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Gastrointestinal disorders chapter 6

Upper GI mouth, esophagus, stomach, takes in and digests food
Lower GI small intestine-duodenum, jejunum, ileum, large intestine(ascending, transverse, descending), rectum, anus,-absorbs nutrients and water, expels aste prducs,
Hepatic-Biliary System liver-production of bile, Gall bladder=storag of bile
other organs spleen, pancreas, kidnesys
bile helps break down fat
if you remove gall bladder what happens there is a change in diet, decrease fat
abdominal quadrants upper right, lower right, upper left, lower left
Upper right quadrant liver, gall bladder
upper left quadrant stomach, spleen, pancreas
lower right quadrant appendix, ascending colon, small intestine
lower left quadrant descending colon, sigmoid color
general signs and symptoms nausea and comiting, abdominal pain, abdominal rigidity, loss of appetite, significant looss in body weight, night pain, prandial or postprandial symptoms, diarrhea, constipation, rectal blood, jaundice
nausea and comiting(upper GI) emesis-vomiting, heatemesis-blood appears in vomit-bright read blood maybe due to swallowing blood from nose or mouth injury, dark, coffee ground appearance-GI bleeding(ie gastric ulcer)
Abdominal pain location(ab quadrant), severity, and quality should be noted, when does it occur, how long what makes it better
abdominal rigidity protective spasmof ab wall muscles caused p! from injury, internal bleeding, disease in ab organs, detected w/palpation, occurs in spec quad orregion rather all ab, p!&difficulty flex trunk, indicated significant disease process requires immediate med att
Loss of appetite may indicate an upper GI problem, infection or cancer
significant loss in body weight suggests poor nutritional absoption, dehydration from recurrent vomiting or diarrhea, infection, cancer
night pain abdominal pain that wakes a person at night is almsot always associated w/ serious pathology
prandial or postprandial symptoms prandial, postprandial, somach p! begins about 1 hr after eatin, dodenal p! occurs 2 hrs or more after eating, food irritates gastic ulcer, releives duodenal ulcer, caffeine, alcohol,&spicy food may irritate gastroesophyagel reflux or peptic ulce
prandial during eatin
postprandial after eating
diarrhea leads to dehydration, electrolyte imbalance, effective treatment of diarrhea involves-hydration&electrolye replacement, meds to reduce bowel output-bismuth, subsalicylate, lopermide, BRAT diet
Constipation(lower GI) abnormal retnetion of feces as reutl of harden stool or decreased bowel motlity
constipation contributing factors poor diet(high-sugar, lowr fiber), dehydration, medications(analgesics that decrease bowel motility), stress, inactivity, GI disease
Rectal blood lower GI-bleeding directly from the rectum-blood detected in feces-black carry stools suggests upper gi bleeding-causes-hemorrhoids, IBS, cancer, parasitic GI infection
Jaundice causes-liver pathology, gall bladder pathology
Esophagus pain patter causes substernal pain, occasionally pain radiats to the back
stomach pain patterns produces epigastic pain
small and large intestinees pain pattern presens diffuse iddle to lower abdominal pain
appendix pain pattern mid ab p! that gradually migrates to RLQ, located 1/3-2/3 distance from the ASIS toward umbilllicus(McBurneys point), p! from acute appendicitis may also refer p! to the central ab, hip, thigh or lower back
liver pain pattern URQ, right shoulder
Gallbladder pain pattern T8 dermatome, radiating to the right scapula as a sharp stabbing pain, maybegin as sensation of heart burn
T8 dermatome band between nipples and belly button
Spleen Pain pattern pain in the ULQ, left shoulder(kehr's sign)
abnormal prodturding abdomen indicates distended bowel from an obstruction, excessive gas in the bowels, hepatomegaly(right enlargement), splenomegaly(left enlargement)
inspection small bulging masses in lower abdomen maybe herneiated bowel, sever abdominal muscle spasms caus a characteristic flexed or sidelying fetal posture, with both arms crossed across the belly
physical examination auscultation, percussion, palpation in that order
ausculation listen for up to 3 minutes w/in each quadrant, normal findings-5-35 sounds per min-tinking, clicking, gurgling, may take up to one minute to begin hearing soudns, abnormal sounds-decreased or absent bowel sounds(suggests bowel obstruction)
percussion techique similar to lungs-indirect techique, all 4 quads-can be preformed to identify-app. loc of liver and spleen as they extend ribcage, detect changes in resonance
resonance dull thud-suggests internal bleeding w/in the ab, dullness-solid organs, high pitchw/vibration-airfilled viscera(most abdomen)
Palpation asses for point tenderness(light), asses for abnormal masses(deep), rigidity, mcburneys point, liver &spleen should be palpated below rib cage in the RUQ and LUQ
Musculoskeletal Trauma vs Internal organ palpate=pain, contract abdominals, palapate again pain decreases=internal organ injury
Superficial Palpation performed using the palmaer aspect of the fingers rather than pokeing with a single finger-depth 1cm
deep palpation performed by places other hand on top of palpating hand, feel edges of abdominal organs, depth 3-4cm
enhanced palpation performed by placing one hand under the appropriate quadrant and other hand on top of the quadrant palpating the organ
Jar or Markle sign instruct th epatient to stand on their toes ten suddenly drop flatly onto their heels, a sharp increase in abdominal pain is positive for peritonities
hammering put hand on organ and pound hand
rebound tenderness p! upon the removal of pressure
Created by: jwebst1
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