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Abdominal Trauma Knowledge Check

Abdominal Trauma POCUS Knowledge Check

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This Knowledge Check for abdominal trauma point-of-care ultrasound (POCUS) gives you an opportunity to test your POCUS knowledge. Each question offers an explanation of the answer, and you'll receive feedback about your final score.

What shape does free fluid present in the abdominal cavity?

Angular

Spherical

Rounded

Where does fluid begin to collect first in a right upper quadrant (RUQ) window?

Inferior edge of the liver

Inferior pole of the kidney

Suprasplenic areas

A 35-year-old African American male with Previous Medical History of Diabetes Mellitus (DM) Type II and ongoing tobacco use presented to the emergency medicine department with complaint of dyspnea, palpitations and chest pain following a road traffic accident 3 hours ago. The patient also has a family history of ischemic heart disease, cerebrovascular accident (CVA).

Temperature - 98.2 F/36.8 C, HR - 110 BPM, BP – 90/72 mm Hg, RR – 32 per minute

EKG – Normal but shows tachycardia. Physical exam shows evidence of bruising on the anterior chest bilaterally.

The above tracing of the Inferior Vena Cava (IVC) was obtained using M-mode by the emergency medicine fellow. The IVC diameter was 0.26 cm during inspiration and 0.77 cm during expiration.

Based on the image and information provided, what is the most accurate statement regarding the patient’s hemodynamic state?

The patient’s maximum and minimum IVC diameter suggests euvolemic status.

The patient’s maximum IVC diameter suggests volume overload.

The patient’s maximum and minimum IVC diameter suggest hypovolemia and a responsive IVC.

A 25-year-old Caucasian female presented to the Emergency Department with a history of blunt trauma to the abdomen. The patient complained of abdominal pain. Her vitals were as follows.

Temperature – 98.4 F/36.9 C, Blood Pressure – 85/50 mmHg, HR – 110/min, RR – 20/min.

A POCUS E-FAST scan was performed and the image above was obtained.

What is the best possible diagnosis?

Small bowel obstruction

Pneumoperitoneum

Anechoic free fluid in the abdominal cavity

A 45-year-old Asian male was brought to the Emergency Department after being involved in a motorcycle accident. Multiple bruises were observed over his trunk and extremities. An E-FAST exam was performed. The view above was obtained in the right upper quadrant (RUQ).

What is the most probable diagnosis?

Free intraperitoneal fluid

Small pleural effusion

Retroperitoneal hematoma

A 45-year-old African American male was brought to the Emergency Department after being involved in a road traffic accident. The above view was obtained in the right upper quadrant (RUQ).

What are the most accurate findings?

Normal Morison’s pouch view with no evidence of free fluid

Abscess seen in region of Morison’s pouch

Hypoechoic and isoechoic clotted blood seen in the Morison’s pouch

A 35-year-old Hispanic female was involved in a road traffic accident and was brought to the Emergency Department for evaluation. The patient was conscious but seemed anxious. The ultrasound fellow decided to perform a quick E-FAST examination. The above view was obtained in the left upper quadrant (LUQ).

What is the most likely diagnosis?

Hemothorax with pneumothorax

Perisplenic clot with hemothorax

Normal left upper quadrant

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