Chapter 16: Gastrointestinal and Urologic Emergencies Flashcards
Discuss
Name the abdominal solid organs
Liver, spleen, pancreas, kidneys, ovaries/testes
Discuss
Name abdominal hollow organs
Stomach, gallbladder, bladder, intestines, uterus, ureter, fallopian tubes
Discuss
Normal adult urine production
1.5-2 L/day
Discuss
Peritoneum
Internal lining of the abdominal cavity. Parietal lines cavity itself and Visceral lines organs
Discuss
Peritonitis
Anything in the peritoneum other than peritoneal fluid can cause irritation. Can cause ileus.
Discuss
Ileus
Paralysis of intestinal peristalsis, causing abdominal distention. Consequence is emesis.
Discuss
Acute abdomen
Sudden onset of abdominal pain, often severe. Untreated can be fatal.
Discuss
Diverticulitis
Inflammation of small weakened pockets in the colon wall filled with feces.
Discuss
Cholecystitis
Inflammation of the gallbladder, often accompanied by fever
Discuss
Abdominal pain vis a vis parietal and visceral peritoneum
Parietal supplied by same nerves as skin, so pain is localized. Visceral supplied by autonomic, only deep pain from stretching, sometimes referred pain.
Discuss
Location of pain: appendicitis
RLQ, navel, rebouding pain
Discuss
Location of pain: cholecystitis
RUQ, right shoulder
Discuss
Location of pain: ulcer
upper midab, upper back
Discuss
Location of pain: Diverticulitis
LLQ
Discuss
Location of pain: AAA
Lower back and lower Q’s
Discuss
Location of pain: Cystitis
Retropubic
Discuss
Location of pain: Kidney infection
Costovetebral angle
Discuss
Location of pain: Kidney stone
Right or left flank radiating to genitalia
Discuss
Location of pain: Pancreatitis
Upper ab and back
Discuss
Location of pain: Pneumonia
Referred pain to upper ab
Discuss
Location of pain: Hernia
Anywhere in ab
Discuss
Location of pain: Peritonitis
Anywhere in ab
Discuss
Causes of acute abdomen
Ulcers, gallstones, pancreatitis, appendicitis, gastrointestinal hemorrhage, esophagitis, esophageal varices, Mallory-Weiss syndrome, gastroenteritis, hemorrhoids
Discuss
Ulcers
Most peptic ulcers a result of H. pylori infection or chronic use of NSAIDs. Burning or gnawing pain that subsides after eating and reemerges 2-3 hrs after.
Discuss
Gallstones
Can lead to cholecystitis
Discuss
Pancreatitis
Caused by gallstone, alcohol abuse, other diseases.
Discuss
Appendicitis
Rebound tenderness is classic
Discuss
Esophagitis
from infection or acids
Discuss
Esophageal varices
Pressure on esophageal blood vessles increases as portal system gets clogged from liver damage. Eventually the vessels burst and bleed into esophagus.
Discuss
Mallory-Weiss syndrome
Tears in the mucosa at the junction of the stomach and esophagus, usually after violent coughing/retching. Produces hematemesis, possibly melena.
Discuss
Gastroenteritis
Acute gastroenteritis is infection combined with diarrhea, nausea, emesis. Noninfectious gastroenteritis has same hallmarks. Diarrhea is primary symptom.
Discuss
Hemorrhoids
Swelling and inflammation of blood vessles around rectum
Discuss
Cystitis
Bladder inflammation, often from infection (UTI).
Discuss
Uremia
Inability to remove urea from the body
Discuss
Kidney stone
Blocking ureter can cause swelling kidney, pain can be intense and radiate to groin
Discuss
Kidney failure
Acute (reversible) and chronic (irreversible from hypertension and diabetes).
S/S:
- AMS
- lethargy
- nausea
- headache
- cramps
- edema in extremities and face.
Discuss
AAA
Abdominal aortic aneurysm. Often get back pain from tearing of peritoneum. Often describe pain uniquely as “tearing”. ACUTE ABDOMEN + S/S SHOCK NEEDS PROMPT TRANSPORT.
Discuss
Hernia
Protrusion of organ through a hole into a cavity where it doesn’t belong. Reducible: can be pushed back in. Incarcerated: may become compressed and lose blood supply, called strangulation, a serious emergency.
Discuss
S/S serious hernia
- Formerly reducible becomes incarcerated
- pain at hernia site, tenderness upon palpation
- blue or red skin over hernia.
Discuss
Method for palpating abdomen with pain
Palpate quadrants clockwise beginning with one AFTER location of pain.
Discuss
What should not be given to acute abdomen pt’s?
Do not give anything by mouth
Discuss
Guarding
Involuntary muscle spasms of abdominal wall; an effort to protect the inflamed abdomen
S/S
Cystitis
- Lower Q pain,
- urgent urination,
- pain around bladder
