GI and GU Systems

Question 1

what is the primary sxs of pts

Answer 1

pain

Question 2

what is vital to the exam process

Answer 2

accurate assessment

Question 3

what is a necessary step in the screening process

Answer 3

recognizing pain patterns

Question 4

pain patterns are

Answer 4

characteristics of systemic dz

Question 5

mechanisms of referred pain

Answer 5

not fully understood

3 phenomena

Question 6

3 phenomena

Answer 6

embryonic development

multisegmented innervation

direct pressure and shared pathways

Question 7

embryonic development

Answer 7

pain is referred to a site where the organ was located during fetal development

Question 8

multisegmented innervation

Answer 8

viscera is innervated by multiple segments

pain that is visceral in origin can be referred to the corresponding somatic areas

Question 9

what is the most accepted theory

Answer 9

direct pressure and shared pathways

Question 10

direct pressure and shared pathways

Answer 10

most viscera is near the diaphragm

anything that impinges upon the diaphragm can result in referred pain

Question 11

anything that impinges upon the diaphragm can result in referred pain

Answer 11

central diaphragm impingement

peripheral diaphragm impairment

Question 12

centra diaphragm impingement

Answer 12

refers to the shoulder

since we are used to afferent info from the shoulder as opposed to the diaphragm

Question 13

peripheral diaphragm impairment

Answer 13

refers pain to the ipsilateral costal margins +/or lumbar region

Question 14

what is unlikely

Answer 14

for a pt w/ back, hip and SI joint pain that has been present for 5-10 years

to demonstrating viscerogenic pain

Question 15

what would be suggested in this unlikely case

Answer 15

a systemic origin would only be suspected if there is a sudden or recent change in the clinical presentation +/or the client develops constitutional sxs

Question 16

comparison of systemic v. MSK pain

Answer 16

aggravating and relieving factors

Question 17

aggravating and relieving factors

Answer 17

systemic pathology

chest/neck and upper back pain

back/shoulder/pelvic or sacral pain

gall bladder pain

tense swollen kidney pain

pancreatic pain

distended hollow organs

Question 18

for systemic pathology

Answer 18

it is usually organ depended

based on visceral fxn

Question 19

chest/neck and upper back pain

Answer 19

d/t a problem with the esophagus will likely be exacerbated w/ the pt swallowing and eating

whereas neck pain d/t HNP would be unchanged

Question 20

back/shoulder/pelvic or sacral pain

Answer 20

made better or worse w/ eating, passing gas or bowel movements

IS A RED FLAG

Question 21

gall bladder pain

Answer 21

can be lessened by leaning forward

or

assuming a hands on knees posture

Question 22

tense swollen kidney pain

Answer 22

may be relieved by flexing the trunk +/or tilting towards the involved side

Question 23

pancreatic pain

Answer 23

pt may sit up and lean forward or lie down w/ knees drawn to chest

to lessen sxs

Question 24

distended hollow organs

Answer 24

body positions or movement that increase intra-abdominal pressure may intensify pain

while positions that reduce pressure or support the structure may ease the pain