Chapter 22 abdominal emergencies Flashcards
peritoneum
membrane that lines the abdominal cavity and covers the organs
-contains the
parietal peritoneum and visceral peritoneum
hollow organs
esophagus stomach small intestine large intestine appendix gallbladder bladder
solid organs
liver
spleen
pancreas
kidney
there is a small space between the two parietal and visceral layers.
it is filled with a lubricant and keeps the two layers from rubbing against each other
abdomen is dissected in 4 quadrants meeting in what spot?
the navel (umbilicus)
organs within the peritoneal cavity
spleen liver gallbladder stomach transverse colon (and ascending/decending colons) small bowel intestine
organs within the retro-peritoneal cavity
kidney (and ureters) pancreas duodenum abdominal aorta inferior vena cava fallopian tube (and ovaries) sigmoid colon uterus rectum urinary bladder
retroperitoneal space
the area posterior to the peritoneum, between the peritoneum and the back
-can fit the entire body blood volume in this area without any signs of swelling
visceral pain
poorly localized, dull or diffuse pain that arises from the abdominal organs or viscera
- intermittent, campy or colicky pain comes from hollow organs
- dull and persistent pain often comes from solid organs
parietal pain
these pains can be easily located and traced back toward an organ within this area of the abdomen
-localized and intense pain arising from the parietal peritoneum
tearing pain
-the most common type of abdominal pain.
aorta and stomach can detect the tearing sensations
-patients with this problem often report burning or tearing pain and frequent heavy bleeding
referred pain
a pain that is felt in a location other than where the pain originated from.
this is due to the organs sharing nerve pathways with spinal cord
“pain in the shoulder” is a common complaint
appendicitis
1 in 15 people will develop appendicitis in their lifetime
- most common cause of people needing surgery
- persistent pain in the RLQ
- if the appendix ruptured the pain would intensify and this would leak into the peritoneal cavity causing peritonitis
peritonitis
easily irritated by gastric juices, bowel contents, and blood (like a ruptured appendix)
cholecystitis / gallstones
inflammation of the gallbladder often caused by gallstones
- severe pain in upper central abdomen just below the diploid process (RUQ)
- high fat foods can make the pain much worse
pancreatitis
inflammation of the pancreas, often caused by chronic alcoholic patients
- pain can be found epigastric area, and may radiate toward the back and shoulders
- in advance situations can cause shock
gastro intestinal bleeding
often can occur with no pain
abdominal aortic aneurysm
(AAA) ballooning or weakening in the wall of the aorta as it passes through the abdomen.
ruptured aneurisms are associated with an extremely high rate of death.
-a leaking aneurism can cause a developing abdominal pain that is sharp or tearing that may radiate from the back.
hernia
when a hole in the muscle layers of the abdomen wall, tissue can protrude against the skin.
very painful, but only life threatening if the hernia causes an obstruction or twisting of the intestine.
renal colic
(kidney stones)
very painful and often associated with nausea and vomiting.
can’t get comfortable
cardiac involvement
pain from a heart attack could be felt as abdominal pain
- often described as indigestion or digestive discomfort.
- commonly felt in the epigastric region.
position of guarding
knees drawn up, arms across abdomen
geriatric patients often have a decreased ability to feel________?
pain
-this makes the other parts of opqrst and sample more important.
atenolol and metoprolol
beta blockers
