Acute Abdomen and Abdominal Trauma Flashcards
What does a sudden onset of abdominal pain indicate?
Indicates peritoneal irritation
What is the anatomy of the abdomen? What are the quadrants?
- The abdomen is the second major body cavity
- It contains major organs of digestion and excretion
What are the descriptions of abdominal pain?
- Local
- General or diffuse
- Referred
- Colic
What is associated with Gastrointestinal (GI) bleeding?
- Pain
- “heartburn”
- Signs of shock
- Bright red rectal bleeding
Melena - Coffee ground emesis
- Bright red emesis
What does bright red rectal bleeding indicate?
- Indicates bleed close to anus
- Minor bleeding usually hemorrhoid
What is Melena? WHere is it occur? What can it indicate? What does melena signify?
- Dark tar like stools
- Occurs: lower GI bleed
- Can be the only indication of GI bleed
- Can represent significant blood loss
What is coffee ground emesis? What is a characteristic of it? Where does it occur?
- Partially digested blood
- Usually chronic
- Occurs in stomach or duodenum
What casues bright red emesis? What can cause it? Is it serious?
- Bleeding of upper GI above the stomach
- Esophageal varices can cause it (enlarged veins)
- Can be severe
What are hemorrhoids? What is associated with it?
- Enlarged blood vessels near the anus
- a. **rectal pain **
b. bleeding
What is an ulcer? WHat is a symptom? What is a sign?
- Erosion of the stomach or intestinal lining
- Epigastric or abdominal pain
-
Hematemsis: blood in emesis
* -bright red or coffee ground*
What is a hernia? What are some S/S?
- Protrusion of tissue through body wall
- -pain
- red or blue skin
- incarcerated
*can be serious medical emergency*
What are esophageal varices? What can it cause?
- Enlarged blood vessels in the esophagus that can rupture
- -Massive bright red bleeding
- Shock - *May have history of liver disease or ETOH (ethanol) abuse*
WHat is bowel obstruction? What are some causes? What are some S/S?
- A blockage of the bowel lumen prohibiting the passage of material
- a. history of recent abdominal surgery
b. constipation - a. colicky abdominal pain
b. abdominal distention
c. nasuea/vomiting
What is appendicitis? What are some S/S?
- Inflammation of the appendix
- -fever
- anorexia
- nausea/vomiting N/V
- right lower quadrant RLQ pain
- rebound tenderness
What is cholecystitis? What are some causes? S/S?
- Inflammation of the gallbladder
- a. gallstones
b. recent ingestion of fatty food - a. RUQ pain
b. gradual onset
c. not colicky pain
What are Kidney stones? Whata re some S/S?
- Calculi (mineral deposit) in the kidney
- -severe flank pain
- maybe colicky
- resltessness
- N/V
What is a urinary tract infection? S/S?
- Bacterial infection in the urinary tract
- -Lower abdominal pain
- pain and/or burning during urination
- hematuria (blood in urine)
- urgency and frequency
What is pyelonephritis? S/S?
- Inflammartion of the kidney
- -flank pain
- pain and/or burning during urination
- hematuria
- fever
What is pelvic inflammatory disease? S/S?
- The inflammation of the female pelvic organs (STD)
- -dull RLQ or LLQ pain
- abnormal vaginal discharge
- N/V
- fever
What is an ectopic pregnancy? S/S?
-
Embryo ghestation outisde uterus
- usually fallopian tubes - -RLQ or LLQ pain
- late last menstrual period LMP
- may have vaginal bleeding
- shock
What is Peritonitis? S/S?
- Inflammation of the peritoneum
-
-generalize abdominal pain
- fever
- rigid abdomen
- N/V
- Distention
What is a dissecting abdominal aortic aneurysm? S/S?
- Aneurysm develops between arterial layers
- -shearing/tearing abdominal pain
- sudden onset
- shock
- unequal femoral pulses
How do you assess acute abdomen and abdominal trauma? What are some S/S to look for?
- a.**OPQRST **
- all pain is not the same
b. SAMPLE or HAM - a. N/V diarrhea
b. anorexia
c. fever
d. weakness or syncope (fainting)
What do you look for in the physical exam of acute abdomen?
- Observe for distention
- Palpate for TRPGR
- Check all four quadrants
- Start away from pain
What does the acronym TRPGR, OPGRST, SAMPLE, and HAM stand for?
- TRPGR: Tenderness, Rigidity, Pulsating masses, Guarding, Rebound tenderness
- OPQRST: Onset, Provoked, Quality, Radiates, Severity (Scale), Time
- SAMPLE: Signs/Symptoms, Allergies, Medication, Past medical history, Last know intake, Event
- HAM: History, Allergies, Medications
What should one consider when assessing females?
- Always consider gynecological problem with women having abdominal pain
- Pregant
- Last menstrual period LMP
- Prior gynecological problems
What is the best treatment for acute abdomen?
- Oxygen
- Position of comfort
- No oral fluids
- Monitor vitals carefully
- Transport
- Treat for shock PRN
What are definitions for Dialysis, shunts/fistulas, kidneys role in homeostasis, and hydrocholirc acid.
- Dialysis: is a process for removing waste and excess water from theblood, and is used primarily as an artificial replacement for lost kidney function in people with renal failure
- Fistula: is an abnormal connection between an organ, vessel, or intestine and another structure
- Shunt: a hole or a small passage which moves, or allows movement of fluid from one part of the body to another
- Kindeys maintain homeostatis: releasing hormones to regulate blood pressure and through altering sodium and electrolyte balances to maintain proper fluid amounts in the body
- Hydrocholoric acid: or digestive juices
What is classified as abdominal trauma?
Penetrating and blunt
Which are the solid organs of the abdomen? And hollow?
- a. liver
b. spleen
c. kidneys
d. pancrease - 2. a. stomach
b. intestines
c. bladder
What organs are in the RUQ?
Largely liver, gallbladder, tail of the pancreas, right kidney with adrenal gland
What organs are in the LUQ?
Stomach, spleen, head of the pancreas, left kidney with adrenal gland
What organs are in the RLQ?
Large/small intestines & ovary
What organs are in the LLQ?
Large/small intestines & ovary
What is a blunt or penetrating injury?
- Blunt: closed injury
- Penetrating: open injury
What are the S/S of abdominal trauma?
- Mechanism of injury
- Pain (pain upon palpatation)
- Tachycardia
- Shock
- Bruising
- Distended or rigid abdomen
- N/V
How do you physically exam an abdominal trauma patient?
- Determine type of injury
- Observe for distention
- Palpate (TRPGR)
- CHeck all four quadrants
- Start away from pain
How do you treat all abdominal injuries?
- High flow O2
- Keep airway clear
- Treat for shock PRN
- No oral fluids
- Rapid transport
- Supine/shock
How do you care for patients with penetrating injuries?
- Check for exit wounds
- Dry sterile dressing
- Bulky dressing for impaled wounds
What is abdominal evisceration? What should you not do? How do you care for it?
- Internal organs or fat protrude through the open wound
- Never try to replae organs
- -cover with moist gauze, then sterile dressing
-keep organs warm and moist
transport promptly
What are the functions of the Mouth, esophagus, stomach, small intestine, large intestine, anus, liver, pancreas, gallbladder
Mouth: mechanically breaks down food; begins chemical breakdown with saliva
Esophagus: moves from mouth to the stomach; muscular and vascular system
Stomach: performs mechanical and chemical breakdown of food; food in, chyme out
Small intestine: major site for chemical breakdown of food; major __absorption of water, fats, proteins, carbohydrates and vitamins
Large intestine: water absorption; formation of feces, bacterial digestion of food
Anus: last portion of large intestine ; sphincter to control release of feces
Liver: prodcution of pile, assissts with carbohydrate, and fat metabolism of nutrients within bloodstream; vitamin storage and manufacture; detoxification of blood; elimination of waste
Pancreas: exocrine; enzymes for protein, carbohydrate, and fat breakdown; endocrine: insulin and glucagon
Gallbladder: storage and bile
