2024 ATLS Module 5 - Abdominal & Pelvic Trauma Latest Questions With Complete Grade A Answers
- why is significant blood loss into the abdominal cavity sometimes hard to notice?
Answer: significant blood loss can be present in the abdominal cavity without a
dramatic change in the external appearance or dimensions of the abdomen and without obvious signs of peritoneal irritation
- what does the retroperitoneal space contain?
Answer: abdominal aorta, inferior vena cava; most of the duoudenum, pancreas,
kidneys, and ureters; posterior aspect of ascending colon and descending colon; and the retroperitoneal compenents of the pelvic cavity
- why are injuries to the retroperitoneal visceral structures difficult to recognize?
Answer: they occur deep within the abdomen and may not initially present with
signs or symptoms of peritonitis *also, it is not sampled by DPL and poorly visualized by FAST exam
*red text*
- how does a direct blow such as contact with the lower rim of a steering
wheel/bicycle/motorcycle handlebars/intruded door in MVC cause injuries to the abdominopelvic viscera and pelvic bones?
Answer: compression and crushing injuries
*these can deform solid and hollow organs and can cause rupture with secondary hemorrhage and contamination by visceral contents, leading to associated peritonitis
- why do shearing injuries occur?
Answer ex when restraint devices are inappropriately worn, fall from significant heights causing deceleration injuries: there is a differential movement of fixed and mobile parts of the body
ex: liver and spleen lacerations... they are both movable organs fixed at sites of their supporting ligaments
- what organs are most commonly affected by blunt traumas?
Answer:
spleen (40-55%) liver (35-45%) 1 / 2
small bowel (5-10%)
- does air bag deployment preclude abdominal injury?
Answer: no... these and restraint devices reduce incidence of many more major
injuries, but they are associated with specific patterns of injury
- how do stab wounds and low energy gunshot wounds cause tissue damage vs high
energy gunshot wounds?
Answer:
-stab wounds and low energy gunshot wounds cause tissue damage by laceration and tearing -high energy gunshot wounds transfer more kinetic energy, causing increased damage surrounding the track of the missile due to temporary cavitation
- how do blast injuries occur?
Answer: via several mechanisms... penetrating fragment wounds and blunt injuries from the pt being thrown back or struck by projectiles *pts close to source of explosion can incur injuries to tympanic membranes, lungs, and bowel related to blast over pressure
- should the potential of overpressure injury following explosion distract the
clinician from a systematic approach to identifying and treating blunt & penetrating injuries?
Answer: no
- in hypotensive pts, the goal is to rapidly id an abdominal or pelvic injury &
determine if it is the cause of hypotension... how does this differ in he- modynamically normal pts?
Answer: hemodynamic pts without signs of peritonitis may undergo a more
detailed eval to determine presence of injuries that can cause delayed morbidity and mortality
- what is important information to gather about a patient who has sustained
penetrating trauma?
Answer:
-time of injury -type of weapon -distance from assailant -number of stab wounds/gunshots sustained -amount of external bleeding noted at scene
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