Chp 22 Abdominal Emergencies Flashcards
Peritoneum
The membrane that lines the abdominal cavity (the parietal peritoneum) and covers the organs with in it ( the visceral peritoneum)
The Abdomen is divided into how many Quadrants, how is it done and and what are they?
Through the midline of the naval and horizontally through it (umbilicus) creating 4 quadrants
What are the two layers of the the peritoneum?
Visceral which covers the organs
Parietal which is attached to the abdominal wall.
Most organs are within the peritoneal cavity, which ones are NOT within it?
Kidneys (and ureters)
Pancreas
Duodenum
What are the solid organ in the abdomen?
Spleen (lymphatic)
Liver (digestive) and regulation of blood and detoxification
Pancreas (digestive)
Kidneys (urinary)
What are the HOLLOW organs in the abdomen?
Stomach Gallbladder Duodenum Large Intestine Small intestine Bladder
The area outside the peritoneum is called the…
Extraperitoneal space which also includes the RETROPERITONEAL space.
What is the RETROPERITONEAL space?
The area between the abdomen and the back and this is where the kidneys and pancreas are located and the aorta.
The Aorta, largest artery travels down through the diaphragm and traverses the ______ space
Retroperitoneal space.
Inferior Vena Cava also found behind the peritoneum
4 Classic types of pain involving pain are:
Visceral Pain
Parietal Pain
Tearing Pain
Referred Pain
Visceral Pain (poorly localized)originates from where? And what kind of pain is experienced?
The organs within the abdomen
Pain is can be crampy, colicky, and intermittent is from Hollow organ
Pain that is persistent and dull is usually from a Solid organ
Parietal Pain arises from the…
Lining of the abdominal cavity referred to as (peritoneal tenderness).
More widespread nerve endings and more easily located and described.
May be SHARP, or constant and localized to a particular area.
Tearing Pain is not the most common type of abdominal pain because
Most structures or organs do not have the ability to detect tearing sensations but THE EXCEPTION is the Aorta and Stomach.
Ex. Abdominal Aortic Aneurysm (AAA), Ulcers in the stomach
Feels like SHARP pain as if the body tissues are being torn apart
Referred Pain is…
Pain felt in a place other than were the pain originates.
Ex. When gallbladder is diseased, pain is often felt in the area of the right shoulder.
This is because of the nerve pathways share the same as the pains in shoulder
About how many develop an infection of the appendix
1 in 15 develop appendicitis in their life.
Where and how do people experience an appendicitis?
Nausea, sometimes vomiting and
Persistent pain int eh RLQ
Peritonitis is when the lining of the abdomen becomes infected/irritated. What could be the cause of this?
Gastric juices, bowel contents and blood.
(Ruptured appendix, ruptured spleen)
Abdomen becomes extremely painful and RIGID
Cholecystitis/Gallstones is what and where is pain felt?
Inflammation fo the gallabaddler caused by gallstones.
Pain is felt in the RUQ
Often confused with chest pain
Pancreatitis is an inflammation of the pancreas and is common in what type of patients?
Chronic Alcoholics
Pain is in the epigastric area and pain may radiate to the back and/or shoulders
Gastrointestinal (GI) Bleeding can happen anywhere from the esophagus to the rectum, what are the signs and symptoms
Blood may pass through the rectum and or mouth and with abnormal stools and dark black or tarry appearance.
Painful GI bleeding most commonly occurs in patients with…
Perforated ulcers or Stomach (gastric ulcers)
GI hemorrhage is referred to as
Small bleed in a vessel with slow loss of blood making patient pale and week over days to weeks.
An abdominal aortic aneurysm (AAA) is
A ballooning or weakening in the wall of the aorta as it passes through the abdomen. Pain can be SHARP, Tearing and radiate to the back.
Hernia is a hole in the muscle layers of the abdominal wall. shows as a mass or lump on the abdominal wall or in the groin. This can be caused by…
Heavy lifting or straining that causes the intestine to push through the weakened area. Can be life threatening if the hernia causes an obstruction or twisting of the intestine.
Renal Colic (kidney stones) is when
One of these stones begins to descend down the ureter on the way to the bladder. It can cause severe flank pain often anteriorly to the groin area.
Consider the application of supplemental oxygen to any hypoxic abdominal pain patient, especially when their saturation is showing less than ___%
Less than 94%
Remember
Abdominal pain or discomfort should always be considered an emergency even if signs of shock are not present
History of the present illness is found through what and what does each mean?
OPQRST
Onset, Provocation, Quality, Radiation, Severity, Time
When performing physical examination of the abdomen you do 2 things as an EMS provider
Inspection and Palpation
When inspecting the abdomen what do you look for?
Distention, bloating or discoloration, protrusions, or other abnormalities.
When palpating the abdominal quadrant you should ALWAYS:
Palpate the area that has pain or discomfort LAST
Guarding is described as…
The patient drawing his arms down across the abdomen OR
The patient tensing muscles before you touch the abdomen
Remember when assessing the lower quadrants it requires you to:
Loosen the clothing as the lower quadrants extend from the umbilicus downward to the pelvis.
For Geriatric patients they may have a decreased ability to perceive pain. However they are more likely to have a more serious cause of their abdominal pain than younger patients. Because of this they are ___ times more likely to die
9x more likely for the same cause of abdominal pain.
Vital signs should be taken how often for abdominal pain patients?
Every 5 min.
Pulse, respiration, blood pressure, skin color, temp and condition
Remember
Never give a patient with complaint of abdominal pain ANYTHING by MOUTH
