What are the three classifications of abdominal pain?
Visceral
Somatic
Referred
Excessive alcohol consumption, excessive smoking, increased stress, ingestion of caustic substances, and poor bowel habits are ?
Risk factors for GI complications
Originates in walls of hollow organs( gallbladder or appendix), in capsules of solid organs (kidney or liver) , or in visceral peritoneum is?
Visceral pain
Mechanisms that produce pain?
Inflammation and distinction ischemia
Vague or poorly localized, dull, or crampy pain is ?
Visceral pain
Sharp pain that travels along definite neural routes to spinal column is ?
Somatic pain
Pain localized to reigon area. Bacterial and chemical irritations of abdomen is from?
Somatic pain
Originates in reigon other than where it is felt is?
Referred pain
Dissecting triple A produces what pain between the shoulder blades?
Referred pain
Sudden onset of GI pain is usually cause by?
Perforations of abdominal organs or capsules
Gradual onset of GI pain is associated with ?
Blockage of hollow organs
If pain lessens when patient draws legs up to cheat or lies on side it usually indicates?
Peritoneal inflammation
If walking relieves GI pain the cause can be?
GI or urinary system
Localized tearing pain is associated with?
Rupture of organ
Dull, steadily increasing GI pain may indicate ?
Bowel obstruction
Sharp pain, particularly in flank, may indicate?
Kidney stone
Any abdominal pain lasting over 6 hours consider
Surgical emergency
Changes in bowel morphology, color, or smell can be only indication of?
Lower GI hemorrhage, gastritis, bleeding diverticula
Pain in the lowest part of abdomen can be due to problems in?
Reproductive System
Gastroesopangeal reflux, gastric ulcers, duodenal ulcers, and gall bladder disease are GI emergencies that cause?
Chest pain
Distention of abdomen , free air build up can be ?
Obstruction of bowel or hemorrhage
Peri umbilical ecchymosis is?
Cullen’s sign
Ecchymosis in flank?
Grey Turner’s sign
One long tube divided into structurally and functionally different parts is ?
GI tract
Liver, gallbladder, pancreas, vermiform appendix are what?
GI organs
Peptic ulcer disease, gastritis, variceal rupture, Malloy-Weiss tear (espongeal laceration), esophagitis, duodenitis are the 6 major causes of ?
Upper GI hemorrhage
Hematemesis (bloody vomitus) is a sign of?
Upper GI bleed
Melena is a sign of
Upper GI bleed that reaches lower GI tract
Hypotension in a GI bleed suggests?
Decreased circulating volume
Increased in portal pressure (portal hypertension) , consumption of alcohol, and ingestion of caustic substances can cause?
Esophageal Varices
Alcoholic liver cirrhosis accounts for two thirds of ?
Esophageal Varices cases
Octreotide is?
The drug of choice for acute variceal bleeding
Inflammation of stomach and intestines associated with sudden onset of vomiting and/or diarrhea is ?
Acute Gastroenteritis
Stress, chemotheraputic agents, ingestion of acidic or alkalotic agent, and infection are other causes of ?
Acute gastroenteritis
Inflammation of GI mucosa marked by long term mucosal changes or permanent mucosal damage is ?
Chronic Gastrenteritis
Transmitted via fecal- oral route or through infected food or water. Due to primarily microbial infection is?
Chronic gastroenteritis
Erosions caused by gastric acid; occur anywhere in GI tract. Occur more in males more than females.
Peptic ulcer
Nonsteroidal anti-inflammatory medications (asprin, ibuprofen, naproxen) , acid-stimulating products(alcohol,nicotine), or helicobacter pylori bacteria are causes of?
Peptic ulcers
N+V, massive hemorrhage , il appearance, and hemodynamic instability are signs of
Peptic ulcer
Jejunum, ileum of small intestine, and entire of large intestine, rectum, and anus are part of ?
Lower GI tract
Nutrients absorbed into blood occurs where?
Small intestine
Water absorbed and solid wastes form in ?
Large intestine
Diverticulosis, colon lesions, rectal lesions, anal fissures, and inflammatory bowel disorders (ulcerative colitis and chrons disease) are causes of?
Lower GI bleeding
Idiopathic inflammatory bowel disorder of unknown origin is
Ulcerative colitis
Presence in intestine of diverticula, small outpouchings of mucosal and submucosal tissue that push through the outermost layer of intestine, the muscle is
Diverticulosis
Inflammation of diverticula secondary to infection. Lower left sided pain, fever, increasing white blood cell count , N+V, tenderness on palpation is
Diverticulitis
Hernias, intussesception, volvulus, and adhesions are the most frequent?
Bowel obstructions
Foreign bodies, gallstones, tumors, adhesions from abdominal surgery, bowel infarction are the common cause of ?
Bowel obstruction
The small intestine is the most common location for ?
Bowel obstruction
1 to 2 inches above anterior iliac crest along direct line from anterior crest to umbilicus is?
McBurney’s Point
Inflammation of gallbladder
Cholecystitis
Diffuse right sided tenderness or point tenderness under right costal margin reveals?
Murphys sign
Metabolic causes , specifically alcoholism account for 80% of
Pancreatitis
Metabolic Mechanical Vascular Infectious Cause?
Pancreatitis
Acinar tissue destruction due to chronic alcohol intake, drug toxicity, ischemia, infectious diseases cause?
Chronic pancreatitis
Any injury to hepatocytes (liver cells) associated with inflammation or infection is ?
Hepatitis
Crowded and unsanitary living conditions, pot hygiene that invites oral fecal transmission, exposure to blood borne pathogens , and chronic alcohol intake are risk factors for?
Hepatitis
Infectious hepatitis is?
Hep A
“Serum Hepatitis” transited as blood borne pathogen is?
Hep B
Pathogen commonly responsible for spreading hepatitis through blood transfusions; chronic and often debilitating damage to liver is ?
Hep C
Less common; pathogen dormant until activated by HBV
Hep D
Waterborne infection
Hep e
Peptic Ulcer Disorder signs and symptoms
Infection with H pylori, chronic use of NSAIDS, alcohol and smoking.
Burning or gnawing pain in the stomach that subsides or diminishes immediately after eating.
The pain is usual felt in the upper abdomen or below sternum.
Some pts the pain occurs immediately after eating. Nausea, vomiting, belching, and heartburn.
If the erosion is severe, bleeding can occur causing hematemesis and melena.
Cholecystitis
Inflammation of gallbladder
Cholecystitis signs and symptoms
Constant, sever pain in the right upper or mid abdominal region and may refer to the right upper back, shoulder area, or flank.
The pain may steadily increase for hours or may come and go.
30 min after a fatty meal and usually at night.
N+V, indigestion, bloating, gas, and belching.
Pancreatitis signs and symptoms
Caused by obstructing gallstone, alcohol abuse, and other diseases.
Severe pain in the upper right and left quadrants and may radiate to the back.
N+V, abdominal distention, and tenderness
Sepsis or hemorrhage can occur, may cause fever or tachycardia
Appendicitis signs and symptoms
Initially, pain is generalized, dull, and diffuse as may center in the umbilical area.
The pain later localizes to the right lower quadrant of the abdomen.
Referred pain : N and V, anorexia, fever, and chills.
Classic sign is rebound tenderness
Common upper GI bleeding
Esophagitis, esophageal Varices
Common Lower GI bleeding
Bowel inflammation, diverticulitis, hemorrhoids
Esophagitis signs and symptoms
Pain with swallowing , feels like something is stuck in there throat
Heartburn, Nausea, Vomiting, and sores in the mouth.
In the worst cases, bleeding can occur from the the small capillary vessels within the esophagus
Formation of gall stones
Cholelithiasis
4 categories of pancreatitis
Metabolic (alcoholism, 80% of cases)
Mechanical (gallstones or elevated serum lipids)
Vascular (thromboembolisms or shock)
Infectious