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35 Cards in this Set
- Front
- Back
upper border of anterior abdomen (for trauma)
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nipple
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lower border of anterior abdomen (for trauma)
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inguinal ligament
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lateral border of anterior abdomen
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anterior axillary line
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2 borders of flank
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anterior axillary line
posterior axillary line |
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upper border of posterior abdomen
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tip of scapula
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2 kinds of penetrating injury
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high energy
low energy |
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example of low energy penetrating trauma
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knife wound
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example of high energy penetrating trauma
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GSW
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tx of high energy penetrating trauma
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exploratory laparotomy
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3 conditions for not doing laparotomy in case of high energy penetrating trauma
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tangential trajectory
full consciousness CT demonstrating extra-abdominal trajectory |
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7 conditions for exploratory laparotomy for low energy penetrating abdominal injury
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hemodynamic instability
acute abdomen distended stomach evisceration hematemesis blood PR blood in Foley cath |
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4 options for asymptomatic low injury penetrating abdominal injury
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24 h observation
local wound exploration FAST CT |
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local wound exploration is performed in ___
in LWE, integrity of ___ (2) is checked. if wound is found to be deep to ___, ___ is performed |
OR
posterior fascia peritoneum peritoneum diagnostic peritoneal lavage (DPL) |
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DPL is macroscopically positive if ___ (5) is found.
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gross blood
bile urine bowel contents pus |
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DPL is microscopically positive if ___ (4) is found
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WBCs > 500
RBCs > 100,000 Amylase > 250 positive gram stain |
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FAST is positive if ___ is seen
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lots of fluid
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CT has high/low sensitivity for injury to diaphragm or mesentery and perforated viscus
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low
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T/F: penetrating injury may be excluded on basis of negative CT
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false
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difference in management of low energy penetrating injury to flank/posterior abdomen from anterior abdomen is for ___ wounds. for these, do ___.
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asymptomatic
abdominal CT with triple contrast |
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triple contrast means ___ (3)
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oral
PR IV |
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T/F: penetrating injury to R diaphragm is indication for surgery
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false
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surgery is not immediately indicated for penetrating R diaphragm injury because ___
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liver may cover hole
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in case of penetrating injury to L diaphragm do ___
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laparoscopy
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probability of diaphragmatic injury after penetrating chest wound triples if ___ is present
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PTX
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tx for patients with penetrating spleen injury
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splenectomy
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given CT shows spleen laceration, 4 indications for exploratory laparotomy
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hemodynamic instability
consumes 3 units of blood/24 h peritoneal signs associated abdominal injury |
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3 kinds of exclusion from conservative tx for spleen injury
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injury-related
patient-related spleen-related |
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injury related indication for operation is ___, e..g ___ (2)
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other injuries present
pelvic fracture head injury |
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2 patient related indication for operation
an example of the former is ___ (3) |
poor physiological resouces
anticoagulants COPD CHF age > 70 |
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3 spleen related indications for operation
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grade 4-5 spleen injury
active splenic bleeding on CT pre-existing spleen disease |
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conservative tx for spleen injury (5)
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admit to ICU
bed rest NPO fluids close monitoring |
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in conservative tx, NPO is for ___ days
bed rest is for ___ days ___ should be checked every ___. |
1
3--5 Hb 8 h |
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operation of choice for spleen
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splenectomy
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indication for isolated liver surgery
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hemodynamic instability
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imaging modality for liver injury
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CT angio
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