ABDOMINAL CONDITIONS Flashcards
Understand abdominal pain, appendicitis, peritonitis, cholecystitis/lithiasis, and AAA / TAA.
What acronym should be used to assess abdominal pain?
OPQRSTU
onset, provoking, quality, radiating, severity, timing, understanding
What is appendicitis?
Inflammation of the appendix / pouch pressure.
What is the #1 symptom of appendicitis?
Pain in the abdomen.
Starting in the middle, then in the RLQ
What is ‘Blumberg’s sign’?
What does it indicate?
When you press slowly and firmly over the painful site followed by quick release, pt reacts.
Indicates inflammation / appendicitis.
Blum = Boom! quick release
AKA rebound tenderness!
What is ‘Rovsing’s sign’?
What does it indicate?
When pressure is applied in LLQ, pain is felt in RLQ.
Ro = Wrong side
Indicates appendicitis.
What is Psoas sign?
What does it indicate?
Patient is supine with right leg raised. When you push down on the thigh, there is pain in RLQ.
Psoas = supine
Indicates inflammation of ilopsoas muscle; appendicitis.
What is McBurney’s point?
What does it indicate?
Pain when palpated 2/3 of the distance between hip bone and umbilicus.
Indicates appendicitis.
Aside from pain, what other manifestations can abdominal issues cause?
most significant
Nause / vomiting
Anorexia
Fever
and more
What are the two main complications of appendicitis?
important!
An appendix rupture can cause:
Peritonitis which then can lead to sepsis
What is peritonitis?
What symptoms does it cause?
Inflammation of the peritoneum often from an infection following rupture of the appendix; complication of appendicitis.
Infection symptoms; fever, fatigue, unwell etc.
Differentiate cholelithiasis vs. cholecystitis.
How do they happen?
Cholelithiasis = gallstones > when cholesterol is not efficiently dissolved by bile it crystalizes. Stones form when trapped in the gallbladder mucus.
Cholecystitis = Infllammation of the gallbladder. Often comes with stones.
What manifestation happens with cholelithiasis but not cholecystitis?
not commonly anyway…
Spasms - lodged stones can cause sudden & severe pain that goes away if dislodged.
This would not occur with inflammation / cholecystitis alone.
What is Murphy’s sign?
What does it indicate?
Pushing in the RUQ takes their breath away.
Murphy’s = Mouth / breathing
Indicates cholecystitis
What are some manifestations of cholecystitis / cholelithiasis?
Any symptoms of inflammation & pain.
+ Indigestion + Jaundice
Amber urine, Clay coloured stools, pruritus, intolerance to fatty foods etc.
What is the main treatment for cholecystitis?
What do you monitor after?
Cholecystectomy - removal of gallbladder
Monitor return of bowel sounds, gas, & first void
What are some complications of cholecystitis / cholelithiasis?
Acute cholecystitis
Acute pancreatitis
Sepsis
Cholangitis - inflammation of bile duct. Not as important
What is an AAA?
AAA = Abdominal Aortia Aneurism
The permanent dilation of the vessel wall.
Balloon like structure.
What are the two types of AAAs?
Shapes
Fusiform = bulge surrounds the artery equally.
Saccular = a bulge on one side of the artery.
Other than abdominal …
What is another location of aortic aneurysm?
Thoracic Aortic Aneurism (TAA)
Ascending or descending
What manifestations can be present for TAA?
Thoracic Aortic Aneurysm
Chest pain
Hoarseness
Dysphagia
Distended jugular
Edema of head & neck
Symptoms of pressure
Can be ASYMPTOMATIC also
What S&S can be present with AAA?
What is the most concerning?
Abdominal
Audible bruits
Pulsating mass just left of umbilical area (^BAD!)
Bowel or back pain
What are the complications of AAA / TAA?
What symptoms could you see?
Hemorrhage - aneurysm rupture > severe back pain
Leaking into the cavity - following hemorrhage > Grey Turner’s sign
Hypovolemic shock - increased HR, hypotension, LOC
Grey Turner’s Sign = pooling of blood seen under the skin in the flanks
What should you monitor following AAA treatment/surgery?
Infection.
Status of cardio, gastro, neuro, peripheral, renal perfusion
meh its broad
