Appendicitis Flashcards
appendicitis
inflm of wall of appendix
appendix location
right lower abd and attached to the cecum (beginning of large intestine)
fx of appendix
stores good bacteria to regenerate normal flora after a diarrheal illness
etiology
- idiopathic
- 2 theories of obstruction
2 theories of obstruction (etiology)
1) twisting of bowel or appendix blocks the entrance and exit of secretions and blood flow
2) intraluminal obstruction d/t fecalith blocking case of appendix
fecalith
hard fecal particle
pathology (7 steps)
- lumen obstruction causes drainage into cecum to be blocked
- goblet cells secreted on inner lining of appendix in large amounts of mucin and builds up
- build-up of mucus inc d/t blocked drainage and causes an inc in pressure within appendix
- pressure pushes onto the outer wall and the blood vessels get pinched shut and cause venous stasis and lack of blood flow
- ischemia results and infarction eventually occurs if obstruction not alleviated
- bacteria stored in appendix moves to resulting necrotic tissue and causes an infection within appendix wall (appendicitis)
- infection leads to inflm of appendix wall causing swelling and exudate production
mnfts
- nausea episodes
- pain (referred pain, rebound pain, guarding pain, pain intensifies)
- fever and elevated WBC
referred pain w/ abrupt onset located where
epigastric or periumbilical regions
rebound pain
palpate and release, on release there is pain
protected/guarding pain
pain when not bent over
McBurney’s Point
anterior superior aspect of iliac crest, draw line to umbilicus and about 1/3 of distance to umbilicus is base of appendix attaches to cecum
Dx
- Hx and Px
- U/S and CT scan (determine size)
- McBurney’s Point
Tx
- IV fluids
- Abx (for infect in appendix wall)
- appendectomy ASAP if needed (any delay –> perforation and peritonitis)
