New York State Emergency Medical Technician (EMT) Practice Exam

What does bruising around the umbilicus indicate during an abdominal assessment?

1. A ruptured spleen

2. A severe liver laceration

3. Intra-abdominal bleeding

4. Rupture of a hollow organ

The correct answer is: Intra-abdominal bleeding

Bruising around the umbilicus, often referred to as Cullen's sign, is an important indicator in medical assessments, particularly in the context of abdominal trauma. The presence of this bruising suggests that there is likely intra-abdominal bleeding, which can occur for various reasons, such as trauma to solid organs like the liver or spleen, or other causes of hemorrhaging within the abdominal cavity. This sign arises because the blood from the source of bleeding can track along the peritoneal lining and find its way to the subcutaneous tissue around the umbilicus. It typically indicates a significant event such as trauma, which warrants immediate medical examination and intervention due to the potential for life-threatening conditions. Understanding this, the other options represent possible conditions that could cause intra-abdominal bleeding but do not specifically denote the umbilical bruising itself. While a ruptured spleen or lacerated liver could be the source of bleeding that leads to Cullen's sign, the bruising itself is more directly associated with the presence of bleeding in the abdominal cavity, making intra-abdominal bleeding the most appropriate indication in this scenario.