OEC 6th Edition Chapter 24

The abdomen is located between the:

A) diaphragm and the pelvic brim.

B) mid-chest and the level of the umbilicus.

C) nipple line and the coccyx of the spine.

D) base of the 5th rib and the pelvic base.

A) diaphragm and the pelvic brim.

The function of organs in the abdomen is:

A) only digestion.

B) the storage of fat.

C) the absorption of oxygen.

D) digestion, production of white blood cells, and the filtering of blood.

D) digestion, production of white blood cells, and the filtering of blood.

When palpating the anterior portion of a patient's abdomen, you note tenderness in the left upper quadrant. You would recognize that which organ might be involved?

A) The kidney

B) The gallbladder

C) The spleen

D) The liver

C) The spleen

A patient complains of severe and sharp pain in the right shoulder when palpating the right upper abdominal quadrant. Based on this sign and location, what organ or structure is most likely involved?

A) Liver

B) Kidney

C) Spleen

D) Appendix

A) Liver

You have been called to aid a patient with generalized abdominal pain. The patient states that he recently had his gallbladder removed. You know that the gallbladder is located in the:

A) left upper abdominal quadrant.

B) right upper abdominal quadrant.

C) lower left abdominal quadrant.

D) lower right abdominal quadrant.

B) right upper abdominal quadrant.

Blunt trauma to the upper right abdominal quadrant can injure the:

A) pancreas.

B) spleen.

C) liver.

D) small intestines.

C) liver.

Which of these organs is most fragile and, therefore, most likely to be injured by blunt trauma?

A) Spleen

B) Heart

C) Colon

D) Skin

A) Spleen

The spleen of a patient has ruptured. Because the spleen is a solid organ, you recognize that the primary threat to life is most likely:

A) blood loss.

B) pain.

C) infection.

D) inflammation.

A) blood loss.

The pancreas is best described as a:

A) nonfunctional organ.

B) hollow organ.

C) solid organ.

D) fluid-filled organ.

C) solid organ.

The most common mechanism of injury to the pancreas is:

A) trauma to the left flank.

B) rotational trauma to the chest wall.

C) direct trauma to the middle of the abdomen above the navel.

D) trauma to the right flank.

C) direct trauma to the middle of the abdomen above the navel.

You are presented with an 18-year-old male who had trauma to the middle of his abdomen during a collision. His difficulty breathing might be due to:

A) pain from damage to his spleen.

B) the bends.

C) intestinal loops having moved into the thoracic cavity.

D) bleeding from the liver.

C) intestinal loops having moved into the thoracic cavity.

In which of the following injuries can the abdominal cavity migrate into the thoracic cavity?

A) A rib fracture

B) An abdominal hernia

C) An intestinal tear

D) A tear in the diaphragm

D) A tear in the diaphragm

An injury to the abdominal wall allowing the intestines to come out of the abdominal cavity is a(n):

A) laceration.

B) evisceration.

C) contusion.

D) abrasion.

B) evisceration.

You would recognize which one of the following situations as an acute abdominal emergency?

A) A patient who complains of stomach pain and has bad-smelling gas

B) A woman who says she drank tequila last night and now has stomach pain with diarrhea

C) A child whose sister has hepatitis and who has just vomited for the first time

D) A ski racer who hit a tree and has significant left flank pain prior to and during palpation

D) A ski racer who hit a tree and has significant left flank pain prior to and during palpation

Which of the following statements indicates that you correctly understand the goal of assessing and managing a patient who has abdominal pain?

A) "It is important to determine if the liver is the cause of pain because that is the most life-threatening condition."

B) "If the patient has tenderness upon any palpation of the abdomen, OEC technicians should assume that bleeding is the cause."

C) "It is more important to recognize a possible abdominal injury or emergency than it is to identify the exact cause."

D) "To best treat the patient, OEC technicians must identify the exact cause of the patient's pain."

C) "It is more important to recognize a possible abdominal injury or emergency than it is to identify the exact cause."

When taking care of a patient with an abdominal injury, your first priority is:

A) controlling massive bleeding.

B) keeping the scene, patient, and all rescuers safe.

C) achieving proper airway management.

D) stabilizing the patient.

B) keeping the scene, patient, and all rescuers safe.

A crying 42-year-old woman states that she has sharp abdominal pain that she localizes to her right lower quadrant. When assessing this patient's abdomen, you would look for distention and symmetry and then:

A) start the exam by palpating the abdomen in the quadrant farthest away from the one that is painful.

B) avoid palpating the entire abdomen.

C) start the abdominal exam by palpating the right lower quadrant.

D) avoid palpating the right lower quadrant.

A) start the exam by palpating the abdomen in the quadrant farthest away from the one that is painful.

When presented with a 6-year-old female with a stick impaled through her lower left abdominal quadrant, an OEC technician should:

A) stabilize the stick.

B) push the stick through the back of the abdominal cavity.

C) pull the stick out partway.

D) saw the stick off, leaving some in place.

A) stabilize the stick.

In most cases, the position of comfort in abdominopelvic trauma is:

A) supine, with padding under the knees to keep them slightly bent.

B) in a right recumbent position with the knees straight.

C) in a left recumbent position with the back bent.

D) in the Trendelenburg position.

A) supine, with padding under the knees to keep them slightly bent.

To prepare a patient with a pelvic fracture for transportation, you should:

A) apply a pelvic binder.

B) place the patient on a scoop stretcher in the right recumbent position.

C) place the patient in a supine position on a backboard.

D) place the patient in a seated position in a toboggan.

A) apply a pelvic binder.

Because pelvic fractures are often associated with heavy internal bleeding, you should expect:

A) to find other fractures as well.

B) that cardiac arrest may occur.

C) to see hypovolemic shock.

D) to need air evacuation for the patient.

C) to see hypovolemic shock.

Intestinal tear and rupture 

Happens due to penetrating trauma, undigested food/fecal matter can leak into abdominal cavity -> pain, inflammation, infection

Abdominal tear/rupture

Most common cause is rapid deceleration or penetrating trauma, causes severe bleeding

Abdominal evisceration injuries

When a tear in abdominal wall and peritoneum exposes intestines or other organs, uncommon, results in severe bleeding, heat loss, infection risk

Symphysis pubis

Protects the bladder, when it fractures, bone fragments can lacerate bladder

When to initiate shock management for abdominal injuries

if patient develops abdominal distention, pain upon exam, elevated pulse, decreased blood pressure. don’t give shock patient anything by mouth and rapid transport to definitive care 

Manage abdominal evisceration

Put abdominal contents back into large wound to not dry out organs and blood vessels don’t stretch. Clean of gross contamination first. If small hole, leave contents out, don’t force back in. Cover area with sterile dressing moistened with sterile water/saline solution. Keep patient warm

Manage fractured pelvis 

Apply a pelvic binder, can slow internal bleeding. Move them as little as possible, more movement = more internal bleeding. Commercial binders are better than ‘homemade’ sheet binder. Before or after applying, best not to logroll instead careful bridgelift