Unit 7 Screening for Gastrointestinal Disease Flashcards
What are the S/S of GI Disorders?
- Dysphagia (Difficulty swallowing)
- Odynophagia (Pain during swallowing
- GI Bleeding
- Epigastric P! with radiation to the back
- Constipation
- Diarrhea
- Fecal incontinence
- Early satiety with weight loss
Sx may also be affected by food
With the S/S of GI disorders, what are the different types of GI Bleeding?
- Coffee-Ground Emesis
–Vomit with blood and gastric acid. (Ulcers) - Bright red blood
–Colon, Rectum, and Anus Lesions (Distal parts of GI) - Melena (Dark Tary stools)
–Stomach/Duodenum Ulcers - Reddish or Mahogany-Colored Stools
–Medicatons or foods (beets)
With Abdominal Pain referral , what structures refer pain to the Epigastric (T3-T5)?
Heart, esophagus, stomach, duodenum, gallbladder, liver or pancreus
With Abdominal Pain referral , what structures refer pain to the Periumbilical (T9-T11)?
Pancreas, small intestine, appendix or proximal colon
With Abdominal Pain referral , what structures refer pain to the Hypogastrum (T10-L2)?
Large Intestine, Colon, bladder, or uterus
What is Gastroesophageal Reflux Disease (GERD)?
This is the backward movement of stomach acids and other stomach contents, such as pepsin and bile, into the esophagus, a phenomenon called acid reflux
What are Typical symptoms for GERD?
- Heartburn
- Regurgitation with bitter taste in mouth
- Belching
What is Peptic Ulcer?
What are Gastric and duodenal ulcers caused by?
A loss of tissue lining the lower esophagus, stomach, and duodenum
Gastric and Duodenal ulcers are caused by infection with Helicobacter Pylori (a corkscrew-shaped bacterium) and chronic use of NSAIDs
What are the Clinical S/S of Peptic Ulcer?
What are the s/s of Gastric and Duodenal ulcers?
- “Heartburn” or epigastric pain
- Radiating back pain, stomach pain
- Right shoulder pain
- Bloody stools, Black, Tarry stools
Gastric: aggravated by food
Duodenal: Releived by food, mild, antacids, or vomiting
What is Appendicitis?
An inflammation of the Verminiform appendix that occurs most commonly in adolescents and yound adults.
- When the appendix becomes obstructed, inflamed, infected, and infected, rupture may occur which leads to peritonitis
This usually requires surgery
What are the Clinical S/S for Appendicitis?
- (+) McBurney’s Point and/or (+) Pinch-an-inch test
- Positive Hop Test
- Periumbilical and/or epigastric pain; RLQ or flank pain; RIght thigh, groin, or testicular pain
- Abnormal involuntary muscle guarding and rigidity
- Nausa Vomiting and anorexia
What is the purpose of Rebound Tenderness or Blumberg’s Sign?
To assess for appendicitis or generalized peritonitis; Press your fingers gently but deeply over the RLQ for 15 to 30 seconds. The hand is then quickly removed.
What is Crohn’s Disease?
What is Ulcerative Colitis?
An inflammatory disease that most commonly attacks the terminal end (or distal portion) of the small intestine (ileum) and the colon due to an abnormal reaction by the body’s immune system
Ulcerative Colitis is an inflammation and ulceration of the inner lining of the large intestine (colon) and rectum
What are the S/S of both Crohn’s Disease and Ulcerative Colitis?
- Night sweats
- Arthritis, Migratory arthralgias
- Hip pain (Iliopsoas abscess)
What is Diverticlits?
This is an infection and inflammation that accompany a micoperforation of one of the diverticula
Diverticulosis is very common, whereas complications results in diverticulits
What are the S/S for Diverticulits?
- Generalized abdominal pain often with loss of appetite, nausa, abdominal bleeding
- (L)LQ pain; Possible (+) Pinch-Test
- Decreased or absent bowel sounds; Palpable abdominal mass
What is Pancreatitis?
An inflammation of the pancreas due to anatomic or functional disorders, autoimmune conditions, Chronic Alcohol Consumption (90% of cases).
What are Acute S/S of Pancreatitis?
- Epigastric pain radiating to the back
- Nausea, vomiting, diarrhea; anorexia
- Fever and sweating, tachycardia
- Malaise, weakness and jaundice
What are Chronic S/S of Pancreatitis?
-Upper Left Lumbar Region Pain
- Weight loss
- Oily or fatty stools and clay-colored or pale stools
What is Irritable Bowl Syndrome (IBS)?
A functional disorder of mobility of the small and larger intestines. Most common GI problem (50% of GI referrals). Linked to psychological issues
What are the S/S of IBS?
- Painful abdominal cramps
- Constipation
- Diarrhea
- Anorexia
- Bad Breath
- Nausea and Vomiting
Psoas abscess originating from GI Disorders
What can cause Obturator or Psoas Abscess?
The iliopsoas is not separated from the abdominal or pelvic cavity
- Any infectious or inflammatory process present in either of these cavities can seed itself to the psoas muscle by direct extension
What are the Clinical S/S of Obturator or Psoas Abscess?
- Fever (“hectic” fever pattern: up and down)
- Night sweats
- Antalgic gait
- Back, pelvic, abdominal, hip and/ or knee pain
- Palpable, tender mass
What are the Guidelines for Immediate Medical Attention for GI Disorders?
- Anytime Appendicitis or Iliopsoas/Obturator abscess is suspected {(+) McBurny’s Test, (+) Iliopsoas, (+) for Rebound Tenderness}
- Any time the therapist suspects Retroperitoeal bleeding form an injured, damaged, or ruptured spleen, (+) Kehr’s sign, or Ectopic Pregnancy; or there is a history of trauma; Missed menses
What is an Ectopic Pregnancy?
This is when the egg attaches itself somewhere outside the uterus, usually to the inside of a fallopian tube
What are the S/S for Ectopic Pregnancy?
- Severe abdominal or pelvic pain accompanied by vaginal bleeding
- Extreme lightheadedness or fainting
- Diarrhea and vomiting
- Shoulder pain
What are the Guidelines for Physician Referral?
- Pt. who chronically rely on laxatives should be encouraged to discuss bowel management w/o drugs
- Joint involvement accompanied by skin or eye lesions may be reflective of Inflammatory bowel disease and should be reported to the physician if they are unaware
- Back Pain associated with meals or relieved by a bowl movement or back pain abdominal pain at the same level requires mediacal evaluation
- Back pain of unknown cause that does not fit a MSK pattern, especiallly in a person with a previous history of cancer.
