Abdominal Trauma Flashcards
7 cards from real TNCC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Abdominal Trauma flashcards as text
A patient with blunt abdominal trauma has a positive FAST exam showing free fluid in the hepatorenal space. Which structure is most commonly injured with right upper quadrant fluid on FAST?
Answer: Liver
The hepatorenal space (Morrison's pouch) collects fluid from liver injuries, making the liver the most commonly injured organ when fluid is seen in that location.
Which mechanism of injury is most associated with hollow viscus (bowel) perforation in blunt abdominal trauma?
Answer: Lap belt restraint without shoulder harness
Lap belt–only restraint causes a classic pattern of bowel perforation and lumbar spine fracture (Chance fracture) because the bowel is compressed against the spine.
A trauma patient develops sudden hypotension 2 hours after a seat belt injury. Initial FAST was negative. What should be the priority diagnostic consideration?
Answer: Delayed hollow viscus injury with peritonitis
A negative initial FAST does not exclude bowel injury; delayed hollow viscus perforation can present with peritonitis and hemodynamic deterioration hours after injury.
Which physical finding is most specific for diaphragmatic rupture in a patient with left-sided blunt thoracoabdominal trauma?
Answer: Bowel sounds auscultated in the left chest
Bowel sounds in the chest are pathognomonic for diaphragmatic rupture with herniation of abdominal contents into the thoracic cavity.
During the secondary survey of a stab wound patient, you note evisceration of small bowel through the abdominal wound. What is the correct initial management?
Answer: Cover with a sterile, moist dressing and do not attempt to reinsert the bowel
Eviscerated bowel should be covered with a sterile, moist (saline-soaked) dressing to prevent desiccation without attempting to reduce the bowel.
A patient with penetrating abdominal trauma has a gunshot wound to the right flank. Which retroperitoneal structure is at greatest risk of injury in this trajectory?
Answer: Right kidney
The right kidney is a retroperitoneal organ located in the right flank and is highly vulnerable to penetrating injuries in that region.
Which lab finding is the earliest indicator of significant intra-abdominal hemorrhage in a hemodynamically stable patient?
Answer: Elevated serum lactate
Elevated serum lactate reflects anaerobic metabolism from inadequate tissue perfusion and is an early marker of occult hemorrhagic shock before hemodynamic instability becomes apparent.