Exam 2 - GI, Screening Chest Breast And Ribs, Lumbar

Question 1

Gi screen indicated if? Upper v Lower?

Answer 1

History of serious GI disorder

UPPER: Abdominal (epigastric), shoulder girdle, thorax pain

LOWER: abdominal (umbilical or hypogastric), pelvic, lumbar pain

Question 2

Upper GI tract structures

Answer 2

1. Mouth
2. Esophagus
3. Liver
4. Stomach
5. Pyloric sphincter
6. Duodenum

Question 3

Lower GI tract structures

Answer 3

1. Pancreas
2. Jejunum (small intestine)
3. Ileum (small intestine)
4. Cecum (large intestine)
5. Appendix
6. Ascending colon (large intestine)
7. Descending colon (large intestine)
8. Anus

Question 4

Functions of small intestine

Answer 4

Accomplishes digestion and absorption of nutrients

Question 5

Functions of large intestine

Answer 5

Absorbs water and electrolytes
Storage of waste until elimination

Question 6

Similarities between S&S of GI dz and constitutional dz

Answer 6

Nausea
Vomiting
Diarrhea

Question 7

S&S specific to GI dz (9)

Answer 7

Hematochezia - “fresh” blood in stool
Anorexia
Constipation
Abdominal pain
Dysphagia - diff. Swallowing
Achalasia - failure to relax smooth muscles of GI tract (neuro)/ loss of peristalsis in lower 2/3 of esophagus
Melena - black, tarry stools
Incontinence
Hematemesis - vomiting of blood
Heart burn

Question 8

S&S specific to constitutional dz (7)

Answer 8

Malaise - overall feeling of discomfort
Fatigue - extreme tiredness
Fever
Night sweats
Diaphoresis
Dizziness
Pallor

Question 9

GI organs - RUQ

Answer 9

Liver
Diaphragm
Lung
Gallbladder

Question 10

GI organs - LUQ

Answer 10

Spleen
Stomach
Lower intestine
Lung/diaphragm

Question 11

GI organs - RLQ

Answer 11

Lower intestine
Appendix

Question 12

GI organs - LLQ

Answer 12

Lower bowel
Descending colon
Abdominal aorta

Question 13

Upper bowel dysfunction

Answer 13

Dysphasia
Nausea
Vomiting
Heartburn/indigestion
Specific food intolerance

Question 14

Lower bowel dysfunction

Answer 14

Constipation
Diarrhea
Caliber
Difficulty initiating BM
Color
Incontinence

Question 15

GI system screen questions

Answer 15

Changes in B&B
Activity, coughing, sneezing, deep breath make it worse?

*certain foods make it worse?
*weight change since onset of symptoms?

**pt reporting “no” to these questions makes it VERY likely that they do NOT have a GI issue

Question 16

SINSS

Answer 16

Severity
Irritability
Nature
Stage
Stability

Question 17

3 major regions of visceral pain - Epigastric region (define region and name organs that might refer pain here)

Answer 17

Midsternum to xiphoid process

Heart
Esophagus
Stomach
Duodenum
Gall bladder
Liver
Other organs corresponding to T3-T5 sympathetic nerve distribution

Question 18

3 major regions of visceral pain - periumbilical region (define region and name organs that might refer pain here)

Answer 18

Above umbilicus

Small intestine
Pancreas
Appendix
T9-T11

Question 19

3 major regions of visceral pain - hypogastrium region (define region and name organs that might refer pain here)

Answer 19

Below umbilicus, corresponds to sacrum

Large intestine
Bladder
Uterus
T10-L2

Question 20

Visceral pain descriptive words

Answer 20

Boring pain
Deep pain
Gnawing
Vague burning
Deep grind-like

Question 21

Hiatal hernia S&S

Answer 21

Superior portion of the stomach rises above the diaphragm

Indigestion and pain with breathing

Question 22

Why is an inguinal hernia dangerous?

Answer 22

Protrusion of intestines through inguinal canal

Dangerous if it gets clamped off and breaks open

Question 23

IBD: 2 examples and what MMTs reveal pain where?

Answer 23

Crohn’s disease - normal areas and skip areas, can affect any area of intestines
Ulcerative colitis - no skips, chronic diarrhea and rectal bleeding

Iliopsoas and obturator internus MMTs reproduce pain in RLQ