Chp 22 Abdominal Emergencies

Question 1

Peritoneum

Answer 1

The membrane that lines the abdominal cavity (the parietal peritoneum) and covers the organs with in it ( the visceral peritoneum)

Question 2

The Abdomen is divided into how many Quadrants, how is it done and and what are they?

Answer 2

Through the midline of the naval and horizontally through it (umbilicus) creating 4 quadrants

Question 3

What are the two layers of the the peritoneum?

Answer 3

Visceral which covers the organs

Parietal which is attached to the abdominal wall.

Question 4

Most organs are within the peritoneal cavity, which ones are NOT within it?

Answer 4

Kidneys (and ureters)
Pancreas
Duodenum

Question 5

What are the solid organ in the abdomen?

Answer 5

Spleen (lymphatic)
Liver (digestive) and regulation of blood and detoxification
Pancreas (digestive)
Kidneys (urinary)

Question 6

What are the HOLLOW organs in the abdomen?

Answer 6

Stomach
Gallbladder
Duodenum 
Large Intestine
Small intestine
Bladder

Question 7

The area outside the peritoneum is called the…

Answer 7

Extraperitoneal space which also includes the RETROPERITONEAL space.

Question 8

What is the RETROPERITONEAL space?

Answer 8

The area between the abdomen and the back and this is where the kidneys and pancreas are located and the aorta.

Question 9

The Aorta, largest artery travels down through the diaphragm and traverses the ______ space

Answer 9

Retroperitoneal space.

Inferior Vena Cava also found behind the peritoneum

Question 10

4 Classic types of pain involving pain are:

Answer 10

Visceral Pain
Parietal Pain
Tearing Pain
Referred Pain

Question 11

Visceral Pain (poorly localized)originates from where?
And what kind of pain is experienced?

Answer 11

The organs within the abdomen
Pain is can be crampy, colicky, and intermittent is from Hollow organ
Pain that is persistent and dull is usually from a Solid organ

Question 12

Parietal Pain arises from the…

Answer 12

Lining of the abdominal cavity referred to as (peritoneal tenderness).
More widespread nerve endings and more easily located and described.
May be SHARP, or constant and localized to a particular area.

Question 13

Tearing Pain is not the most common type of abdominal pain because

Answer 13

Most structures or organs do not have the ability to detect tearing sensations but THE EXCEPTION is the Aorta and Stomach.
Ex. Abdominal Aortic Aneurysm (AAA), Ulcers in the stomach
Feels like SHARP pain as if the body tissues are being torn apart

Question 14

Referred Pain is…

Answer 14

Pain felt in a place other than were the pain originates.
Ex. When gallbladder is diseased, pain is often felt in the area of the right shoulder.
This is because of the nerve pathways share the same as the pains in shoulder

Question 15

About how many develop an infection of the appendix

Answer 15

1 in 15 develop appendicitis in their life.

Question 16

Where and how do people experience an appendicitis?

Answer 16

Nausea, sometimes vomiting and

Persistent pain int eh RLQ

Question 17

Peritonitis is when the lining of the abdomen becomes infected/irritated. What could be the cause of this?

Answer 17

Gastric juices, bowel contents and blood.
(Ruptured appendix, ruptured spleen)
Abdomen becomes extremely painful and RIGID

Question 18

Cholecystitis/Gallstones is what and where is pain felt?

Answer 18

Inflammation fo the gallabaddler caused by gallstones.
Pain is felt in the RUQ
Often confused with chest pain

Question 19

Pancreatitis is an inflammation of the pancreas and is common in what type of patients?

Answer 19

Chronic Alcoholics

Pain is in the epigastric area and pain may radiate to the back and/or shoulders

Question 20

Gastrointestinal (GI) Bleeding can happen anywhere from the esophagus to the rectum, what are the signs and symptoms

Answer 20

Blood may pass through the rectum and or mouth and with abnormal stools and dark black or tarry appearance.

Question 21

Painful GI bleeding most commonly occurs in patients with…

Answer 21

Perforated ulcers or Stomach (gastric ulcers)

Question 22

GI hemorrhage is referred to as

Answer 22

Small bleed in a vessel with slow loss of blood making patient pale and week over days to weeks.

Question 23

An abdominal aortic aneurysm (AAA) is

Answer 23

A ballooning or weakening in the wall of the aorta as it passes through the abdomen. Pain can be SHARP, Tearing and radiate to the back.

Question 24

Hernia is a hole in the muscle layers of the abdominal wall. shows as a mass or lump on the abdominal wall or in the groin. This can be caused by…

Answer 24

Heavy lifting or straining that causes the intestine to push through the weakened area. Can be life threatening if the hernia causes an obstruction or twisting of the intestine.

Question 25

Renal Colic (kidney stones) is when

Answer 25

One of these stones begins to descend down the ureter on the way to the bladder. It can cause severe flank pain often anteriorly to the groin area.

Question 26

Consider the application of supplemental oxygen to any hypoxic abdominal pain patient, especially when their saturation is showing less than ___%

Answer 26

Less than 94%

Question 27

Remember

Answer 27

Abdominal pain or discomfort should always be considered an emergency even if signs of shock are not present

Question 28

History of the present illness is found through what and what does each mean?

Answer 28

OPQRST

Onset, Provocation, Quality, Radiation, Severity, Time

Question 29

When performing physical examination of the abdomen you do 2 things as an EMS provider

Answer 29

Inspection and Palpation

Question 30

When inspecting the abdomen what do you look for?

Answer 30

Distention, bloating or discoloration, protrusions, or other abnormalities.

Question 31

When palpating the abdominal quadrant you should ALWAYS:

Answer 31

Palpate the area that has pain or discomfort LAST

Question 32

Guarding is described as…

Answer 32

The patient drawing his arms down across the abdomen OR

The patient tensing muscles before you touch the abdomen

Question 33

Remember when assessing the lower quadrants it requires you to:

Answer 33

Loosen the clothing as the lower quadrants extend from the umbilicus downward to the pelvis.

Question 34

For Geriatric patients they may have a decreased ability to perceive pain. However they are more likely to have a more serious cause of their abdominal pain than younger patients. Because of this they are ___ times more likely to die

Answer 34

9x more likely for the same cause of abdominal pain.

Question 35

Vital signs should be taken how often for abdominal pain patients?

Answer 35

Every 5 min.

Pulse, respiration, blood pressure, skin color, temp and condition

Question 36

Remember

Answer 36

Never give a patient with complaint of abdominal pain ANYTHING by MOUTH