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GIdisorders
Gastrointestinal disorders chapter 6
| Question | Answer |
|---|---|
| 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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