GI/GU Flashcards
What is viscera? What is the difference between solid and hollow viscera?
Viscera are all organs in the abdominal cavity
- solid viscera have a specific shape, such as the liver, pancreas, spleen, etc.
- hollow viscera depend on the contents, such as the stomach, gallbladder, small intestine, colon, etc.
What is peristalsis?
The involuntary contraction and relaxation of the digestive tract to move contents from the esophagus to the anus
What is dysuria? Hematuria?
Pain with urination; blood in the urine
Why do we auscultate before palpation for GI/GU?
Palpation may increase peristalsis and give false interpretation of bowel sounds
Describe how to complete an abdominal inspection
- skin colour, lesions, masses
- contour/shape
- size
- symmetry
- umbilicus
- pulsations
- peristaltic waves
- urine
- emesis
- stool
- swallow
- mucosa/teeth
- lips
What are the four different abdominal shapes that can be inspected?
- flat
- rounded
- scaphoid
- protuberant
Describe how to complete auscultation of GI
- begin in RLQ and work clockwise
- use the diaphragm of stethoscope for bowel sounds and bell for vascular sounds
- should hear 5-30 bowel sounds per minute and should not hear any vascular sounds
What are the four types of bowel sounds and how many sounds would be indicated per minute?
- Absent - no BS for 5 mins
- Hypoactive - less than 5 BS per min
- Active - 5 to 30 BS per min
- Hyperactive - over 30 BS per min
What could cause hypoactive bowel sounds?
- constipation
- inflammation
- late bowel obstruction
- can occur with pneumonia
What could cause hyperactive bowel sounds?
- early bowel obstruction
- gastroenteritis
- diarrhea
- laxative use
What is borborygmi?
Bubbling or gurgling sounds made in the bowels
How do you complete palpation during a GI assessment?
Light palpation that is 1-2cm deep, done in a circular motion with the pads of the fingertips
What are nine situations that are considered acute emergencies?
- pain
- tarry stool
- bloody stool
- hematemesis
- trauma
- vomitus with fecal odor
- jaundice
- inability to void
- referred cardiac pain
What is stress incontinence?
Increased abdominal pressure under stress (weak pelvic floor muscles)
What is urge incontinence?
Involuntary contraction of the bladder muscles
What is overflow incontinence?
Due to a blockage of the urethra - you have the urge to urinate but can release only a small amount. This can be due to a weak bladder muscle or to blockage. Since your bladder doesn’t empty as it should, it gets too full. It then leaks urine later, even though you feel no urge to urinate.
What are some older adult considerations?
- less saliva and stomach acid
- decreased taste
- slower peristalsis
- dysphagia
- reduced muscle mass
- risk of dehydration
What is an aneurysm?
A weakened blood vessel wall that results in the ballooning/widening of a vessel
What are ascites?
Fluid collects in spaces within the abdomen
What is hepatitis?
Inflammation of the liver
What is melena?
black, tarry stool that comes from bleeding in your upper GI tract
What is splenomegaly?
Enlargement of the spleen
What are striae?
Stretch marks
Describe how to complete an inspection of the penis
Groin and Penis
- skin, colour, lesions, rashes
- hair distribution
- inspect shaft
Glans
- ask patient to retract foreskin
Urethra
- discharge
Scrotum
- asymmetries (normal)
- smoothness of testes
- tenderness
Perineum
- spread buttocks to inspect
What are some considerations for male older adults?
- less testosterone affects sexual function
- pubic alopecia
- prostate enlargement
- scrotum dropping lower due to decreased muscle tone
Describe how to complete an inspection of external female genitalia
Mons pubis
- hair distribution
- lice
- nits
Skin
- colour
- redness
- swelling
- lesions
Labia
- size
- swelling
- symmetry
- piercings
- redness
Discharge
- amount, colour, consistency, odor
What are some older female adult considerations?
- limited/absent estrogen
- menopause
- uterus may prolapse due to weakened musculature
- vaginal dryness
How much urine does an adult bladder hold?
400-600mL of urine
On average, how many times do people empty their bladder per day? How much in mL per day?
5-7 times/day with 1500-1600 mL/day
What is the expected output of urine per hour?
0.5 mL/kg/hr which is roughly 30-40mL/hr
What is pyrosis?
Heartburn
