Chapter 23 - Abdominal, Hematologic, Gynecologic, Genitourinary, and Renal Emergencies Flashcards Preview

EMT - Basic - Prehostpital Emergency Care 10th Edition > Chapter 23 - Abdominal, Hematologic, Gynecologic, Genitourinary, and Renal Emergencies > Flashcards

Flashcards in Chapter 23 - Abdominal, Hematologic, Gynecologic, Genitourinary, and Renal Emergencies Deck (97):
1

the inner most layer of the abdomen and is in contact with the abdominal organs.

visceral peritoneum

2

the outer most layer of the abdominal cavity

parietal peritoneum

3

abdominal quadrant :
most of stomach
spleen
pancreas
part of large intestine
kidney

LUQ

4

abdominal quadrant :
most of liver
gallbladder
part of large intestine
kidney

RUQ

5

abdominal quadrant :
appendix
part of large intestine
fallopian tube
ureter
ovary

RLQ

6

abdominal quadrant :
part of large intestine
ureter
fallopian tube
ovary

LLQ

7

contains/encloses the abdominal organs such as the stomach, spleen, liver, gallbladder, pancreas, small intestine, and part of the large intestine

Intraperitoneal

8

contains/encloses the abdominal organs such as the kidneys, ureters, pancreas, and abdominal aorta

retroperitoneal

9

the abdominal cavity contains three types of structures:

hollow organs
solid
vascular

10

contains some type of substance that may leak into the abdominal cavity if the organ is perforated or injured. any substance that leaks may lead to chemical or bacterial peritonitis.

hollow organs - typically do not have the same blood volume therefore they do not bleed as much.

11

organs that are very vascular (contain a large amount of vessels and blood). some are covered by a thick fibrous capsule (liver and spleen). when ruptured or injured, tends to bleed, potentially leading to severe shock.

solid organs

12

large blood vessels found in the abdominal cavity. rupture or injury to either vessel with result in major bleeding, rapid blood loss, and death.

vascular structures

13

hollow organs

appendix
bladder
common bile duct
fallopian tubes
gallbladder
intestines
stomach
uterus
ureters

14

solid organs

kidneys
liver
ovaries
pancreas
spleen

15

major vascular structures

abdominal aorta
inferior vena cava

16

abdominal pain usually results from one of the following three mechanisms:

mechanical forces (stretching)
inflammation
ischemia (organ and tissue hypoxia)

17

a saclike, stretchable pouch located below the diaphragm that receives food from the esophagus (tubelike structure from the throat). the stomach enables digestion by secreting a specialized fluid to air in the breakdown and absorption of food.

stomach

18

the first part of the small intestine that connects to the stomach

duodenum

19

a tubelike structure beginning at the distal end of the stomach and ending at the beginning of the large intestine. its digestive function is to absorb nutrients from intestinal contents

small intestine

20

a tubelike structure beginning at the distal end of the small intestine and ending at the anus. it reabsorbs fluid from intestinal contents, enabling the excretion of solid waste from the body

large intestine

21

a large, solid organ located in the RUQ just beneath the diaphragm with a slight portion extending to the LUQ. it filters the nutrients from blood as it returns from the intestines, stores glucose (sugar) and certain vitamins, plays a part in blood clotting, filters dead red blood cells, and aids in the production of bile. proportionally larger in the pediatric Pt.

liver

22

a pear-shaped sac that lies on the underneath right side of the liver. holds bile, which aids in the digestion of fats.

gallbladder

23

an elongated, oval, solid organ located in the LUQ behind and to the side of the stomach. it aids in the production of blood cells as well as the filtering and storage of blood. proportionally larger in the pediatric Pt.

spleen

24

a gland composed of many lobes and ducts located in both the RUQ and LUQ, just behind the stomach. it aids in the digestion and regulates carbohydrate metabolism.

pancreas

25

paired organs located behind the abdominal wall lining (retroperitoneal), one on each side of the spine. excrete urine and regulate water, electrolytes, and acid-base balance.

kidneys

26

a saclike structure that acts as a reservoir for the urine received from the kidneys

urinary bladder

27

pain from the organ itself
poorly localized, intermittent, crampy, dull of aching pain associated with ischemia, tearing, or distention of an organ.

visceral pain - also associated with nausea and vomiting

28

localized, intense, sharp, usually found on one side or the other - typically constant pain associated with irritation of the peritoneum.

parietal pain - also called somatic pain

29

abdominal regions:
right 3

right hypochondriac region
right lumbar region
right illiac region

30

abdominal regions:
middle 3

epigastric region
umbilical region
hypogastric region

31

abdominal regions:
left 3

left hypochondriac region
left lumbar region
left illiac region

32

pain that is felt elsewhere in the body. it is usually poorly localized but is felt consistently in the part of the body it is referred to. occurs when organs share a nerve pathway with a skin sensory nerve.

referred pain - the brain becomes confused in the interpretation of the impulse and causes the Pt to feel pain at a location that may be totally unrelated to the organ involved.

33

irritation and inflammation of the peritoneum. occurs when blood, pus, bacteria, or chemical substances leak into the peritoneal cavity.

peritonitis

34

abdominal contents that are ______ that leak into the abdominal cavity and irritate the peritoneum will produce a sudden onset of severe, sharp, constant abdominal pain

acidic or alkaline

35

S/S:
abd pain or tenderness
N/V or diarrhea
fever and chills
lack of appetite
positive markle (heel drop/jar) test

peritonitis

36

inflammation of the appendix

appendicitis

37

S/S:
initial - umbilicus
late - localized RLQ
abd pain or cramping
N/V
fever
lack of appetite
abd guarding
positive markle (heel drop)

appendicitis

38

inflammation of the pancreas

pancreatitis

39

S/S:
abd pain
N/V
abd tenderness and distention
mild jaundice (depending on cause)
severe abd pain - radiation from umbilicus to back and shoulders
fever, rapid pulse, and signs of shock (in some cases)

pancreatitis

40

inflammation of the gallbladder

cholecystitis (ko-luh-sis-TIE-tis)

41

S/S:
sudden onset of abd pain located from the middle upper quadrants (epigastric area) to RUQ areas (pain is present more commonly at night and associated with ingestion of fatty foods. pain may also be referred to the right scapula.)
tenderness upon palp of RUQ
belching or heartburn
N/V (contents may be greenish)

cholecystitis (ko-luh-sis-TIE-tis)

42

S/S:
abd pain or tenderness
hematemesis (vomit - bright red blood or coffee grounds)
hematochezia (bright red blood in stool - rapid onset)
melena (dark tarry stools)
AMS
tachycardia
signs of shock

gastrointestinal bleeding

43

vomiting blood, which can be bright red or look like coffee grounds

hematemesis

44

bright red blood in the stool normally signifying a rapid onset

hematochezia

45

dark tarry stools containing decomposing blood normally from the upper gastrointestinal system

melena

46

bulging, engorgement, or weakening of the blood vessels in the lining of the lower part of the esophagus.

esophageal varices

47

a chronic disease of the liver marked by degeneration of cells, inflammation, and fibrous thickening of tissue. It is typically a result of alcoholism or hepatitis.

cirrhosis

48

S/S:
large amounts of bright red hematemesis (vomiting of blood)
absence of pain or tenderness in the abd
rapid pulse
dyspnea
pale, cool, clammy skin
s/s of shock
jaundice

esophageal varices

49

inflammation of stomach and small intestines, commonly associated with presence of abdominopelvic pain.

gastroenteritis

50

S/S:
abd pain or cramping
N/V and diarrhea
abd tenderness
fever and dehydration
s/s of shock and hemorrhage may be present

gastroenteritis

51

open wounds or sores within the digestive tract, usually in the stomach or the beginning of the small intestine

ulcers

52

S/S:
sudden onset of abd pain normally in the LUQ and epigastric area, usually described as a burning or gnawing-type pain before meals or during stressful events
N/V
hematemesis, hematochezia, or melena or coffee ground emesis in some cases
s/s of shock in cases of massive bleeding
pertonitis with a rigid abd in cases of perforation

ulcers

53

a blockage that interrupts the normal flow of the intestinal contents

intestinal obstruction

54

S/S:
abd pain
N/V
constipation
abd distension and tenderness
abnormally prominent, high-pitched bowel sounds w/ auscultation
most at risk - age 50+

intestinal obstruction - can lead to sepsis, perforation, intestinal infarction, peritonitis

55

protrusion or thrusting forward of a portion of the intestine through an opening or weakness in the abdominal wall.

hernia

56

S/S:
sudden onset of abd pain (usually after heavy lifting or straining
fever
rapid pulse
tender mass at point of hernia
others similar to intestinal obstruction

hernia

57

a weakened, ballooned, and enlarged area of the wall of the abdominal aorta

AAA - abdominal aortic aneurysm

58

small tear of the inner vessel structure, which allows blood to leak between the walls of the aorta.

aortic dissection

59

S/S:
-gradual onset of lower lumbar, groin, and abd pain
-rupture associated with sudden onset of severe, constant abdominal pain. may radiate to lower back, flank, or pelvis. may be described as "tearing" pain.
-testicular pain in males
-possible N/V
-pale cool clammy possibly cyonotic in legs
-absent or decreased femoral or pedal pulses
-if abd is soft, a pulsating abdominal mass may be felt. if the aneurysm has burst, the abd will be rigid and tender
-if the aortic aneurysm is starting to rupture, the skin below the waistline may become cyanotic, cold, and mottled. from drop in blood flow to extremities

abdominal aortic aneurysm - AAA

60

a pt with an acute abd generally appears very ill and will assume a __________ with his knees drawn up and his hands clenched over his abdomen.

guarded position

61

abdominal wall contraction the Pt cannot control

involuntary guarding also referred to as rigidity

62

when Pt contracts the abdominal muscles, usually in anticipation of pain or an unpleasant sensation.

voluntary guarding

63

S/S:
pain or tenderness
anxiety and fear
position - feet drawn up/guarding
rapid shallow breathing
rapid pulse
BP changes
N/V and/or diarrhea
rigid abdomen or guarding
distended abdomen
fever and chills
belching or flatulence
changes in bowl/urination
other s/s of shock
signs of internal bleeding - hematemesis, melena, hematochezia

acute abdominal pain

64

emergency care for abdominal pain

airway
pos of comfort
oxygen = 94%
NEVER GIVE ANYTHING BY MOUTH
calm and reassure
treat for shock if need be
ALS

65

reduction of number of red blood cells in the circulating blood volume

anemia

66

hereditary blood disorder - red blood cells have abnormal hemoglobin that does not carry adequate oxygen. as a result the cells take on a crescent shape and become fragile, stiff, and rigid.

sickle cell anemia

67

four common acute patterns for sickle cell crisis:

bone crisis
acute chest syndrome
abdominal crisis
joint crisis

68

sickle cell crisis that typically involves the large long bones in the arm and leg, causing sudden sever pain

bone crisis

69

sickle cell crisis that involves a sudden onset of chest pain, possibly with dyspnea, hypoxia, and cough, which may be nonproductive, or the pt may cough up blood. a low-grade fever may be present

acute chest syndrome

70

sickle cell crisis that causes sudden, constant abdominal pain that may be general or localized. there may or may not also be nausea, vomiting, and diarrhea.

abdominal crisis

71

sickle cell crisis that presents with an acute onset of one or more painful, stiff joints

joint crisis

72

S/S:
bone pain
joint pain
fever
chest pain
SOB
fatigue
pale
tachycardia
jaundice
ulcers on lower legs
excessive thirst
priapism
frequent urination
sudden blindness in one eye (retinal detachment)

sickle cell crisis

73

blood disorder that affects clotting. when a person with hemophilia is injured, it takes longer for the bleeding to stop because clots are unable to form properly.

hemophilia

74

the branch of medicine that studies health of the female Pt and her reproductive system

gynecology

75

the uterus is lined by the endometrium, which is sloughed off during ______, or the menstrual period

menses

76

S/S:
lower abdominal or pelvic pain
abd tenderness
vaginal bleeding
rapid pulse
s/s of shock

spontaneous abortion

77

severe pain or cramps during menstruation

dysmenorrhea

78

abdominopelvic pain during the middle of a menstrual cycle that is associated with ovulation

mittelschmerz

79

fluid-filled sac that forms inside or on an ovary. formed during ovulation when a follicle containing the egg fails to open as it is supposed to.

ovarian cyst

80

S/S: unilateral abdominopelvic pain that may radiate to the back
abdominal tenderness
vaginal bleeding - irregular or abdnormal
pain during sex or bowel movements
most are asymptomatic (have no symptoms)

ovarian cyst

81

an inflammation of the endometrium.

endometritis

82

S/S:
abdominopelvic pain or tenderness
fever
abdominal distention
vaginal bleeding or discharge
discomfort during a bowel movement

endometritis

83

inflammation of the female reproductive tract.
cause by the same bacteria that lead to STDs

pelvic inflammatory disease - PID

84

S/S:
abdominopelvic pain or tenderness
vaginal discharge with an abdnormal color, consistency, or odor
fever and chills
anorexia
N/V
irregular vaginal bleeding or cramping
pain during sex

pelvic inflammatory disease - PID

85

most stds are cuased by
1
2
3
4

bacteria
viruses
parasites
fungi

86

S/S:
abdominopelvic pain or tenderness
vaginal discharge with abnormal color, consistency or odor
fever and chills
N/V
irregular vaginal bleeding or cramping
pain during sexual intercourse or urination
genital itching, redness, swelling
lesions or ulcers

STD

87

the branch of medicine that studies the urinary system in females and the genitourinary system in males

urology/urologist

88

the urinary system is composed of:
1
2
3
4

kidneys
ureter
urinary bladder
urethra

89

S/S:
abdominopelvic pain or tenderness
blood in urine
urine with cloudiness or a foul or strong odor
pain or burning with urination or sex
frequent or urgent need to urinate
genital or flank pain
fever or chills
N/V
AMS

UTI

90

crystals of substances such as calcium, uric acid, struvite, and crystine that are formed from metabolic abnormalities.
most frequently occur in men between the ages of 20 and 50

kidney stones or renal calculi

91

S/S:
abdominopelvic pain or tenderness
flank or back pain that is colicky and severe
groin pain
abnormal urine color
pain with urination
frequent or urgent need to urinate
fever or chills
N/V

kidney stones

92

during this condition, the kidneys are not able to filter the wastes and maintain homeostasis as they normally would.

kidney failure

93

S/S
blood in urine or stool
AMS
edema of feet, ankles, legs
decreased urine or no urine
hypertension
swelling or easy bruising
anorexia
tachycardia

kidney failure

94

an artificial process used to remove water and waste substances from the blood when kidneys fail to function properly

dialysis

95

special fluid for dialysis

dialysate

96

dialysis machine containing dialystate is connected to an access site on the Pt.

hemodialysis

97

dialystate ran through a tube in the Pt's abdomen.

peritoneal dialysis

Decks in EMT - Basic - Prehostpital Emergency Care 10th Edition Class (44):