Chapter 22 abdominal emergencies

Question 1

peritoneum

Answer 1

membrane that lines the abdominal cavity and covers the organs

-contains the

parietal peritoneum and visceral peritoneum

Question 2

hollow organs

Answer 2

esophagus 
stomach
small intestine 
large intestine
appendix
gallbladder
bladder

Question 3

solid organs

Answer 3

liver
spleen
pancreas
kidney

Question 4

there is a small space between the two parietal and visceral layers.

Answer 4

it is filled with a lubricant and keeps the two layers from rubbing against each other

Question 5

abdomen is dissected in 4 quadrants meeting in what spot?

Answer 5

the navel (umbilicus)

Question 6

organs within the peritoneal cavity

Answer 6

spleen
liver
gallbladder
stomach
transverse colon (and ascending/decending colons)
small bowel intestine

Question 7

organs within the retro-peritoneal cavity

Answer 7

kidney (and ureters)
pancreas
duodenum 
abdominal aorta
inferior vena cava
fallopian tube (and ovaries)
sigmoid colon
uterus
rectum
urinary bladder

Question 8

retroperitoneal space

Answer 8

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

Question 9

visceral pain

Answer 9

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

Question 10

parietal pain

Answer 10

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

Question 11

tearing pain

Answer 11

-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

Question 12

referred pain

Answer 12

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

Question 13

appendicitis

Answer 13

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

Question 14

peritonitis

Answer 14

easily irritated by gastric juices, bowel contents, and blood (like a ruptured appendix)

Question 15

cholecystitis / gallstones

Answer 15

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

Question 16

pancreatitis

Answer 16

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

Question 17

gastro intestinal bleeding

Answer 17

often can occur with no pain

Question 18

abdominal aortic aneurysm

Answer 18

(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.

Question 19

hernia

Answer 19

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.

Question 20

renal colic

Answer 20

(kidney stones)
very painful and often associated with nausea and vomiting.

can’t get comfortable

Question 21

cardiac involvement

Answer 21

pain from a heart attack could be felt as abdominal pain

• often described as indigestion or digestive discomfort.
• commonly felt in the epigastric region.

Question 22

position of guarding

Answer 22

knees drawn up, arms across abdomen

Question 23

geriatric patients often have a decreased ability to feel________?

Answer 23

pain

-this makes the other parts of opqrst and sample more important.

Question 24

atenolol and metoprolol

Answer 24

beta blockers

Question 25

signs and symptoms of abdominal stress (some)

Answer 25

• nausea
• vomiting
• blood in vomit
• diarrhea
• pain shooting toward the back