GI Flashcards
1
Q
What quadrants are Ovaries, fallopian tubes, ureters, and spermadic cords in?
A
left and right lower
2
Q
spleen quadrant
A
LUQ
3
Q
Stomach quadrant
A
LUQ
4
Q
Body of pancreas quadrant
A
LUQ
5
Q
Kidney quadrants
A
LUQ and RUQ
6
Q
Splenic flexure of colon quadrant
A
LUQ
7
Q
Transverse/descending colon quadrant
A
LUQ
8
Q
Descending/sigmoid colon quadrant
A
LLQ
9
Q
Cecum quadrant
A
RLQ
10
Q
Appendix quadrant
A
LLQ
11
Q
Liver quadrant
A
RUQ
12
Q
Gallbladder quadrant
A
RUQ
13
Q
Duodenum quadrant
A
RUQ
14
Q
hepatic flexure of colon quadrant
A
RUQ
15
Q
Pancreatic head quadrant
A
RUQ
16
Q
Ascending/ transverse colon quadrant
A
RUQ
17
Q
Which body part goes through all 4 quadrants?
A
intestines
18
Q
Costovertebral angle is a landmark where and for what?
A
Posterior, kidneys
19
Q
Relevant History for GI assessment
A
weight changes, food allergies/intolerance, diet, chewing/swallowing difficulty, supplements, changes in appetite, vomiting, BM frequency/color/texture, pain , family history
20
Q
Frank blood in vomit
A
- bright red
- indicative of esophageal bleeding
- urgent
21
Q
Coffee Grounds in vomit
A
- indicative of active bleeding
- blood is coagulated so looks like coffee grounds
22
Q
What does it mean when vomit contains partially digested food?
A
food has not been in stomach long
23
Q
Constipation = how many days without pooping?
A
> 3
24
Q
Abdominal pain can be ___ pain
A
referred pain
25
When doiing GI assessment patient should have...
1. empty bladder
2. supine/draped appropriately
3. quiet room
4. watch the patient's face
26
Assessment sequence for GI
1. Inspect
2. Auscultate
3. Palpate
4. Percuss if needed
27
why auscultate before palpate/percuss?
palpating and percussing stimulates bowel movement
28
Protruberant belly =
- central obesity
- ascites
- pregnancy
29
Scaphoid belly
concave
30
Inspection: where to do it?
get eye level with right ride of patient's belly
31
what is ascites?
collection of fluid in abdoment
32
How do we test for ascites? 2 trademarks?
1. percussion
| 2. belly button pushed out
33
Reasons for distention (5)
fat, flatus, feces, fluid, fetus
34
What are striae typically associated with?
pregnancy or rapid weight gain
35
cullen's sign
internal bleeding manifested by purple around the umbilicus
36
What is a spider hamngioma?
- central real area with spider web out
- associated with liver disease
- often times on face
37
IF you see a mass....
Don't palpate it!
38
Visible venous structures are a sign of
JVD, portal hypertension
39
Is it normal to feel Aorta in GI assessment?
Yes
40
Rippling and GI assessment
normal if GI output, abnormal if no GI output
41
Stool assessment criteria
- color
- frequency
- consistency
- odor
- associated symptoms
42
Higher fat stool is has ____ odor
smellier
43
Bight Red stool =
bleeding in rectum or rapid/large amount from GI tract
44
Maroon/dark red stool=
bleeding in lower parts of intestine
45
Black/not sticky/no odor stool =
iron or bismuth containing medications
46
Black tarry/ foul odor stool=
bleeding in stomach or upper part of small intesting
47
Melena =
black/tarry/fould smelling stool from GI bleed
48
Clay colored stool=
- contains little or no bile
| - caused by diseases resulting in obstruction of bile flow to intestines
49
Yellow/greasy/foul smell stool =
presence of undigested fat
| -caused by pancreatic disease (not enough pancreatic enzymes in intestine)
50
2 general locations of ostomy
colostomy (large intestine)
| ileostomy (small intestine)
51
small intestine ostomy =
ileostomy
52
large intestine ostomy =
colostomy
53
what determines type of stool output from ostomy?
location of ostomy
54
assessing ostomy consider
```
colors
turgor
edema/ retraction
size/shape
bleeding
peristomal area
```
55
when dealing with ostomy use _____technique
clean
56
sew intestine backs together after ostomy
reanastomosis
57
healthy stoma
- beefy red
- protruding 1-2 inches
- peristomal intact
58
When is the ideal time to empty an ostomy bag?
1/3 full
59
hematemsis
vomiting of blood
60
coffee ground vomit results from
precipitation of blood clots in emesis
| -emergency situation!
61
critical signs with vomit
fecal matter
| blood
62
emesis assessment
```
color
consistency
frequency
associated symptoms
odor
```
63
when auscultating abdomen start with
iliocecal valve and work clockwise using diaphragm
64
how long to listen to each quadrant
15-20 seconds
65
NG tube and abdomen assessment
turn of NG tube prior
66
How to listen to determine if absent bowel sounds
3-5 minutes
67
causes of hypoactive bowel sounds
constipation
68
causes of hyperactive bowel sounds
early bowel obstruction
| increased peristalsis
69
borborygmus
stomach growling
70
what else might you hear when auscultating bowel sounds?
vascular sound like bruits (whooshing)
71
arterial sounds you can here
Abdominal aorta
illiac
femoral
72
What is tympany?
percussive sound
hear over abdomen
gas filled
73
what is a dull percussive sound?
over organs in the abdominal cavity like liver or spleen
| -fluid filled
74
Ascites assessment- shifting dullness
ask patient to turn on one side then percuss from tympany to dullness
- fluid will sink to lowest point
- 500-1000 ml in belly if have shifting fluid
75
2 assessments for ascites
- shifting dullness
| - fluid wave
76
assessing for kidney tenderness
- posterior- find CVA (costovertebral angle)
| - flat hand, hit with other hand, tenderness if present
77
when using palpation to assess belly use....
- light touch
- palmar surface of fingers
- depress no more then 1cm or 1/2 in
- watch facial expression
78
normal to have _____ with palpation
voluntary or involuntary guarding
79
what is most sensitive indicator of tenderness?
patients facial expression
80
tenderness- sign or symptom
sign
| -discomfort caused or increased by exam
81
pain- sign or symptom
symptom
| -something patient tells you as part of history
82
what is rebound tenderness?
| test for?
- more painful when pressure is released
| - test for appendicitis in RLQ
83
meconium
thick, black substance that fills the baby's intestines before birth. For the first few days, when babies pass stool, the meconium is passed out of their body
84
pulsating mass in assessment
do NOT palpate!
85
Pain meds and abdominal pain
-do NOT administer pain meds (esp narcotics), antispasmodics, anticholingergics, or smooth muscle relaxant to a patient with new onset abdominal pain until a MEDICAL exam is performed
86
pilonidal cyst
A pilonidal cyst is an abnormal pocket in the skin that usually contains hair and skin debris. A pilonidal cyst is almost always located near the tailbone at the top of the cleft of the buttocks.
87
abnormal findings
fissure
pruritis ani
hemorrhoids
rectal prolapse
