1
Q
Define:
gastric distention
A
It occurs from excessive positive pressure ventilation that inflates the stomach.
Impedes lung expansion.
2
Q
Define:
peristalsis
A
Involuntary, rhythmic muscular contractions of the smooth muscle in the digestive tract that propel food and liquids forward through the system — from the esophagus to the rectum.
3
Q
Define:
Portal Vein
A
It transports venous blood from the GI tract directly to the liver.
4
Q
What does the cardiac sphincter connect?
A
The esophagus to the stomach.
5
Q
What acidic chemical is present in the stomach?
A
Hydrochloric acid
6
Q
What does the pyloric sphincter connect?
A
The stomach to the small intestine.
7
Q
What is the material that exits the pyloric sphincter?
A
chyme
8
Q
Fill in the blank:
The first part of small intestine is the _______.
A
duodenum
9
Q
What are the functions of the liver?
A
- Produces bile.
- Promotes carbohydrate conversion.
- Converts glycogen into glucose.
- Fat and protein metabolism.
- Detoxifies drugs
10
Q
Define:
bile
A
A digestive fluid that helps break down fats.
11
Q
What is the purpose of the small intestine?
A
It dissolves water-soluble and fat-soluble substances.
90% of absorption occurs in the small intestine.
12
Q
Name the three sections of the small intestine.
A
- Duodenum (last part of upper GI)
- Jejunum (first part of lower GI)
- Ileum
13
Q
What is the purpose of the large intestine?
A
It completes the reabsorption of water that the small intestine missed.
14
Q
How long is the typical time of digestion?
A
8 - 72 hours
15
Q
Define:
ascites
A
Accumulation of fluid in the abdomen, causing abdominal swelling.
16
Q
Define:
protuberant
A
It refers to a protruding abdomen, indicating that it is bulging or sticking out abnormally.
17
Q
Define:
scaphoid
A
It refers to a concave abdomen, indicating that the abdomen is sunken in or hollowed out.
18
Q
How frequently do normal bowel sounds occur?
A
5-30 times a minute.
19
Q
Define:
borborygmi
A
Prolonged stomach growling.
20
Q
Describe:
visceral pain
A
- Difficult to localize.
- Burning, cramping, or aching sensation.
21
Q
Describe
parietal pain
A
- Easier to localize.
- Pain increases with movement.
22
Q
Describe:
somatic pain
A
- Localized pain felt deeply.
- Resulting from injury to tissue.
23
Q
Describe:
referred pain
A
Pain originating in one place and occurring in another.
24
Q
What is the purpose of obtaining an orthostatic vital?
A
To gauge if someone is hypovolemic.
25
List common **medications** and their **dosages** for **abdominal pain**.
* **Morphine** 5-10mg
* **Toradol** 15-60mg
* **Fentanyl** 50-100mcg
* **Demerol** 50-150mg
* **Nubian** 10mg
26
List common **medications** and **dosages** for **nausea**.
* **Zofran** 4mg
* **Benadryl** 10-50mg
* **Vistaril** 25-100mg IM
* **Phenegran** 12.5-25mg
27
* What is **hyponatremia**?
* What are the **signs/symptoms** associated with it?
* Low-sodium
* _Symptoms_:
* weakness
* cramps
* convulsions
28
* What is **hypernatremia**?
* What are the **signs/symptoms** associated with it?
* High-sodium
* _Symptoms_:
* muscle weakness
* thirst
* irritability
* seizures
29
What are the **first** and **second** main causes of **hypovolemia**?
1. vomiting and diarrhea
2. hemorrhage
30
What are the most common causes of **upper GI bleeds** in the esophagus, stomach, and duodenum?
* **Esophagus:** varices, cancer, tear, dilated veins, cirrhosis, GERD
* **Stomach:** ulcer, cancer, gastritis
* **Duodenum:** ulcer
31
What are the most common causes of **lower GI bleeds** in the small intestine, large intestine and rectum?
* **Small intestine:** irritable bowel disease, cancer
* **Large intestine:** infections, ulcerative colitis, colorectal polyps, diverticula disease
* **Rectum:** hemorrhoids
32
# Define:
esophageal varices
Increased pressure in the vessels around the **esophagus and stomach**.
## Footnote
These vessels drain into the portal vein, leading to portal hypertension and eventual rupture.
33
# Assessment
esophageal varices
Vomiting of **bright red blood**.
34
# Treatment:
esophageal varices
Fluid resuscitation.
## Footnote
In hospital: cauterize affected area.
35
# Define:
Mallory-Weiss syndrome
A **tear at the junction** between the esophagus and stomach, often due to **forceful vomiting**.
36
# Assessment:
Mallory-Weiss syndrome
Chronic vomiting.
## Footnote
Common in hyperemesis gravidarum.
37
# Treatment:
Mallory-Weiss syndrome
Fluid resuscitation
38
# Define:
Peptic Ulcer Disease
| PUD
**Erosion of the stomach and duodenum**, allowing acids to eat the protective lining.
39
# Assessment:
Peptic Ulcer Disease
Pain in the stomach that **subsides after eating** and then reoccurs after 2 or 3 hours.
40
# Define:
Gastroesophageal Reflux Disease
| GERD
The **sphincter** between the **esophagus** and the **stomach** opens, allowing stomach acid to move upwards.
## Footnote
Acid reflux disease.
41
# Assessment:
GERD
Heartburn
## Footnote
Increases while laying flat.
42
# Define:
hemorrhoids
**Swelling and inflammation** of the vessels around the rectum.
## Footnote
Caused by excessive straining.
43
# Assessment:
hemorrhoids
**Bright red blood** during defecation.
44
# Define:
anal fissure
**Tears of mucosal lining** that connect anus.
45
# Assessment:
anal fissure
**Pain and bright red blood** with defecation.
46
# Treatment:
anal fissure
**Place 5 x 9 gauze pad** over affected area.
47
# Define:
Hepatitis
An **inflammation** of the liver.
48
# Define:
Peritonitis
An inflammation of abdomen with **_generalized pain_** and **_rebound tenderness_**.
49
List the **Biliary Tract Disorders**.
* Cholangitis
* Cholelithiasis
* Cholecystitis
* Acalculous Cholecystitis
## Footnote
Involve inflammation of gallbladder.
50
# Define:
Cholangitis
An inflammation of **bile duct**.
51
# Define:
Cholelithiasis
gallstones
52
# Define:
Cholecystitis
An inflammation of the **gallbladder**.
53
What **effects** do **gallstones** have on the body?
* **Increase** bile production.
* **Decrease** bile emptying.
54
# Assessment:
Cholecystitis
Severe RUQ pain.
| Right upper quadrant
## Footnote
Pain isn't typically present until a fatty meal is eaten.
55
# Treatment:
Cholecystitis
* pain control
* nausea control
* fluid replenishment
56
# Define:
Appendicitis
An inflammation of the **appendix**.
## Footnote
Fecal matter accumulates in the appendix, and increases pressure, resulting in a rupture.
57
What are the **early**, **ripe**, and **mature** signs of appendicitis?
**Early:**
* periumbilical pain
* nausea
* vomiting
* low grade fever
**Ripe:**
* pain in LRQ (McBurney's point)
**Rupture:**
* decrease in pain
* tenderness
* rebound tenderness
* generalized pain
58
# Describe:
Dunphy's sign
RLQ pain with coughing.
| Right lower quadrant
## Footnote
Indicates peritonitis.
59
# Treatment:
Appendicitis
* pain control
* fluid replenishment
60
What is **diverticulum**?
A **weak area in the colon** that outcrops into pouches.
61
# Assessment:
Diverticulitis
**Abdominal pain** localized to the **LLQ**.
62
# Define:
Pancreatitis
The tubes to the pancreas become **blocked**, causing the pancreas to start breaking down or *“auto-digesting”* itself.
63
# Assessment:
Pancreatitis
A pain localized to the **RUQ**.
## Footnote
Radiating back pain is common.
64
Differentiate **Cullen Sign** & **Grey Turner Sign**.
**Cullen:** bruising around umbilicus.
**Grey Turner:** bruising in flanks.
65
# Define:
Ulcerative Colitis
An inflammation of the **colon**.
66
# Assessment:
Ulcerative Colitis
* bloody diarrhea
* Hematochezia (bloody poop)
* abdominal pain, fever, malaise
67
# Define:
Irritable Bowel syndrome
It is characterized by pain and changes in bowel habits.
## Footnote
e.g., diarrhea or constipation.
68
# Assessment:
Irritable Bowel syndrome
* Hypersensitivity of pain.
* Hyperresponsiveness of smooth muscles causing diarrhea.
* Psychiatric episodes.
69
# Define:
Crohn's disease
The immune system **attacks the GI tract**, causing inflammation.
70
# Assessment:
Crohn's disease
**RLQ** pain.
71
# Define:
Acute Gastroenteritis
An infection associated with:
* fever
* abdominal pain
* malaise
* nausea
* vomiting
## Footnote
Caused by fecal matter entering through the mouth.
72
# Define:
Cirrhosis
Liver failure.
## Footnote
_Causes:_
* drinking
* hepatitis
* trauma
* autoimmune disorder
73
# Assessment:
Two phases of Cirrhosis.
**First phase:**
* joint aches
* weakness
* nausea
* vomiting
* urticaria
* itching
**Second phase:**
* alcoholic stools
* darkening of urine
* jaundice
* icteric conjunctiva
* ascites
74
When treating a patient with Cirrhosis, what is the difficulty with **medication administration**?
Drugs given will remain in the body much longer.
## Footnote
Use lower dosages.
Give medications at longer intervals.
75
# Define:
Hepatic Encephalopathy
**Liver failure** causes a decline in brain function from **increased ammonia production**.
76
What is the most common cause of **small-bowel obstructions**?
Post-operative adhesions
77
# Assessment:
small-bowel obstruction
* abdominal pain
* cramping
78
What is the most common cause of **large-bowel obstruction?**
Mechanical obstruction
79
# Assessment:
large-bowel obstruction
* abdominal pain
* nausea and vomiting
80
# Define:
Hernia
* **Protrusion** of an organ or structure into an adjacent cavity.
* Can be felt during a cough by increased **abdominal pressure**.
* **COPD** related due to constant coughing.
81
Describe the **four** types of **hernias**.
* **Reducible:** returns to normal place with manipulation.
* **Incarcerated:** trapped in a new location.
* **Strangulated:** intestine trapped and squeezed until blood supply is diminished.
* **Incisional:** from prior surgeries, herniation occurs
82
# Define:
Gastroschisis
When a **baby** is born with their **bowels outside of the body**.
83
# Define:
Pyloric Stenosis
**Hypertrophy** of pyloric sphincter of stomach.
