CHP 21: GI EMERGENCIES Flashcards
two behavioral risk factors for GI disorders
smoking and excessive alcohol comsumption
which organ produces bile
liver
what does the pancreas produce
enzymes to break down proteins, fats, and carbs
insulin, somatostatin, glucagon
which organ stores bile
gallbladder
which organ filters blood
spleen
where is the stomach located
left upper quadrant
where is the liver located
right side of central upper abdomen
where is the spleen located
left upper abdomen
what is the major site for chemical breakdown of food and vitamin absorption
duodenum
what is the major site for water reabsorption
colon
where does 90% of absorption occur
small intestine
what does pancreatic juice do
helps neutralize gastric acid
what organ converts glycogen to glucose
liver
what does the appendix secrete
T and B lymphocytes and immunoglobulin A
why is SpO2 not reliable with GI bleeds
pt’s can have decreased hemoglobin levels
what is melena
black, tarry stool
what is cholecystitis and what usually causes a flareup of it
inflammation of the gallbladder
fatty meals
what are striae
stretch marks
what is a scaphoid abdomen a result of
decreased abdominal volume (diaphragmatic hernia, dehydration, malnutrition)
what is borborygmi
stomach growling
how should the abdomen sound to percussion
tympanic (empty)
rebound tenderness is also called what
parietal pain
visceral pain
-origin
-description
-cause
hollow organs
dull, cramping, poorly localized
organ contracts too much or is distended
parietal pain/rebound pain
-origin
-description
-cause
peritoneum
steady, achy pain, easy to localize, increases with movement
inflammation of peritoneum
somatic pain
-origin
-description
-cause
peripheral nerve tracts
localized deep pain, sharp/stabbing
irritation or injury to tissue
referred pain
-origin
-description
-cause
peripheral nerve tracts
pain originating in stomach and causing pain elsewhere
occurs after initial visceral, parietal, or somatic pain
3 vitals showing significant volume loss during orthostatic BP
decrease in systolic BP by 20
increase in diastolic BP by 10
increase in HR by 20
S/S of hyponatremia
low sodium - muscle weakness, cramps, coma, convulsions
S/S of hypernatremia
coma, convulsions
S/S of hypokalemia
muscle cramps, weakness, paralysis, dysrhythmias, flattened T waves, U waves
S/S of hyperkalemia
muscle weakness, cramps dysrhythmias, tall T waves
what is hematochezia
bright red blood in the stool
what causes esophagogastric varices
pressure increases in the blood vessels that surround the esophagus and stomach
what is pruritus
itching
what is Mallory-Weiss syndrome
vomiting increases pressure and junction between esophagus and stomach tears - does not go entirely through esophagus wall
what is Boerhaave syndrome
occurs during vomiting, esophagus tears longitudinally completely through wall
how to differentiate Boerhaave from other throat bleeding
sudden upper chest pain and little bleeding, swallowing exacerbates pain
what is peptic ulcer disease
protective layer of stomach and duodenum have been eroded and acid starts to eat the organ
what is gastritis
preulcerative state in which stomach is inflamed but erosion has not occurred
what are Curling ulcers
cause by stress related to burns
what are Cushing ulcers
caused by head injuries or brain tumors
what is Zollinger-Ellison syndrome
tumors within pancreas and duodenum cause increased gastric acid production leading to peptic ulcer disease
what is dyspepsia
belching, bloating, and fatty food intolerance
what is the result of a perforated ulcer
peritonitis with rebound tenderness and potential hypotension
what is GERD
lower esophageal sphincter opens and allows stomach acid to move up
what is a hiatal hernia
protrusion of portion of stomach through the diaphragm
treatment for GERD and hiatal hernias
antacids, H2 blockers, proton pump inhibitors
what can large amounts of antacids cause
metabolic alkalosis
what are anal fissures
linear tears to mucosal lining near anus that can cause lower GI bleeds
what is dyspepsia
heartburn
what is stricture
abnormal narrowing of a structure
what are lower esophageal strictures most often caused by
GERD
what medication can be used for esophageal stricture/stenosis
glucagon because it causes dilation of esophagus
what is hepatitis
inflammation of liver
what is ascites and what is it most commonly associated with
abdominal edema - peritonitis
where will pain be located with appendicitis
right lower quadrant
where will pain be located with ruptured diverticulum
left lower quadrant
what is dunphy sign
peritoneal pain increasing with coughing
what are Biliary tract disorders
involve inflammation of the gallbladder
what is cholangitis
inflammation of bile ductw
hat is cholelithiasis
gallstones
five Fs of cholecystitis
fair, fat, female, fertile, fourty-fifty
what is a positive Murphy sign
sudden increase of pain on inspiration
what is Charcot triad and what is it indicative of
fever, right upper quadrant pain, jaundice - inflammation of common bile duct
3 classic presentations of appendicitis
early (periumbilical pain, vomiting, fever)
ripe (pain in lower right quadrant - McBurney point)
rupture (decrease in pain from pressure, severe abdominal pain, rebound tenderness)
where is pain located in pancreatitis
left upper quadrant with radiation to the back
what nutrient deficiency is common with pancreatitis and what symptom is present
hypocalcemia - muscle spasms
what is Cullen sign
bruising around umbilicus
what is Grey Turner sign
bruising in flanks
what is IBD and what two conditions fall under this umbrella term
chronic inflammation of all parts of GI tract
ulcerative colitis and Crohn disease
ulcerative colitis and its symptoms
generalized inflammation of the colon resulting in weakened, dilated rectum
rectal discharge, left lower quadrant pain, tenesmus
what is tenesmus
feeling of rectal fullness
Crohn disease and its symptoms
inflammation occurs in patches, usually in the ileum
rectal bleeding, weight loss, arthritis
three main factors with IBS
hypersensitivity of bowel pain receptors, hyperresponsiveness of smooth muscle in bowel, psychiatric disorder connection
3 characteristics of cirrhosis
portal hypertension, coagulation deficiencies, diminished detoxification
what is icteric conjunctiva
yellow eyes
what causes jaundiced skin
buildup of bilirubin
what is hepatic encephalopathy
brain function impairment secondary to cirrhosis from rising ammonia levels and change in blood-brain barrier’s permeability
what is intussusception
telescoping of intestines into themselves
what is volvulus
twisting of the intestines
peds tend to have entrapment at the ____, adults tend to have entrapment at the ___
UES, LES
primary symptoms of esophageal obstruction
dysphagia and drooling
what is strangulated obstruction
bowel becomes twisted or blood supply is compromised and ischemia occurs
most common 2 causes of large bowel obstruction
colon cancer and diverticulitis
what is a hernia
protrusion of an organ or structure into an adjacent cavity
what is a reducible hernia
will return to its normal location spontaneously or by manual manipulation
what is an incarcerated hernia
organ is trapped in new location, most common consequence is bowel obstruction
what is a strangulated hernia
intestine trapped and squeezed to where blood supply to area is diminished
what is an incisional hernia
intestinal contents herniating through an incision after abdominal surgery
what type of hernia is a life-threatening emergency
strangulated
four main causes of mesenteric ischemia
acute arterial embolism, acute arterial thrombosis, profound vasospasm, mesenteric venous thrombosis
what is cachexia
malnutrition and weight loss
