GI Flashcards
Name the four quadrants of the GI system
Right upper quadrant (RUQ), left upper quadrant (LUQ), right lower quadrant (RLQ), left lower quadrant (LLQ).
What is the one body part that goes through all four quadrants?
Intestines
Name the organs in the RUQ
Liver, gallbladder, duodenum, hepatic flexure of colon, pancreatic head, ascending/transverse colon, right kidney
Name the organs in the RLQ
Cecum, appendix, right ovary & fallopian tube, right ureter & spermadic cord
Name the organs in the LUQ
Stomach, spleen, body of pancreas, left kidney, splenic flexure of colon, transverse/descending colon
Name the organs in the LLQ
Descending and sigmoid colon, left ovary & fallopian tube, left ureter & spermadic cord
Bony landmarks on the anterior body include:
Xiphoid process of sternum, costal margin, midline, umbilicus, anterior iliac spine, superior margin of pubis
What is a good posterior landmark?
The costovertebral angle. This is the back version of the costal angle)
What is dysphasia?
Chewing or swallowing difficulties
When is dysphasia common?
Post-stroke
What is eructation?
Belching
What is pyrosis?
Heartburn
What are some problems that can happen with digestion?
- Eructation (Belching)
- Pyrosis (Heartburn)
- Nausea with and without emesis
Characteristics of vomitus: What is usually happening when you see frank blood?
Usually related to esophageal bleeding
Characteristics of vomitus: What is usually happening when you see fecal matter?
This is rare, but can be from blockage
Characteristics of vomitus: What is usually happening when you see coffee ground looking material?
Usually with bleeding, acid in stomach
S/s of constipation:
Fecal matter is hard, small, < 3 x/week, difficult to pass
What can happen as a result of constipation?
hemorrhoids
Questions to ask about dentition and swallowing:
- Do they have teeth? Do their dentures fit? Are the dentures theirs?
What does it mean to PQRST something in regards to pain?
P stands for palliative or precipitating factors, Q for quality of pain, R for region or radiation of pain, S for subjective descriptions of pain, and T for temporal nature of pain (the time the pain occurs).
What is referred pain?
Pain which manifests at a site distant from the actual pathology
General tips for abdominal assessment:
- The patient should have an empty bladder
- The patient should be lying supine appropriately draped
- The examination room must be quiet to perform adequate auscultation and percussion
- Watch the patient’s face for signs of discomfort during the exam!
The sequence of assessment is different for GI What is the correct sequence here?
- Inspect
- Auscultate
- Percuss
- Palpate
What does scaphoid mean?
Concave (as in the shape of the stomach upon inspecition)
What does protuberant mean?
Bulging (as in the shape of the stomach upon inspecition)
Things to note with abdominal distention?
- Note position of umbilicus
- Note portion of abdomen that is distended
- Reasons for distention: fat, flatus (gas), feces, fluid (ascites),fetus
If the umbilicus is pushed out with distention, what might you suspect is the cause?
Fluid
If the umbilicus is positioned inward with distention, what might you suspect is the cause?
Ascites
What is Cullen’s sign?
Purple around umbilicus. High urgency. Some sort of bleeding.
What causes spider angiomas ?
Common with liver disease, esp cirrhosis
T/F It is normal to see pulsations with pale skin and a thin abdomen?
True
If you see a mass, should you palpate or not palpate?
JUST SAY NO
What is hematochezia?
Bleeding in the rectum, bright red.
When fecal matter is tinged maroon/dark red, what might you suspect?
Bleeding in lower parts of the intestine
When fecal matter is tinged red, what might you suspect?
Bleeding in the rectum (hematochezia )or occasionally from rapid or large amt of bleeding in GI tract
When fecal matter is black, not sticky, and with no odor what might you suspect?
Iron or bismuth containing medications (Pepto Bismol)
When fecal matter is black, tarry, and with foul odor what might you suspect?
RED FLAG. Bleeding in stomach or upper part of small intestine.
What does melena refer to (with stool)?
Black stool
When fecal matter is clay-colored and/or pale, what might you suspect?
Contains little or no bile – diseases or obstructions that cause obstruction of flow of bile to the intestines
When fecal matter is yellow, greasy and with a foul smell , what might you suspect?
Presence of undigested fat – diseases pancreas (reduced enzymes to
What is the main thing you want to check when you are assessing an ostomy?
The stoma
T/F: The look of your stool will depend on the ostomy you have.
True
What is hematemesis?
Vomiting of blood
When auscultating the abdomen, where do you begin?
Start at ileocecal valve & continue clockwise using diaphragm
How long should you spend in each quadrant?
15-20 seconds
How many clicks/gurgles per minutes is normal?
5-34
If you about to listen to bowel sounds on someone who has an NG tube, what should you do?
Turn off or pinch
How long should you technically listen before documenting absent bowel sounds?
3-5 minutes
What are you testing for when you ask the patient to turn to one side, then percuss from tympany to dullness; fluid will sink to lowest point.
Used with ascites: Testing for “shifting dullness,” ask patient to turn to one side, then percuss from tympany to dullness; fluid will sink to lowest point. “Positive for shifting dullness.”
When assessing for a fluid wave how much fluid is needed to be present before this is detected?
Detected after >500 ml fluid accumulated
What is the difference between tenderness and pain?
- Tenderness is discomfort caused or increased by their examination (a sign)
- Pain on the other hand, is something the patient tells you about as part of the history (a symptom)
