominal lining

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29
Q

what are the causes of blunt trauma

A

Deceleration (Contents damaged by change in velocity)

Compression (Organs trapped between other structures)

Shear (Part of an organ is able to move while another
part is fixed)

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30
Q

if you have a female athelete with abdominal pain, what is imporatnt to ask

A

if pregnant

if mentrual cycle

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31
Q

what are some symtoms you can ask for abdonamal

A 
fever
neauas
chills
general confition
reffered pain
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32
Q

what are the observations

A 
 Athlete looks sick?
 Contracting
 Distention
 Contusion
 Scars
 Masses (especially if
previous injuries there)
 Discoloration
 Redness
 Bruising
 Swelling
 Rigidity
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33
Q

what is collens sign

A

above belly button
indications pertineal bleeding, often pancratic hemmoriat

=sign in ruptured ectopic pregnancy

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34
Q

what is grey turners sign

A 
Bluish discoloration of lower
flanks, lower back; associated
with retroperitoneal bleeding of
pancreas, kidney, or pelvic
fracture.
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35
Q

what is kehr signs

A

Left shoulder pain when supine

caused by disapgragmic irrtation (ssign of ruptured spleen)

36
Q

whar is the test for kehlr signs

A

Athlete supine
 Elevate the LE (Trendelenburg position)
 Delayed classic symptom of a ruptured spleensign
(30min) of spleen injury once elevated
 Severe LEFT shoulder pain
 From blood or irritant in peritoneal cavity
CATA 262 29

37
Q

true or false: umbilical hernials get worse when valsave method

A

true , creates internal pressure

38
Q

what is the comfortable position for abdominal injruies

A

Usually, supine with a pillow under the
knees is the most comfortable for most
athletes.

 For those who do not find this position
comfortable, then the therapist must find
another position that relieves the pain.

39
Q

what is ridigity in the quadratnts

A

invulentary control of abdominal wall musculartor (no relaxion)

40
Q

what is guarding

A

voluntary contraction of the abdominal wall muscularature (relax when pressing)

41
Q

what is rebound tenderness

A

shaking, gentle pressing

if pain when lift up, radiating pain= irritation of the peritoneum

42
Q

how to perform rebound tenrerness

A

HOW: the AT maintains hand pressure
over an area of tenderness. The AT then
releases the hand pressure suddenly. Pain
denotes a positive test.

43
Q

how to find masses

A

ciurcular motion (deeper palpation)

44
Q

what are some abdominal special tets

A 
Psoas test
 Obturator sign
 Shake pelvis
 Hematuria
 Intra abdominal mass
 Cough sign
 Rovsing's sign
 Blumberg’s sign (rebound tenderness)
 Murphy’s sign
45
Q

if you have appendix issue, where is reffered pain

A

around belly button (RLQ)

46
Q

if you have liver issue, where is reffered pain

A

right shoulder RUQ

47
Q

if you have spleen issue, where is reffered pain

A

left shoulder (LUQ)

48
Q

if you have kidney issue, where is reffered pain

A

low back

49
Q

if you have ulcer issue, where is reffered pain

A

upper mod abdoment or upper back

50
Q

if you have aortic aneurysm issue, where is reffered pain

A

low back and RLQ

51
Q

if you have kidney issue, where is reffered pain

A

costovertebral angle (low back)

52
Q

if you have pancreas issue, where is reffered pain

A

upper abdomen

53
Q

what ate the general signs and symtoms of abdominal injruy

A 
Rigid, tender, rebound tenderness
 Athlete protects abdomen (guarding)
 Pain radiating to the shoulder
 Back pain (kidney injury)
 Blood in urine
 Nausea and vomiting
 Rapid, shallow breathing
 Rapid pulse
 Low BP
54
Q

what are ACUTE ss of abdomen

A 
Tachycardic  Fluid loss
 Hypotensive  Bowel inactivity
 Abdominal tenderness  Tense/distended abdomen
 Attemps at stomach emptying  Rapid shallow breathing
 Rebound tenderness  Stomach irritated
 Rigid abdomen  Guarding
 Decreased bowel sounds  Coliky pain
 Gas – feces retention  Peritonitis
 Abdominal wall injury  Infection
 Pain with respirations  Constipation
 Local/diffuse pain  Fever
 Back pain (without any back trauma)
 Referred pain to the shoulder
 Parietal vs. Visceral peritoneum
 Nausea/vomiting/loss of appetite****
 Pain on movement (athlete remains still to decrease pain)
 Shock: rapid pulse (tachycardia)/CATA 262 hypotensive
55
Q

what is the treatment for abdonal

A 
Maintain the airway, UABCd’s
 Calm athlete
 Oxygen (check SpO2)
 Treat for shock
 Control any external bleeding
 Place the athlete in a comfortable position
 Transportation
 Nothing to eat/drink
 No medications
56
Q

athletes withmild blunt abdominal trauma (contusion) may RTp after how long 15 min

A
57
Q

what is appendicities

A

inflamation

Smarts as general pain and gradually locatluzes to umbiliic in LRQ

58
Q

where will vyou feel pain with appendicities

A

pain on palpation of MCBurney’s point (2/3 between umbilical and ASIS)

59
Q

how can you ellicit pain for aappendicities

A

 Extending the thigh (active and passive) and resisted

flexion of thigh elicits pain

60
Q

what is ruptured appendix

A

abdominal pain that keeps on increasing

nausea, rigitidy

61
Q

if a male has a blow to the scrotum and pain is stead of increasing 15-20 minutes, what do you do

A

send to MD

62
Q

what is winded caused by

A

direct blow to the neural solar plexus of epigastric region

63
Q

what are the SS of beig windex

A

temporary repirtaty paralysisi

64
Q

what is the treatment for Tx windedd

A

loosen restrictive clothing and do gentle hip/knee flexion

65
Q

explain diaphragmic rupture

A

Dx: L>R diaphragm rupture 4X more likely,

abdominal contents spill in thoracic cavity

66
Q

what are the SS of diapgramic rupture

A

peritonitis, respiratory distress,
referred pain, muffled lung fields on
affected side, bowel sounds in chest cavity

67
Q

treatment of diaphragmitc rupture

A

911, 02, urgent surgical intervention

68
Q

what is thje collar sign

A

hourglass sign
sign of a diaagraph ripsure
(hernitated organs)

69
Q

are stomch contisuions.ruptures rare or common

A

rate

70
Q

what are the signs and simptooms of stomach contusion

A

S/S: classical abdominal findings: guarding,
rebound tenderness, absent bowel sounds, rigid
abdomen, chemical or bacterial peritonitis

71
Q

for someone with a stomach contusion, do you get o2 wiht the bvm

A

no , since they are breakthing on their own

72
Q

intestinal contusion is same as stmach contusion

A
73
Q

true or false: liver contusions are more common

A

true

74
Q

what is the MOI for liver rupture/contusion

A

durect blunt to right side (6-10 ribs)

75
Q

what are the signs and symptoms of liver contsusiin

A

S/S: shock signs: tachycardic, hypotensive, RUQ

pain/ref to shoulder?

76
Q

what is the most tcommon injuryed organ with blunt trauma

A

spleen

77
Q

what is the MOI for spleen rupture

A

blunt left trauma left side ribs

78
Q

what are the ss of spleen ocontusion

A

S/S: sharp ULQ pain, abdominal distention,
referred pain to left shoulder (Kerh’s sign),
shock signs, can occur acutely – might be
delayed for hours or even days

79
Q

what is more common, kidney contision or rupture

A

contusion

80
Q

what are SS of kidney contusion

A

local/reffered pain, low back pain, blood in urine

81
Q

what is the MOI for kidneys

A

MOI: direct blunt trauma to posterior lower back
Left kidney T11 to L2
Right kidney T12 to L3 (lower)

82
Q

what nis the MOI for pancreas contision

A

local trauma inferior to stomach.liver

83
Q

what are ss of penetratin trauma

A

Pain
 Nausea/ Vomiting
 Athlete will prefer to lie very still with his/her
legs drawn up because it hurts to move or
straighten the legs
 Athlete might complain about every bump
during transport
 If major vesses are cut or solid organs are
lacerated, bleeding may be rapid and severe

84
Q

what to do for penetrating trauma

A

Do not attempt to remove the object
 Inspect the athlete’s back and sides for exit wounds
 Stabilize the object with supportive bandaging around
the it to control external bleeding and minimize
movement of the object
 Dry, sterile dressing to all open wounds
 Check vitals (pallor, cold sweat, rapid-thready pulse,
low BP
 Treat for shock
 O2 via non-rebreather mask
 keep warm with blanket
 Ensure that you protect the spine
 Transportation to emergency dept

85
Q

WHAT IS abdominal evisceration

A

opened abdominal from wich organs and fat protrude

86
Q

what do you cover a abdomial evsceiration by

A

mositerior (steril solution), sterile cause or with occulsive dressing

262 - cata (18 decks)

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