Screening for Hepatic and Biliary Disease Flashcards
what organ systems are included in the hepatic and biliary system?
- liver
- gallbladder
- common bile duct
MSK symptoms associated with hepatic and biliary disease more often refer to:
- Mid-back
- Scapular
- R Shoulder
S/S of hepatic and biliary disorder
- Skin and nail bed changes
- MSK pain
- neurological symptoms
- GI symptoms
- Ascites
Skin and nail bed changes associated with impairment to the hepatic system
- Jaundice, pallor and orange/green skin
- sclera changes
- skin changes
- pruritus
- bruising
- spider angiomas
- palmar erythema
- nails of terry
what are spider angiomas?
- permanently enlarged and dilated capillaries visible on the surface of the skin caused by vascular dilation
- common in pts w/liver impairment as a result of increased estrogen levels that are normally detoxified by the liver
what are palmar erythema?
warm redness of the skin over the palms
- due to extensive collection of arteriovenous anastomoses
a pt with a palmar erythema may c/o what?
throbbing or tingling in the palms
what are nails of Terry?
opaque nail plate with a narrow line of pink at the distal end instead of the more normal pink nail plate in the Caucasian
List MSK pain that is associated with hepatic and biliary systems
- Thoracic pain between shoulder blades
- R shoulder
- R upper trapezius
- R interscapular
- R subscapular
Rhabdomyolysis may occur with what?
- acute trauma
- severe burns
- overextension
- liver impairment secondary to alcohol abuse
- alcohol poisoning
- statins
what causes neurological symptoms in hepatic and biliary diseases?
secondary to increased serum ammonia and urea levels because of liver dysfunction
list neurological symptoms that can occur in hepatic and biliary diseases
- confusion
- sleep disturbances
- muscle tremors
- hyper-reactive reflexes
- numbness/tingling
- asterixis
T/F: there is no correlation between liver disease and bilateral carpal tunnel syndrome
FALSE
what is Asterixis?
inability to maintain wrist extension with forward flexion of UE
- outward sign of liver disease
- also called flapping tremors or liver flap
when screening for liver impairment in pts with bilateral carpal tunnel what should you ask about?
- ask about similar symptoms in the feet (bilateral tarsal tunnel)
- ask about personal history of liver/hepatic disease
- look for history of alcoholism
- ask about current or previous use of statins
- look for other signs of liver impairment
describe GI symptoms related to hepatic and biliary disease
- light colored stool (almost white)
- potential causes
- gallbladder diseases
- hepatotoxic medications
- pancreatic cancer blocking bile duct
- potential causes
- urine the color of tea or cola