3] GI, Hepatic And Biliary System Flashcards Preview

Differential Diagnosis > 3] GI, Hepatic And Biliary System > Flashcards

Flashcards in 3] GI, Hepatic And Biliary System Deck (55)
Loading flashcards...
1

GI disease can also appear to be

MSK disease

2

What is GI disease?

Ulceration of mucosal lining of GI tract

3

Primary GI pain pattern

Epigastric
Periumbilical
Lower abdomen (hypogastric)

4

What’s th epigastric region

Midsternum to xiphoid process

5

Where does pain in epigastric regions adiare

Around ribs or straight through chest

6

Structures in the epigastric region

Stomach
Esophagus
Duodenum
Pancreas

7

Innervation of epigastric region

T3-T5 sympathetic

8

DDx of epigastric region

HEart
Liver
Gallbladder

9

Structures in periumbilical region

Small intestine
Pancreas
Appendix
Proximal colon

10

Innervation of periumbilical region

T9 - T 11 sympathetic

11

Lower ab region structures

Large intestine
Colon

12

Innervation of Lower ab

T10 - L 2 sympathetic

13

DDx for lower ab region

Bladder
Uterus

14

Dermatomes associated with nerve roots innervating organs

Referred GI pain

15

Associated signs and sx for GI

Melena
Dysphagia
Etc

16

NMS signs and Sx

Paresthesias in UE, B&B signs, etc

17

Primary pain pattern for GI

Epigastric
Periumbilical
Lower ab
Chest

18

Referred pain pattern

Dermatomes of nerve roots associated with levels innervating diseased organs OR those having pressure/tension applied to them

19

Mid back, low back, shoulder, peri-scapular

Referred pain pattern for GI disease

20

With the GI system there is referred pain to...

MS system at the same level

21

Quality of visceral pain

Deep ache
Boring
Burning
Cramping
Gnawing

22

Associated signs and symptoms with GI

Dysphagia
Odynophagia
Bleeding (melena)

23

What is the Kehrs sign

Referred pain when you place pressure on upper abdomen

24

3 special tests for appendicitis

Rebound tenderness
Rovsings sign
Pinch an inch test

25

Rebound tenderness

Pain happens after you let go.
RLQ

26

Rovsings sign

+ is palpation of the LLQ of abs increases the pain felt in the RLQ

27

Pinch an inch test

McBurney’s point
+ pain with release

28

What is McBurney’s point

1/3 from ASIS to umbilical (where appendix is)

29

Possible extension of infection into peritoneum, kidneys, lumbar IVD or vertebra

Iliopsoas abscess

30

4 tests for Iliopsoas abscess

Heel tap
Hop test
Iliopsoas uscle test- active SLR
Palpation at appendix

31

3rd most common CA

Colorectal cancer

32

Colorectal cancer is more common in?

Males
Older age

33

Action of NSAIDs

Analgesic, anti-inflammatory, antipyretic, antithrombotic

34

Adverse drug reaction of NSAIDs

GI bleed, may lead to death

35

Other adverse rxns of NSAIDs

Renal toxicity
Increased BP
CNS problems
Hepatoxicity
CV

36

Signs and Sx of using NSAIDS

Indigestion
Increased BP
Tinnitus

37

Risk factors of NSAID induced gastric ulceration

More than 65 years
Corticosteroid, anticoagulant, antidepressant use

38

Hepatic means

Liver

39

Innervation of liver

T5 - T 11 ANS

40

Primary location

Midepigastrium or RUQ

41

Referred pain location of hepatic disease

T7-T10
R shoulder and upper trap

42

#1 cause of sudden liver failure in the USA

Non-viral drug induced hepatitis

43

Innervation of gall bladder for biliary disease

T5-T11 ANS

44

Location of bile duct/gallbladder

RUQ

45

Referred pain of biliary disease or gallbladder

R shoulder, upper trap
R interscapular (T4-T8) and R subscap

46

Cholelithiasis

Presence or formation of gall stones

47

Blockage or cystic duct by gallstones

Cholecystitis

48

Additional Sx of hepatic and biliary disease

Rhabdomyolysis
Joint aches
NM Sx

49

Liver flap

Asterixis

50

How do you do asterixis?

Pt raises arm to 90 flex, elbows ext and forearms pronated —> add wrist ext with finger ext and ABD and observe for any large amplitude tremors at the wrist (flapping)

51

Signs of hepatic and biliary disease

Skin and nail changes, asterixis, referred shoulder pain, ascites, cholecystitis test

52

Gallbladder special test

Murphys sign

53

What does Murphy’s sign indicate

Cholecystitis

54

How do you perform Murphy’s sign?

Hook fingers under lower R costal border. Ask pt to take a deep breath in, palpate liver and ask about pain while watching the face

55

Risk factors for ADRs

More than 65 years old
Polypharmacy
Hyperpharmacotherapy
Alcohol
Small
Women