GI sign symptoms abdominal pain
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| abdominal pain: common etilogies in various ages | all: gastroenteritis; <2 yr: trauma, intussessception, incarcerated hernia; 2-5 yr: sickle cell anemia, right lower lobe PNA, UTI; > 5yr: appendicitis; adolescent: dysmenorrhea, ectopic pregnancy; adults: pancreatitis, cholecystitis, PUD, renal stones |
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| abdominal pain: assessment: history | onset: sudden, rapid or gradual; progression; migration; character & intensity; localization |
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| Kehr's sign |
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| visceral vs. somatic pain | visceral: due to distention of a hollow viscus; poorly localized; somatic: due to peritoneal inflammation; sharper & more localized |
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| rebound tenderness | palpate deeply in the abdomen where the client has pain and suddenly release pressure; positive Blumberg's sign: perceive pain when pressure released |
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| Rovsing's sign | palpate deeply in LLQ; pain in RLQ during pressure in LLQ positive Rovsing's sign |
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| obturator sign | support client right knee & ankle, flex hip & knee & rotate leg internally & externally; positive if pain in RLQ | appendicitis or perforated appendix
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| Murphy's sign | to assess RUQ pain or tenderness, press fingertips under the liver boarder at the right costal margin and ask client to inhale deeply; accentuated sharp pain that causes client to hold his or her breath | cholecystisis
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| psoas sign | raise client right leg from the hip & place your hand on the lower thigh; ask client to keep leg elevated as you apply pressure downward against lower thigh; pain in RLQ associated with irriation of iliopsoas muscle | appendicitis
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| abdominal pain: differential diagnosis base on location | RUQ: cholecystitis, cholelithiasis, hepatitis; RLQ: appendicitis, ectopic pregnancy, tubo-ovarian pathology; LUQ: splenic enlargement, pancreatitis; LLQ: diverticulitis, PID, ectopic pregnancy; epigastric/midline: gastritis, PUD, AAA |
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