Abdominal and Pelvic Trauma Flashcards

A motorcyclist is thrown from his bike and presents with lower rib fractures on the left. Which underlying organ injury must be STRONGLY suspected?

Answer: Splenic injury

Left lower rib fractures are closely associated with splenic injury because the spleen lies immediately beneath these ribs.

In the context of PHTLS, 'damage control resuscitation' in the prehospital phase refers to:

Answer: Limiting crystalloids, using blood products when available, and permissive hypotension

Damage control resuscitation limits crystalloids to prevent dilutional coagulopathy, uses blood products, and accepts permissive hypotension until surgical control.

A female patient in her third trimester of pregnancy suffers blunt abdominal trauma. Which placental injury is the MOST life-threatening to the fetus?

Answer: Placental abruption

Placental abruption, premature separation of the placenta from the uterine wall, is the leading cause of fetal death following maternal trauma.

Which of the following best explains why the pediatric patient is at higher risk for solid organ injury from blunt abdominal trauma compared to adults?

Answer: Children have less subcutaneous fat and a more compliant chest wall, providing less protection

The pediatric thorax is highly compliant, so significant force is transmitted directly to underlying organs without rib fractures serving as a warning sign.

A trauma patient has a gunshot wound to the right flank and is hemodynamically stable. During transport, vital signs suddenly deteriorate. The MOST likely explanation is:

Answer: Delayed rupture of a solid organ or vascular structure

Delayed hemodynamic deterioration following penetrating abdominal trauma typically indicates delayed solid organ rupture or vascular injury that was not bleeding initially.

Which of the following findings on abdominal exam is MOST consistent with intraperitoneal hemorrhage rather than retroperitoneal hemorrhage?

Answer: Diffuse rebound tenderness throughout the abdomen

Diffuse rebound tenderness indicates peritoneal irritation from blood or bowel contents freely in the peritoneal cavity, characteristic of intraperitoneal injury.

After applying a pelvic binder to an open-book pelvic fracture, the paramedic notes an open wound over the sacrum. The MOST appropriate action is to:

Answer: Pack the wound with gauze, then reapply the binder over the dressing

Open wounds should be packed with hemostatic or plain gauze before reapplying the binder, addressing both hemorrhage control priorities simultaneously.