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Paramedic 02 > Abdominal Emergencies > Flashcards

Abdominal Emergencies Flashcards

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1
Q

Esophagus

A

Posterior portion of pharynx
Like a deflated tube, allowing air to pass into trachea easily
Unable to dissolve food but helps transport

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2
Q

Gastric Distention

A

Occurs when too much positive pressure ventilation occurs and causes the esophagus to dialate and let air in impeding lung expansion

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3
Q

Peristalsis

A

Transports food from mouth to stomach using rhythmic contractions

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4
Q

Esophageal Veins

A

Veins intertwined around esophagus

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5
Q

Portal Vein

A

Conversion of esophageal veins.
Transports venous blood from GI Tract directly to the liver for nutrients that have been absorbed.
No valves exist.

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6
Q

Cardiac Sphincter

A

Doorway connecting esophagus and the stomach.
Called so because people that have regurgitation of acid from the stomach to the esophagus often feel as if they are having a heart attack

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7
Q

Stomach

A

Secretes HCl acid to break down food.
Contracts and mixes it’s food until smooth consistency achieved.
Water and fat soluble substances dissolved

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8
Q

Pyloric Sphincter

A

Doorway between the inferior portion of stomach to the entry of the small intestine

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9
Q

Chyme

A

Material that exits the pyloric sphincter

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10
Q

Duodenum

A

First part of small intestine.

Connects gallbladder, liver and pancreas to the digestive system.

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11
Q

Liver

A

Produces bile and stored in gall bladder.
Also can promote carbohydrate conversion.
Liver can convert glycogen into glucose.
Fat and protein metabolism occurs when blood flows through the liver.
Detoxifies drugs, break downs red and white blood cells, stores vitamins and minerals.

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12
Q

Bile

A

Enzyme that helps break down fats

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13
Q

Small Intestine

A

Where 90% of all absorption occurs.
20’ long.
Water soluble and fat-soluble vitamins absorbed by diffusion into blood stream.

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14
Q

Three sections of Small Intestine

A

Duodenum ( last part of upper GI )
Jejunum ( first part of lower GI )
Ilieum

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15
Q

Large Intestine

A

Or colon.
5’ long.
All nutrients have already been dissolved by small intestine and waste is now called feces.
Cecum, Ascending Colon, Transverse Colon, Descending Colon, Sigmoidal Colon, Rectum
MAIN role of Large Intestine is to complete the resorption of water to solidify stool. If hindered, this process causes diarrhea.

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16
Q

Time of Digestion

A

From mouth to anus takes 8 to 72 hours.

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17
Q

Ascites

A

Fluid buildup in the abdomen

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18
Q

Striae

A

Stretch marks

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19
Q

Protuberant

A

Protruding abdomen

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20
Q

Scaphoid

A

Concave abdomen

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21
Q

Normal bowel sounds

A

Occur 5-30 times a minute

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22
Q

Borborygmi

A

Prolonged stomach growling indicating strong contractions of the intestines

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23
Q

Visceral Pain

A

Difficult to localize.
Describe as burning, cramping, or aching. Felt superficially.
Organ contracts too forcefully or is distended

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24
Q

Parietal Pain

A

Steady, achy pain. Easier to localize.
Pain increases with movement.
Caused by inflammation (bleeding or infection)

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25
Q

Somatic Pain

A

Localized pain, felt deeply.

Injury to tissue

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26
Q

Referred Pain

A

Pain originating one place and occurring elsewhere.

Occurs after somatic, visceral and parietal pain.

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27
Q

Orthostatic Vital

A

Vitals standing and sitting to gauge hypovolemia

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28
Q

Pain management for abdominal Pain

A 
Morphine 5-10mg 
Toradol 15-60mg
Fentanyl 50-100mcg
Demerol 50-150mg
Nubian 10mg
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29
Q

Medications for nausea

A

Zofran 4mg
Benadryl 10-50mg
Visatril 25-100mg IM
Phenegran 12.5-25mg

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30
Q

Hyponatremia

A

Low sodium
Swelling of cells
Symptoms- weakness, cramps, convulsions

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31
Q

Hypernatremia

A

High sodium

Shrinking of cells

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32
Q

Main cause oh hypovolemia

A

Vomiting and diarrhea

Second cause- hemmorage

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33
Q

Hyperkalemia

A

High potassium
Shortened QT interval and tented t waves
Symptoms- bradycardia, cramps, weakness

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34
Q

Hypokalemia

A

Low patassium
Prolonged QT interval and flattened QT intervals
Symptoms- weakness, paralysis, heart failure

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35
Q

Upper GI bleeding by Cause

A

Esophagus- Varices, Cancer, Tear, Dilated Veins, Cirrhosis, GERD
Stomach- Ulcers, Cancer, Gastritis
Small intestine (duodenum)- ulcer

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36
Q

Lower GI bleeding by Cause

A

Small Intestine- irritable bowel disease, cancer
Large Intestine- infections, ulcerative colitis, colorectal polyps, diverticula disease
Rectum- hemorrhoids

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37
Q

Esophagogastric Varices

A

Caused by pressure increases in the blood vessels that surround esophagus and stomach. These vessels drain into portal system. If liver is damaged blood cannot effectively flow through it easily, causing blood to back up and create pressure.

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38
Q

Esophageal Varices Assessment

A

Initially signs of Liver Disease- fatigue, weight loss, jaundice
Rupture of Varices is sudden- pain in threat, dysphasia, vomiting of bright red blood

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39
Q

Esophageal Varices Management

A

Fluid resuscitation

In hospital, cauterize effected area

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40
Q

Mallory-Weiss Syndrome

A

Junction between esophagus and stomach tears, causing severe bleeding. Reason for tearing is during an act of vomiting, pressure in the stomach can increase so greatly that causes a failure of structure

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41
Q

Mallory-Weiss Syndrome Assessment

A

Linked to vomiting.

Woman, can be related to hyperemsis graviadarum.

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42
Q

Mallory-Weiss Syndrome Management

A

Fluid resuscitation

43
Q

Peptic Ulcer Disease

A

Protective layers of stomach and duodenum have been eroded, allowing acid to eat into the lining.
Can be caused by chronic use of NSAIDS, SMOKING and ALCOHOL

44
Q

PUD Assesment

A

Pain in the stomach that subsides after eating and then reemerges after 2 or 3 hours.
Pain described as burning and gnawing.
Nausea, vomiting, heartburn and severe then bleeding can occur.

45
Q

PUD Management

A

Assess degree of blood loss.
Orthostatic signs are critical in determining fluid needs.
In hospital- acid neutralization and antibiotics

46
Q

Gastroesophageal Reflux Disease (GERD)

A

The Sphincter between the esophagus and the stomach opens, allowing stomach to move superiorly.
“Acid reflux disease”.
Smoking, obesity, and pregnancy increase chances of GERD

47
Q

GERD Assesment

A

Heartburn most common and may increase with position, Like lying flat.

48
Q

GERD Management

A

Pain may be confused with an infacrtion

Ask how many antacids patient has taken

49
Q

Hemorrhoids

A

Swelling and inflammation of the vessels around the rectum. Caused by straining, irritation or pressure of the rectum.

50
Q

Hemorrhoids Assesment

A

Bright red blood during defecation.

Mass on rectum formed by clotting of broken vessels

51
Q

Anal Fissure

A

Linear tears to the mucosal lining in and near the anus.

Passage of large hard stools or physical activities.

52
Q

Anal Fissure Assesment

A

Pain and bright red blood with defecation

53
Q

Anal Fissure Management

A

Facilitate Pt comfort with a 5x9 over affected area

54
Q

Hepatitis

A

Inflammation of the live, pain in upper right quadrant

55
Q

Peritonitis

A

Inflammation of abdomen that is generalized pain and experiences rebound tenderness

56
Q

Biliary Tract Disorders

A

Involve inflammation of gallbladder

  • choleangitis
  • cholelithiasis
  • cholecystitis
  • acalculus cholecystitis
57
Q

Choleangitis

A

Inflammation of bile duct

58
Q

Cholelithiasis

A

Presence of stones in gallbladder

59
Q

Cholecysitis

A

Inflammation of gallbladder

60
Q

Gall stones

A

Increased production of bile

Decrease emptying of bile

61
Q

Gallbladder inflammation

A

Arise from decreased flow of biliary materials
-trauma, sespsis, sickle cell Disease, fasting
Women get cholecystitis two to three times more than men

62
Q

Cholecystitis Assesment

A

No pain until fatty meal is present (gall bladder releases bile to break down foods)
Then severe RUQ pain

63
Q

Cholecystitis Management

A

Pain control- morphine and meperidine
Nausea controlled
Fluid replenishment

64
Q

Appendicitis

A

Inflammation of appendix occurs when fecal matter accumulates in the appendix causing pressure to build and eventually will rupture. Decrease blood flow with pressure and decrease lymph fluid causing decreases in body’s ability to fight infection.

65
Q

Appendicitis Assesment

A

Early- periumbilical pain, nausea, vomiting, low grade fever
Ripe- pain in LRQ (McBurney’s point)
Rupture- decrease in pain and tenderness, rebound tenderness, generalized pain

66
Q

Dumphy Sign

A

RLQ pain with coughing indicative for peritonitis

67
Q

Appendicitis Management

A

Pain control

Fluid replenishment

68
Q

Diverticulum

A

A weak area in the colon that begins to have small outcropping that turn into pouches. Condition called diverticulosis.
Adhesions can develop narrowing of colon resulting in constipation.

69
Q

Diverticulitis Assesment

A

Abdominal Pain localized to the LLQ.
Symptoms- fever, malaise, body ache, nausea, chills
Pain can occur anywhere in colon, thus, resulting in pain presenting as another condition
Fitsulas can occur with colon and bladder

70
Q

Diverticulitis Management

A

Fluid resuscitation and possible vasopressors

71
Q

Pancreatitis

A

Caused from “auto digestion of pancreas”.
Occurs when tube in pancreas carrying enzymes that break down substances becomes block and starts to break down substances of pancreas leading to inflammation
Main causes are alcohol consumption and gallstones

72
Q

Pancreatitis Assesment

A

Pain localized to RUQ or epigastric area.
Can be sharp and quite severe.
Radiation of the back is common.
-Nausea, fever, malaise, tachycardia, muscle cramps, hypotension
Tends to cause hypocalcemia which leads to muscle spasms
Hemorrhage can occur if autodigestion is advanced

73
Q

Cullen Sign

Grey Turner Sign

A

Bruising around umbilicus
Bruising in flanks
-indicative of severe hemorrhage

74
Q

Peritonitis Management

A

Assess for severe hemorrhage
Fluids resuscitation
Pain control- meperidine

75
Q

Ulcerative Colitis

A

Caused by inflammation of the colon

Which causes weak spots of the colon forming ulcers

76
Q

Ulcerative Colitis Assesment

A

Gradual onset of bloody diarrhea, hematochezia (bloody poop), and abdominal Pain, fever, malaise

77
Q

UC Management

A

Assess degree of hemodynamic stability

78
Q

Irritable Bowel Syndrome

A

Pain and changes in bowel habits
-hypersensitivity of pain
-hyperresponsiveness of smooth muscles causing diarrhea and cramps (constipation)
-psychiatric causes or IBS causes psychiatric
Can be triggered by stress, large meals, wheat, rye, chocolate and soda

79
Q

IBS Assesment

A

Pain relieved by bowel movements

-diarrhea, steatorrhea (oily fatty stools that float) or constipation or bloated

80
Q

IBS Management

A

Supportive
Psychiatric condition may be coexistant
Pain control

81
Q

Crohn Disease

A

Similar to Ulcerative Colitis, however, the entire GI tract can become involved.
Usually ileum tends to be involved more.
(Last portion of small intestine before joining large intestine)
Unknown cause
Immune system attacks GI tract

82
Q

Crohn’s Assesment

A

Chronic complaint of abdominal pain
Often in RLQ
-rectal bleeding, weight loss, diarrhea, skin problems, and fever

83
Q

Crohn’s Management

A

Volume control
Pain control
Nausea

84
Q

Acute Gastroenteritis

A

Family of conditions revolving around a central theme of infection with fever, abdominal pain, malaise, nausea and vomiting.
Viruses enter through fecal-oral route and seen when swimming or drinking contaminated water

85
Q

Acute Gastroenteritis Assesment

A

-GI upset and diarrhea in hours or days of contamination and can last days to weeks or until death
Dehydration and hyponeutremia occurs resulting in death

86
Q

Acute Gastroenteritis Mangement

A

Analyze degree of fluid deficient
Orthostatic vitals!
Analgesic and Anti-emetics
-control fluids, diarrhea and nausea/vomiting

87
Q

Rectal Abscess

A

Rectum creates mucus to lubricate feces during defecation.
If ducts become blocked an Abscess can occur.
Blockage allows bacteria to grow and spread around anus

88
Q

Abscess Assesment

A

Rectal pain that increases with defecation

Fever and rectal drainage

89
Q

Abscess Management

A

Comfortability

Transport in POC

90
Q

Liver Disease: Cirrhosis

A

Defined as “liver failure” can be from multiple causes such as drinking, hepatitis, trauma, autoimmune disorder

91
Q

Cirrhosis Assesment

A

First Phase: joint aches, weakness, fatigue, nausea, vomiting, urticaria and itching
Second Phase: severe damage characterized by alcoholic stools, darkening of urine, jaundice, icteric conjuctiva and ascites.

92
Q

Cirrhosis Management

A

Drugs given will remain in body much longer due to liver comprimisation
Use lower ends of dose range for liver failure patients
Give medications at longer intervals

93
Q

Liver Disease: Hepatic Encephalopathy

A

When brain function begins to decline from liver failure.

Ammonia levels rise in body with lever failure, and effect neurons.

94
Q

Small-Bowel Obstruction

A

Postoperative adhesions most common cause in small intestine

95
Q

SBO Assesment

A

Abdominal pain with cramping

Increase in pressure from buildup causing increased in peristalsis causing severe cramping

96
Q

Large Bowel Obstruction

A

Caused by mechanical obstruction or dialate on causing decreased internal diameter

97
Q

LBO Assesment

A

Abdominal Pain with nausea and vomiting

Record recent Bowel habits

98
Q

Hernia

A

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

99
Q

Hernia Assesment

A

Reducible: returns to normal place with manipulation
Incarcerated: trapped in new location
Strangulated: Intestine trapped and squeezed until blood supply is diminished
Incisional: from prior surgeries, herniation occurs

100
Q

Hernia Management

A

Pain control

101
Q

Mesenteric Ischemia

A

Mesentery artery occluded

102
Q

Gastroschisis

A

Baby born with bowel outside of the body due to malformation

103
Q

Pyloric Stenosis

A

Hypertrophy of pyloric Sphincter of stomach

Paramedic 02 (27 decks)

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