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Block 32- GI/surgery > Acute abdominal pain Pt2 > Flashcards

Acute abdominal pain Pt2 Flashcards

1
Q

symptoms of peritonitis

A 
acute abdo pain 
abdo tenderness 
abdo guarding 
rebound tenderness  
rigidity
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2
Q

blumberg sign=

A

rebound tenderness- less pain when hand is pressed down severe pain on release

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3
Q

localised peritonitis is due to

A

involvement of the somatic parietal peritoneum

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4
Q

what is the nerve supply of parietal peritoneum

A

same somatic nerve supply as the region of the abdominal wall that it lines

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5
Q

what does the nerve supply of parietal peritoneum mean

A

pain from the parietal peritoneum is well localised.

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6
Q

what nerves coordinate generalised peritonitis

A

splanchnic nerves

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7
Q

what is generalised peritonitis

A

peritonitis affecting the entire abdomen

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8
Q

what is the pain pattern in localised peritonitis

A

pain starts as epigastric pain but becomes specific in location when the impacted organ distends and impacts the parietal peritoneum

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9
Q

where are the splanchnic nerves located

A

visceral peritoneum

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10
Q

where is the visceral peritoneum

A

inside

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11
Q

where is the parietal peritoneum

A

outside

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12
Q

pain in generalised peritonitis

A

diffuse and widespread

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13
Q

2 types of peritonitis

A

infection

non-infective

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14
Q

non-infective peritonitis=

A

leakage of bodily fluids into the peritoneum via perforation of a viscus

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15
Q

ruptured viscus=

A

rupturing of an abdominal organ

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16
Q

main definitive cause of a ruptured viscus

A

trauma

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17
Q

possible medical conditions causing a ruptured viscus

A

appendicitis
diverticulitis
peptic ulcer
ischaemic bowel disease

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18
Q

perforated duodenal ulcer–>

A

sudden onset epigastrium pain

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19
Q

perforated gastric ulcer–>

A

burning sensation in epigastrium associated with flatulence and dyspepsia

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20
Q

small intestine rupture =

A

sudden onset pain

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21
Q

large intestine rupture=

A

more gradual onset pain

22
Q

oesophageal rupture=

A

sudden onset chest pain

23
Q

symptoms of ruptured viscus (6)

A
  • severe abdominal pain (worse with movement)
  • N&V
  • fever and rigors
  • rigid abdomen
  • abdominal distention
  • generalised peritonitis
24
Q

causes of small intestine bowel obstruction (3)

A

hernias
adhesions
tumours

25
Q

adhesions=

A

areas of tough fibrous connective tissue that form a scar

26
Q

where do adhesions develop after surgery

A

outside of injured intestines or pelvic organs

27
Q

what surgerys are particularly likely to cause adhesions (2)

A
  • gynaecological surgeries

- appendix surgeries

28
Q

4 causes of large bowel obstruction

A

diverticular disease
volvulus
crohns
colorectal cancer

29
Q

volvulus=

A

twisted intestine

30
Q

what happens in volvulus

A

usually produces a closed loop of bowl with a pinched base causing obstruction

31
Q

strictures in Crohns due to

A

muscular hypertrophy

32
Q

stoma =

A

opening of the surface of the abdomen surgically created to divert flow of feces or urine

33
Q

3 main types of stoma

A

colostomy
ileostomy
urostomy

34
Q

colostomy=

A

colon redirected through abdomen -normally left flank

35
Q

output of a colostomy

A

1-3 times/ day

36
Q

ileostomy=

A

opening of the small intestine onto abdomen -especially ileum

37
Q

ileostomy usually done in

A

Crohns skip lesions severe in ileo-cecal region

38
Q

ouput of ileostomy

A

looser

3-6 times/ day

39
Q

urostomy=

A

opening of urine using part of the small intestine and attaching ureters to it forming a passage way to abdominal wall

40
Q

usual urostomy location

A

right side of body

41
Q

5 consequences of stomas

A 
retraction 
herniation 
prolapse 
stenosis 
skin complications
42
Q

stoma retraction=

A

when stoma falls below skin levels

43
Q

what type of stoma is retraction more common with

A

ileostomy

44
Q

what patients is stoma retraction more common in

A

obese patients

45
Q

consequence of stoma retraction

A

more prone to leaks -skin irritation

46
Q

what type of hernia is a stoma hernia

A

incisional hernia

47
Q

appearance of stoma hernia

A

stoma can look more raised

48
Q

stoma prolapse=

A

bowel protrudes through stoma opening at abnormal lengths

49
Q

consequences of stoma prolapse

A

infection
trauma
blood constriction

50
Q

stoma stenosis=

A

narrowing of the stoma

51
Q

presentation of stoma stenosis

A

cramps combined with no stoma output

52
Q

what type of skin complications from a stoma

A
  • allergic reactions to adhesive
  • fungal infections
  • skin irritation

Block 32- GI/surgery (9 decks)

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