chapter 31 abdominal and genitourinary injuries
313
31. in any case of trauma to a female patient, you should always determine if the patient:
a. is on birth control
b. is pregnant
c. is currently menstruating
d. has a history of ovarian cysts
32. in cases of sexual assault, which of the following is true?
a. you should always examine the genitalia for any sign of injury
b. advise the patient not to wash, urinate, or defecate.
c. in addition to recording the facts, it is important to include your personal thoughts.
d. you should use plastic bags when collecting items such as clothes.
true/false
if you believe the statement to be more true than false, write the letter \ in the space provided. if you believe the
statement to be more false than true, write the letter \f\.
1. hollow organs may release free air into the abdomen if injured.
2. one of the most common signs of a significant abdominal injury is an elevated pulse rate.
3. patients with abdominal injuries should be kept supine with the head elevated.
4. peritoneal irritation is in response to hollow organ injury.
5. eviscerated organs should be covered with a dry dressing.
6. injuries to the kidneys usually occur in isolation.
7. peritonitis is an inflammation of the peritoneum.
8. the abdomen is divided into two quadrants.
9. patients with abdominal pain may want to lie still with their legs drawn up.

Question

chapter 31 abdominal and genitourinary injuries
313
31. in any case of trauma to a female patient, you should always determine if the patient:
a. is on birth control
b. is pregnant
c. is currently menstruating
d. has a history of ovarian cysts
32. in cases of sexual assault, which of the following is true?
a. you should always examine the genitalia for any sign of injury
b. advise the patient not to wash, urinate, or defecate.
c. in addition to recording the facts, it is important to include your personal thoughts.
d. you should use plastic bags when collecting items such as clothes.
true/false
if you believe the statement to be more true than false, write the letter 	\ in the space provided. if you believe the
statement to be more false than true, write the letter \f\.
1. hollow organs may release free air into the abdomen if injured.
2. one of the most common signs of a significant abdominal injury is an elevated pulse rate.
3. patients with abdominal injuries should be kept supine with the head elevated.
4. peritoneal irritation is in response to hollow organ injury.
5. eviscerated organs should be covered with a dry dressing.
6. injuries to the kidneys usually occur in isolation.
7. peritonitis is an inflammation of the peritoneum.
8. the abdomen is divided into two quadrants.
9. patients with abdominal pain may want to lie still with their legs drawn up.

Accepted Answer

### Question 31
# Brief Explanations:
In trauma cases for female patients, determining pregnancy (option B) is crucial as it impacts treatment (e.g., radiation, medications, surgical approach) and fetal well - being. Birth control (A) is less urgent, menstruation (C) and ovarian cyst history (D) are not as critical as pregnancy status in trauma assessment.
# Answer:
B. is pregnant

### Question 32
# Brief Explanations:
- Option A: In sexual assault, the genitalia should be examined for injury, but this is done carefully and with proper consent and protocols. However, the key correct action here is option B.
- Option B: Advising the patient not to wash, urinate, or defecate is correct as these actions can destroy evidence (e.g., semen, DNA, bodily fluids) that is important for forensic investigation.
- Option C: Including personal thoughts in the report is unprofessional and against medical/legal documentation standards.
- Option D: Reusing plastic bags for collecting items like clothes can contaminate evidence, so this is incorrect.
# Answer:
B. Advise the patient not to wash, urinate, or defecate.

### True/False Questions
1. # Brief Explanations:
Hollow organs releasing air into the abdomen (pneumoperitoneum) is a sign of hollow organ injury (e.g., bowel perforation), so the statement is true.
# Answer:
T

2. # Brief Explanations:
Elevated pulse rate (tachycardia) can be due to blood loss, pain, or shock from significant abdominal injury, and it is a common sign. So the statement is true.
# Answer:
T

3. # Brief Explanations:
Patients with abdominal injuries, especially if there is shock or potential for aspiration, are usually kept supine with legs elevated (Trendelenburg) or flat, not with the head elevated (which can worsen shock or cause respiratory issues). So the statement is false.
# Answer:
F

4. # Brief Explanations:
Peritoneal irritation (e.g., pain, tenderness, guarding) is a common response to hollow organ injury (due to spillage of contents like gastric juice, feces) or solid organ injury (due to blood). So the statement is true.
# Answer:
T

5. # Brief Explanations:
Eviscerated organs should be covered with a moist, sterile dressing (to prevent drying and further injury), not a dry dressing. So the statement is false.
# Answer:
F

6. # Brief Explanations:
Kidney injuries often occur with other abdominal or retroperitoneal injuries (e.g., spleen, liver, or spinal injuries), not usually in isolation. So the statement is false.
# Answer:
F

7. # Brief Explanations:
Peritonitis is inflammation of the peritoneum, which can be due to infection, injury, etc. So the statement is true.
# Answer:
T

8. # Brief Explanations:
The abdomen is divided into four quadrants (right upper, right lower, left upper, left lower) or nine regions, not two. So the statement is false.
# Answer:
F

9. # Brief Explanations:
Patients with abdominal pain may draw their legs up (flexed) to relax the abdominal muscles and reduce pain (similar to the fetal position). So the statement is true.
# Answer:
T

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