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GI ISH Flashcards

1
Q

NSAIDS and type of Pain consideration

A

Always Consider NSAIDS in scenarios because they cause ulceration and damage gastric mucosa lining. (e.g OA patient with deep boring pain in abdominal/mid bacl…)

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2
Q

Where is an umbilical hernia and what are contraindications

A

Umbilicus

Contradiction with strong abdominal contractions (e.g vasalva, situps, BL SLR)

Deep Diaphragm is indicated for these patients

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3
Q

Where is the hiatal hernia

A

into esophagus

Contraindications same as other

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4
Q

Where is inguinal hernia

A

Inguinal ligament
Contraindications

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5
Q

Skin turgor test

A

Pinch skin and look for recoil, if it takes long time then dehydrated

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6
Q

What is common side effect of too many NSAIDS

A

Gastric lining degradation and ulceration due to damaged prostaglandin synthesis of gastric mucosa

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7
Q

Coffee-ground emesis

A

Vomited blood that touched stomach acid (peptic ulcer)

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8
Q

Hematamesis

A

Bright red blood (ingested)

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9
Q

Melena

A

Black tarry stools due to upper GI

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10
Q

Hematochezia

A

Rectal related bleeding seen in stools (marron color)

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11
Q

GI bleeding indications

A

low hematocrit
low hemoglobin
Fecaal blood test

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12
Q

Causes of GI bleeding

A

Trauma
peptic ulcer (heliobacter pylori
NSAID
alcohol

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13
Q

Gastric ulcer pain time

A

30-90 min after eating

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14
Q

duodenal/pyloric ulcers

A

pain 2-4 hrs after b/c distal to stomach later in digestion

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15
Q

Gerd and hiatal hernia positioning

A

Avoid flat supine and prone
do left sidelying
schedule PT before meals or at least 1.5 hr after

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16
Q

Melena (dark-colored stools)

A

due to upper GI tract

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17
Q

Gerd considerations

A

Backflow of acid and contents from stomach

Causes heartburn, sharp stabbing pain, hoarseness and coughing, damage to tissues

Caused by NSAIDS, smoking, alcohol, other meds, hematamesis (vomited red blood)

Related to other respiratory and GI issues, leads to further damage of esophagus if untreated

Made worse with recumbency, supine b/c gravity is NOT holding contents down in these positions

Exercise can induce sx, tight clothing, constipation

Left sidelying is ideal

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18
Q

Flow of GI

A

Upper: mouth to esophagus to stomach (Left) to

Lower: small intestines:duodenum to jujenum to ilium t
then large intestine:ascending, transverse, descending, signmoid, rectum, anus

Pancreas (Left)
Gallbladder and Liver (Right)
secrete digestive enzymes (gland organs)

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19
Q

Stomach

A

Grinds food with secretion of hydrochloric acid, secretions from gland orhans

*Gastritis, peptic ulcer

20
Q

Duodenum (small intestine)

A

Neutralizes acid*

21
Q

Jujenum (small intestine)

A

Absorbs nutrients, water, electrolytes

22
Q

ilium (small intestine)

A

Absorbs bile and waist

23
Q

Large intestine

A

Cont to absorb water, and electrolytes, then eliminated undigested food/feces

24
Q

Gallbladder

A

R side
Produces bile to assist with digestion in duodenum

25
Liver
R side Produces bile for absorption of and maintenance of nutrients (proteins, fats, lipids) Related to RBC and vitamin K
26
Pancreas
L side Secretes insulin to regulate blood glucose levels (Insulin signals for cellular uptake) and bicarbonate, other
27
General considerations for GI disease
- vomiting, diahhreah, weight loss can cause electrolyte imbalances - Orthostatic hypotension due to imbalance - Muscle cramping due to imbalance - Dysphagia - Back pain shoulder pain due to GI ulcer, bleeding - Kehrs sign means unwanted blood or air in the abdominal cavity - Avoid Valsalva
28
Gastritis considerations
Stomach Inflammation of gastric mucosa of stomach - Nausea, vomiting, may be asymptomatic - may be acute due to NSAIDS, alcohol, infection (REMOVE STIMULUS) - May be chronic due to H pylori/peptic ulcer (treat with meds proton pump inhibitor and antibiotics) - If blood in stools, refer out - Avoid aspirin, blood thinners due to bleeding - Take food with meds Proton pump inhibitors end in zole
29
Peptic ulcer disease considerations
Stomach - Imbalance, stomach acid related - NSAIDS or h pylori infection (peptic ulcer) - Long list of GI sx dependent on location and severity of ulcer - meds to intervene - Back pain may be due to ulcer on back of stomach or duodenum - Epigastric pain b/c stomach is upper - Mid thoracic pain* radiating to RUQ, R shoulder pain due to blood in peritoneal cavity
30
Constipation vs diarrhea
Constipation means difficulty emptying due to hard stools Diarrhea refers to abnormal frequency and/or volume of stools
31
Malabsorption Syndrome
- Lack of absorbing nutrients - Many causes (think Chrons, celiac, cystic fibrosis, Addison's disease, aids, etc.) - Weight loss, chronic diarrhea, anemia fatigue, bloating, bone pain, oil-covered stools PT-related - increased risk osteoporosis, weight loss, energy loss, muscle spasms, lack of protein , neuropathy
32
Hiatal hernia
Stomach protrudes through the diaphragm into the esophagus, causing heartburn,
33
Irritable bowel syndrome
Think of it as general condition. All around GI symptoms. Severity may vary, but not a disease. Usually triggered and regulated by psychosocial/stress, diet, strengthening immune system, less caffeine, etc. Exercise and breathing exercises are good This can be anyone
34
Diverticulitis
Inflamed pouches that branch off from intestine 1/4 of people have diverticula but not infalmed Treat with increased deitary fiber (20-35 g) per day * Exercise (in remission periods) and breathing is good Avoid too much abdominal pressure may have tenderness in L Lower abdomen*
35
Appendicitis
Consider McBurney point, rebound tenderness, psoas sign, pain that goes from belly button to LRQ
36
Hepatitis A, B. C Consideration
Sx - fever flu, jaundice, dark urine, enlarged spleen and lover - usually viral or due to other virus - Acute treated medically - Chronic may require transplant Healthcare worker considerations if come in contact with blood of someone with disease, require immunoglobulin therapy - pt will require rest and energy conservation during PT - Type A requires enteric precautions - Always standard precautions
37
Cirrhosis of liver
Typically due to alcohol or hepatitis C Scar tissue lays down in liver Sx Ascites,* LE edema, * jaundice, * gallstones, spider anginoma, oliguria (decrease urine), RUG pain, Rhabdomyolysis. light-great stools Process can be treated but not reversed Report any blood loss Avoid excessive exercise and valsalva maneuver
38
1. Cholecystitis and 2. Cholelithiasis
1. Inflammation and 2. gallstones Gallstones in the cystic duct - most common sx is RUQ pain if lodged into cystic duct, and inter scap region - Jaundice, fever, etc. Treatment to break up stones or if no stones then will resolve with meds Exercise and precautions of surgery occurs
39
INFLAMMATORY bowel disease
Autoimmune, systematic, ulcerative colitis Related to reactive arthritis b/c autoimmune
40
Peritonitis
Inflammation of walls of the abdominal cavity Rebound test
41
All hernias
Avoid strong abdominal contraction and valsalva D breathing is good
42
Pancreatitis
Epigastric pain and referred to L side Bluish discoloartion, tachycardia, GI sx
43
Colorectal cancer
Rectal bleeding (hematochezia, maroon color stool), back, abdominal, sacral pain, general GI sx, weight loss, fever
44
Pernicious anemia
Lack of gastric intrinsic factor (IF) = less absorption of B12. Due to malabsorption related issues, gastrititis
45
If above L1
Spastic and hyperreflexia but reflexes intact so can use digital stimulation for bowel
46
If below L1
Flacid and areflex so will require manual removal, stool softeners and laxatives may help
47
If too much acetaminophine
Pancreatitis

NPTE Prep (44 decks)

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