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NREMT® Paramedic > EMT-P (4) Medical > Abdominal and GI Emergencies > Flashcards

Abdominal and GI Emergencies Flashcards

Explore the Abdominal and GI systems and the prehospital emergencies within

1
Q

Define:

gastric distention

A

It occurs from excessive positive pressure ventilation that inflates the stomach.

Impedes lung expansion.

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2
Q

Define:

peristalsis

A

These are rhythmic contractions that transport food through the mouth to the stomach.

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3
Q

Define:

Portal Vein

A

It transports venous blood from the GI tract directly to the liver.

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4
Q

What does the cardiac sphincter connect?

A

The esophagus to the stomach.

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5
Q

What acidic chemical is composed in the stomach?

A

Hydrochloric Acid

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6
Q

What does the pyloric sphincter connect?

A

The stomach to the small intestine.

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7
Q

What is the material that exits the pyloric sphincter?

A

chyme

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8
Q

Fill in the blank.

The first part of small intestine is the _______.

A

duodenum

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9
Q

What are the functions of the liver?

A
  • Produces bile.
  • Promote carbohydrate conversion.
  • Convert glycogen into glucose.
  • Fat and protein metabolism.
  • Detoxifies drugs
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10
Q

Define:

bile

A

An enzyme that helps break down fats.

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11
Q

What is the purpose of the small intestine?

A

It dissolves water soluble and fat soluble substance.

90% of absorption occurs in the small intestine.

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12
Q

Name the three sections of the small intestine.

A
  1. Duodenum (last part of upper GI)
  2. Jejunum (first part of lower GI)
  3. Ilieum
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13
Q

What is the purpose of the large intestine?

A

It completes the reabsorption of water that the small intestine missed.

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14
Q

How long is the typical time of digestion?

A

8 - 72 hrs.

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15
Q

Define:

ascites

A

Accumulation of fluid in the abdomen, causing abdominal swelling.

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16
Q

Define:

protuberant

A

It refers to a protruding abdomen, indicating that it is bulging or sticking out abnormally.

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17
Q

Define:

scaphoid

A

It refers to a concave abdomen, indicating that the abdomen is sunken in or hollowed out.

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18
Q

How frequently do normal bowel sounds occur?

A

5-30 times a minute.

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19
Q

Define:

borborygmi

A

Prolonged stomach growling.

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20
Q

Describe:

visceral pain

A
  • Difficult to localize.
  • Burning, cramping, or aching sensation.
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21
Q

Describe

parietal pain

A
  • Easier to localize.
  • Pain increases with movement.
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22
Q

Describe:

somatic pain

A
  • Localized pain felt deeply.
  • Resulting from injury to tissue.
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23
Q

Describe:

referred pain

A

Pain originating in one place and occurring in another.

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24
Q

What is the purpose of obtaining an orthostatic vital?

A

To gauge if someone is hypovolemic.

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25
Q

List common medications and their dosages for abdominal pain.

A
  • Morphine 5-10mg
  • Toradol 15-60mg
  • Fentanyl 50-100mcg
  • Demerol 50-150mg
  • Nubian 10mg
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26
Q

List common medications and dosages for nausea.

A
  • Zofran 4mg
  • Benadryl 10-50mg
  • Visatril 25-100mg IM
  • Phenegran 12.5-25mg
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27
Q
  • What is hyponatremia?
  • What are the signs/symptoms associated with it?
A
  • Low-sodium
  • Symptoms:
    • weakness
    • cramps
    • convulsions
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28
Q
  • What is hypernatremia?
  • What are the signs/symptoms associated with it?
A
  • High-sodium
  • Symptoms:
    • muscle weakness
    • thirst
    • irritability
    • seizures
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29
Q

What are the first and second main causes of hypovolemia?

A
  1. vomiting and diarrhea
  2. hemorrhage
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30
Q

What are the most common causes of upper GI bleeds in the esophagus, stomach, and duodenum?

A
  • Esophagus: varices, cancer, tear, dilated veins, cirrhosis, GERD
  • Stomach: ulcer, cancer, gastritis
  • Duodenum: ulcer
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31
Q

What are the most common causes of lower GI bleeds in the small intestine, large intestine and rectum?

A
  • Small intestine: irritable bowel disease, cancer
  • Large intestine: infections, ulcerative colitis, colorectal polyps, diverticula disease
  • Rectum: hemorrhoids
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32
Q

Define:

esophageal varices

A

Increased pressure in the vessels that surround the esophagus and stomach.

These vessels drain into the portal vein, which, in result, creates increased portal vein pressure and eventually, rupture.

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33
Q

Assessment

esophageal varices

A

Vomiting of bright red blood.

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34
Q

Treatment:

esophageal varices

A

Fluid resuscitation.

In hospital: cauterize affected area.

35
Q

Define:

Mallory-Weiss syndrome

A

The junction between esophagus and stomach tears.

36
Q

Assessment:

Mallory-Weiss syndrome

A

Chronic vomiting.

Common in hyperemesis gravidarum.

37
Q

Treatment:

Mallory-Weiss syndrome

A

Fluid resuscitation

38
Q

Define:

Peptic Ulcer Disease

PUD

A

Erosion of the stomach and duodenum, allowing acids to eat the protective lining.

39
Q

Assessment:

Peptic Ulcer Disease

A

Pain in the stomach that subsides after eating and then reoccurs after 2 or 3 hours.

40
Q

Define:

Gastroesophageal Reflux Disease

GERD

A

The sphincter between the esophagus and the stomach opens, allowing stomach acid to move upwards.

Acid reflux disease.

41
Q

Assessment:

GERD

A

Heartburn

Increases while laying flat.

42
Q

Define:

hemorrhoids

A

Swelling and inflammation of the vessels around the rectum.

Caused by excessive straining.

43
Q

Assessment:

hemorrhoids

A

Bright red blood during defecation.

44
Q

Define:

anal fissure

A

Tears of mucosal lining that connect anus.

45
Q

Assesment:

anal fissure

A

Pain and bright red blood with defecation.

46
Q

Treatment:

anal fissure

A

Place 5 x 9 gauze pad over affected area.

47
Q

Define:

Hepatitis

A

An inflammation of the liver.

48
Q

Define:

Peritonitis

A

An inflammation of abdomen with generalized pain and rebound tenderness.

49
Q

List the Biliary Tract Disorders.

A
  • Cholangitis
  • Cholelithiasis
  • Cholecystitis
  • Acalculous Cholecystitis

Involve inflammation of gallbladder.

50
Q

Define:

Cholangitis

A

An inflammation of bile duct.

51
Q

Define:

Cholelithiasis

A

gallstones

52
Q

Define:

Cholecystitis

A

An inflammation of the gallbladder.

53
Q

What effects do gallstones have on the body?

A
  • Increase bile production.
  • Decrease bile emptying.
54
Q

Assesment:

Cholecystitis

A

Severe RUQ pain.

Right upper quadrant

Pain isn’t typically present until a fatty meal is eaten.

55
Q

Treatment:

Cholecystitis

A
  • pain control
  • nausea control
  • fluid replenishment
56
Q

Define:

Appendicitis

A

An inflammation of the appendix.

Fecal matter accumulates in the appendix, and increases pressure, resulting in a rupture.

57
Q

What are the early, ripe, and mature signs of appendicitis?

A

Early:

  • periumbilical pain
  • nausea
  • vomiting
  • low grade fever

Ripe:

  • pain in LRQ (McBurney’s point)

Rupture:

  • decrease in pain
  • tenderness
  • rebound tenderness
  • generalized pain
58
Q

Describe:

Dunphy’s sign

A

RLQ pain with coughing.

Right lower quadrant

Indicates peritonitis.

59
Q

Treatment:

Appendicitis

A
  • pain control
  • fluid replenishment
60
Q

What is diverticulum?

A

A weak area in the colon that outcrops into pouches.

61
Q

Assessment:

Diverticulitis

A

Abdominal pain localized to the LLQ.

62
Q

Define:

Pancreatitis

A

The tubes to the pancreas become blocked, causing the pancreas to start breaking down or “auto-digesting” itself.

63
Q

Assessment:

Pancreatitis

A

A pain localized to the RUQ.

Radiating back pain is common.

64
Q

Differentiate Cullen Sign & Grey Turner Sign.

A

Cullen: bruising around umbilicus.

Grey Turner: bruising in flanks.

65
Q

Define:

Ulcerative Colitis

A

An inflammation of the colon.

66
Q

Assessment:

Ulcerative Colitis

A
  • bloody diarrhea
  • Hematochezia (bloody poop)
  • abdominal pain, fever, malaise
67
Q

Define:

Irritable Bowel syndrome

A

It is characterized by pain and changes in bowel habits.

Eg, diarrhea or constipation.

68
Q

Assessment:

Irritable Bowel syndrome

A
  • Hypersensitivity of pain.
  • Hyperresponsiveness of smooth muscles causing diarrhea.
  • Psychiatric episodes.
69
Q

Define:

Crohn’s disease

A

The immune system attacks the GI tract, causing inflammation.

70
Q

Assessment:

Crohn’s disease

A

RLQ pain.

71
Q

Define:

Acute Gastroenteritis

A

An infection associated with:

  • fever
  • abdominal pain
  • malaise
  • nausea
  • vomiting

Caused by fecal matter entering through the mouth.

72
Q

Define

Cirrhosis

A

Liver failure.

Causes:

  • drinking
  • hepatitis
  • trauma
  • autoimmune disorder
73
Q

Assessment:

Two phases of Cirrhosis.

A

First phase:

  • joint aches
  • weakness
  • nausea
  • vomiting
  • urticaria
  • itching

Second phase:

  • alcohoic stools
  • darkening of urine
  • jaundice
  • icteric conjunctiva
  • ascites
74
Q

When treating a patient with Cirrhosis, what is the difficulty with medication administration?

A

Drugs given will remain in the body much longer.

Use lower dosages.
Give medications at longer intervals.

75
Q

Define:

Hepatic Encephalopathy

A

Liver failure causes a decline in brain function from increased ammonia production.

76
Q

What is the most common cause of small-bowel obstructions?

A

Post-operative adhesions

77
Q

Assessment:

small-bowel obstruction

A
  • abdominal pain
  • cramping
78
Q

What is the most common cause of large-bowel obstruction?

A

Mechanical obstruction

79
Q

Assessment:

large-bowel obstruction

A
  • abdominal pain
  • nausea and vomiting
80
Q

Define:

Hernia

A
  • Protrusion of an organ or structure into an adjacent cavity.
  • Can be felt during a cough by increase abdominal pressure.
  • COPD related due to constant coughing.
81
Q

Describe the four types of hernias.

A
  • Reducible: returns to normal place with manipulation.
  • Incarcerated: trapped in a new location.
  • Strangulated: intestine trapped and squeezed until blood supply is diminished.
  • Incisional: from prior surgeries, herniation occurs
82
Q

Define:

Gastroschisis

A

When a baby is born with their bowels outside of the body.

83
Q

Define:

Pyloric Stenosis

A

Hypertrophy of pyloric sphincter of stomach.

EMT-P (4) Medical (8 decks)

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