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Liver Function Stores glycogen, vitamins and iron Detoxifies and secretes bile Converts fat soluble wastes into water soluble material for renal excretion Produces antibodies, substances for blood coagulation and plasma proteins
Gallbladder concentrates and stores bile
Pancreas Exocrine and endocrine organ Produce enzymes that help to break down carbohydrates, fats and proteins islet cells produce insulin and glucagon Has an excretion function and serves as an endocrine gland
Spleen Filters blood Produces lymphocytes and monocytes
Appendix Extension of large intestine
Kidneys Produce renin Converts Vitamin D to active form 1,25(OH)2D Has an excretion function and serves as an endocrine gland
What happens to abdominal muscles in a pregnant woman? Abdominal muscles stretch and loose tone
What happens to GI transit time during pregnancy? What does it lead to? GI transit time is prolonged. Leads to constipation and increased absorption
What happens to the pyloric sphincter during pregnancy? Becomes incompetent. Leads to heartburn.
What risks are increased during pregnancy? Gall bladder statis, gallstones, renal stones, and urinary statsis
What is naegle Rule used to calculate the estimated date of confinement First day of last menstrual period +7 days - 3 months
When is fundal height most accurate? 20-30 weeks
How is fundal height measured? from the pubic symphysis to the superior fundus uterus
What is intestinal motility like in elderly? decreased
What happens to the liver in the elderly? loses the ability to metabolize certain drugs
What are special things to focus on in HPI? abdominal pain, indigestion, nausea/vomiting, diarrhea, constipation, fecal imcontinence, jaundice and urinary changes
What happens to the colon during pregnancy? displaced laterally and upward
What happens to the appendix during pregnancy? displaced up and laterally
What happens to blood flow during pregnancy and what does it lead to? Increases and results in hemorrhoids
When must auscultation of the abdomen occur? BEFORE percussion or palpation
How long must you listen to abdominal sounds? 5 minutes
What do you percuss? liver span spleen kidneys
What should patient do to relax tight abdominal muscles during palpation? flex knees
Cholecystitis enlarged, tender gallbladder
Common Bile Duct Obstruction enlarged, non-tender gall bladder
Murphy Sign positive if pain and halts respiration. indicates an inflamed gall bladder
Splenogegaly enlarged spleen
What does splenomegaly indicate? mononucleosis
What is mononucleosis? ebstein barr virus primarily affects adolescents causing them to be tired and have a sore throat
Abdominal Aortic Aneurism When there is lateral pulsation of the aorta
Ascites abnormal intraperitoneal accumulation of fluid. Shifting dullness, fluid wave, puddle, or auscultatory percussion
Apley Rule Farther from the naval the patient points when asked where the pain is, the more likely the pain is organic If the patient points to teh naval and is otehrwise well think non-organic
Rebound tenderness indicates peritoneal irritation Postitive sign is pain with rapid withdraw of hand
Blumberg Sign rebound of teh compressed structures causes a stabbing pain at the site of peritoneal irritataion
Iliopsoas Muscle Test Indicates Appendicitis Postivie sign is pain in the right lower quadrant Patient lies supine and flexes right hip against the physician's resistance
Obturator Muscle Test indicates ruptured appendix or pelvic abscess Positive sign is pain in hypogastric region Patient lies supine and you flex patient's hip and knee and rotate the leg laterally and medially
Aaron Sign Tests for appendicitis Pain or distress occurs in the area of the heart or stomach on palpation of McBurney's Point
Balance Sign Fixed dullness to percussion in left flank, and dullness in right flank that disappears on position change. Tests for peritoneal Irritation
Blumberg Sign Pertitoneal Irritation and appendicitis Rebound Tenderness
What is Cullen Sign Ecchymosis around the umbilicus Tests for hemoperitoneum, pancreatitis and ectopic pregnancy
Dance sign Absence of bowel sounds in right lower quadrant. Intussusception
What is intussusception? intestines get blocked and move over into another section of intestines
Grey Turner Sign Tests for hemoperitoneum and pancreatitis Ecchymosis of the flanks
Kehr's sign Tests for spleen rupture, renal calculi and ectopic pregnancy. Abdominal Pain radiating to the left shoulder
Markel's Sign Heel Jar Test Tests for peritoneal irritation and appendicitis
McBurney Sign Rebound Tenderness and sharp pain when palpated. Tests for appendicitis
Where is McBurney Point? midway between the ASIS and the umbilicus
Murphy Sign Cholecystitis Abrupt cessation of inspiration on palpation of the gallbladder
Rovsing Sign Right lower quadrant pain intensified by left lower quadrant palpation Peritoneal irritation and appendicitis Appendicities
Romberg-Howship Sign Strangulated obturator hernia Pain down the medial aspect of the thigh to the knee
Constipation pneumonic Congential obstruction Neoplasm Stricture of colon Topical (hemorrhoid/fissue) Impatction Prolapse of rectum Anorexia/Depression Teperature high (Dehydration) Endocrine (hypothyroid) Diet, Diverticulitis, drugs
Pyloric Stenosis hypertrophy of circular muscle that causes obstruction.
When does pyloric Stenosis present? First month of life with projectile vomiting and eager feeding in spite of vomiting.
What is origin of acute diarrhea? usually viral Can be foodbore/waterborne
What diarrhea comes from camping? Giardia and campylobacter
Salmonella or Campylocbacter undercooked poultry
Undercooked beef or unpasteurized milk? e. Coli
Cruse ships and raw shellfish norwalk virus
GERD Esophageal Reflux disease Incompetence/Relaxation of lower esophagus Burning chest pain or epigastric Pain
Crohn's Disease Chronic inflammatory disorder of GI tract Transmural wall thickens, lumen narrows, ulceration in mucosa Ulceration, fibrosis, abscess and malabsorption diarrhea, bleeding perianal skin tag, mouth ulcer
ulcerative colitis Chronic inflammatory disorder of teh colon and rectum Inflammation only in mucosa (begins in rectum and progresses thru colon. Bloody, watery diarrhea, weght loss and fatgue
Appendicitis Pain initially periumbilical (localized to right lower quadrant) McBurney point Guarding, tenderness iliopsoas sign, obturator sign, skin hypersensitivity, N/V, Aaron sign, rovsing sign, and markle sign
colorectal cancer change in frequency and character of stook (occult blood) Screening 50 year old patiens
What tests for colorectal cancer? yearly fecal occult blood flexible signoidoscopy every 5 years ore colonscopy every 10 years
Hepatitis Characterized by hepatocellular necrosis
What causes hepatitis? viral infection, alchohol, drugs, adn toxins
What does hepatitis cause? jaundice, hepatomegaly, anorexia, clay-colored stool, tea colored urine
Is there a vaccine for hepatitis? only A and B
Cholecystits inflammation of the gallbladder with pain in RUQ radiating around torso and to the right scapula
Intussusception prolapse of 1 intestine segment into another infants 3-12 months
ABCDEF of intussusception Abdominal/Anal Sausage Blood from rectuem (red current jelly) Colic Distention, dehydration and shock Emesis Face Pale
Created by: tjamrose
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