Ch19: Gastrointestinal and Urologic Emergencies Flashcards
acute abdomen
sudden onset of pain in abdomen that usually indicate peritonitis; medical or surgical treatment needed immediately
role of spleen
part of lymphatic system that stores blood, filters blood and fights infection in the blood
where is the urinary tract located
retroperitoneal space
what is a common cause of secondary hypertension
kidney disease
what is the urinary bladder located right behind?
pubic symphysis
what kind of muscle is the urinary bladder made up of?
smooth muscle
what membrane is the abdominal cavity lined by?
peritoneum membrane
what membrane lines the walls of the abdominal cavity?
parietal peritoneum
what membrane lines the organs of the abdominal cavity?
visceral peritoneum
what fluid does the abdominal space usually contain to bathe and lubricate the abdominal organs?
peritoneal fluid
what is peritonitis
when another fluid besides the peritoneal fluid (e.g. blood, bile, pus, pancreatic juice) causes inflammation of the peritoneum
why is peritonitis usually characterized by emesis or vomiting.
peritonitis causes ileus. Ileus causes bowel paralysis. Hence the only way the stomach can empty itself is by vomiting (emesis)
what is a possible consequence of peritonitis?
ileus - paralysis of bowel movement
Diverticulitis
Inflammation of irregular bulging pouches in the wall of the large intestine
Cholecystitis
inflammation of galbladder
Radiating vs referred pain
Referred pain is caused by something else in the body while radiating pain is caused by an issue or problem with the tissues or nerves in the area where it’s felt.
what kind of pain does the visceral peritoneum experience?
deep, hard to locate; can also cause referred pain
because nerves are from autonomic nervous system
what kind of pain does the parietal peritoneum experience?
more localized, sharp
because nerves in the abdomen skin are also present in the parietal peritoneum
what is the pain and location of appendicitis?
radiating - RLQ
referred - nasal
palpation - rebound tenderness
what is the pain and location of cholecystitis?
radiating - RUQ
referred - right shoulder
what is the pain and location of diverticulitis?
LLQ
what is the pain and location of ulcer?
upper mid-abdomen
upper back
what is the pain and location of abdominal aortic aneurysm (rupture or dissection)?
lower quadrants and lower back
what is the pain and location of kidney infection?
costovertebral angle (located at lowest rib)
what is the pain and location of cystitis (inflammation of bladder)?
lower mid-abdomen (where the bladder is)
what is the pain and location of kidney stones?
Left or right flank (anterior area right below ribs), radiating to genitalia
what is the pain and location of pancreatitis?
upper quadrants of abdomen
back
what is the pain and location of hernia?
anywhere in abdomen
what is the pain and location of peritonitis?
diffused throughout abdomen
Peptic ulcer disease (PUD)
when protective layers of stomach and duodenum destroyed that cause the acid to eat into the tissue
causes of PUD
usually by bacterial infection (Helicobacter pylori)
also by NSAIDs (non-steroid anti-inflammatory drugs) like aspirin and ibuprofen
worsened by alcohol and smoking by increasing acidity
type and location of PUD pain
burning, gnawing pain
radiating - upper abdomen
referred - sternum
does eating temporarily relieve PUD
yes
symptoms of mild/moderate PUD
nausea
vomiting
belching
heartburn
when does cholecystitis commonly show symptoms?
after a fatty meal! usually at night
symptoms of severe PUD
hematemesis (hema+ emesis = vomiting blood)
melena (black, tarry stools)
complications of pancreatitis
hemorrhage or sepsis
stool color and texture with upper GI bleeding
black, tarry stools as blood is partially digested
stool color and texture with lower GI bleeding
maroon, red colour
how liver failure causes esophageal varices
blood cannot flow through liver causing back up in the vessels of the esophagus. can cause an upper GI bleed
esophagitis
inflammation of esophagus because of infection or acid
signs of liver disease + esophageal varcies
jaundice
weight loss
abdominal edema
fatigue
signs of esophageal varices rupture
sudden-onset pain in sternum or epigastric region
hematemesis
inability to swallow
Mallory weiss tear
Tear in lining between esophagus and stomach –> severe bleeding and possible death
gastroenteritis
group of conditions of infection combined with nausea, vomiting and diarrhea
aspects to ask patients during Hx taking
nausea and vomiting
changes in bowel habits
changes in urination
weight loss
belching, flatulence
pain - OPQRST
other symptoms
kidney’s role in blood pressure regulation
filters out excess sodium and water
urinary tract infection (UTI)
start with bacterial infection introduced in urethra and travels to bladder (cystitis) or kidney (pyelonephritis)
risk factors of UTI
sedentary
poor hygiene
