Appendicitis Flashcards
What is the caecum?
situated in lower right side of abdomen the junction of small intestine and the large intestine - it connects to the appendix
What does the appendix do?
produces mucus - the inner lining contains goblet cells - this mucus protects the inner surface of the appendix
Transports mucus into the lumen of the appendix to remove waste. The mucus traps pathogens and helps in the removal
What is appendicitis?
inflammation of the appendix - typically occurs when the appendix becomes blocked, leading to infection
What are the primary causes of appendicitis
Blockage of the appendix, bacterial infection, inflammation and rupture, tumours (rare)
What are the different blockages that can occur in the appendix?
Fecaliths (hard stool)
Enlarged lymphoid tissue
Foreign objects or parasites
What happens in appendicitis?
the inflammation caused by the virus causes faeces to obstruct the appendix, the mucus outflow is then blocked but the body keeps producing it, this distends the appendix and then bacteria builds up inside. Initially the pressure on the visceral nerve fibres is small and so a generic stimuli of pain is sent to the brain, when the pressure increases the pain becomes more localised to the LRQ, the inflammation gets worse because of this and so the pressure builds up, this affects blood flow to the organ causing severe pain & infection
How long does appendicitis take to progress?
4-6 hours
What is the McBurney’s point?
a point used to assess for tenderness or pain associated with appendicitis
How do we perform the Psoas sign - back
pt lies on back, while on their back ask them to bend their leg at the knee, we extend the leg fro. the hip while keeping the knee straight by pulling it, this stretches the psoas muscle which will come into contact with the inflamed appendix if positive result
How do we perform the Psoas sign - left side?
pt lies on left side, we pull the pt’s right leg backwards and ask the pt to lift the leg against resistance
How do we perform the Roving’s sign?
apply deep pressure to LLQ, the pressure is then gradually released while observing the patient’s response
What is a positive Roving’s sign?
If pain is felt in the LRQ even though the pressure was on the LLQ - this occurs due to the shifting of gas or the movement of the peritoneum which causes irritation to the inflamed appendix
What are the most common symptoms of appendicitis?
Sudden pain that begins broadly then migrates to LRQ
Loss of appetite
nausea or vomiting
fever
abdominal bloating
What are the potential complication of delayed treatment of appendicitis?
Peritonitis - infection of the abdominal cavity lining - life threatening
Abscess formation in the abdomen which requires drainage
Sepsis
