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34 Cards in this Set
- Front
- Back
What is visceral pain?
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from organs themselves
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What type of pain does distention of a hollow organ cause?
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visceral spec. periumbilical pain and nausea
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What type of pain is felt with peristalsis against obstruction?
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cramping pain, vomiting (pt. will move around)
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What is somatic pain?
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pain from the body wall
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Do patients with peritonitis move or lie still?
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lie still
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Where does pain in the diaphragm radiate to?
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shoulder
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Where does pain in kidneys refer?
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testes
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Where does pain in gallbladder radiate?
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scapula
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Where does pain in pancreas radiate to?
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straight through back
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Examples of extra abdominal causes of abdominal pain
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lower lobe pneumonia, lumbar spine fracture, urinary tract
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Method for relaxing abdominal wall for PE.
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slightly flex the knees
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Reliable sign of peritonitis.
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tenderness to PERCUSSION, heel tap and rebound tenderness positive
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Term for free air in the abdomen outside GI tract.
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pneumoperitoneum
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What is loss of liver dullness a sign of?
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pneumoperitoneum
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Using cold hands causes what?
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rigid abdomen
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In older people, what dies pain out of proportion to physical findings suggest?
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bowel ischemia from occlusion of mesenteric artery
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Method for testing for CVA tenderness.
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test unaffected side first; start at shoulder and tap all the way down
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CVA tenderness is a sign of what?
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pyelonephritis, but can also be acute cholecystitis, subphrenic abscess, retrocecal appendicitis, and hepatitis
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Lab tests for suspected cholelithiasis and pancreatitis
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LFTs, amylase/lipase
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Acute abdomen series
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CXR, KUB (flat abdominal film), upright abdominal film
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MC cause of colon obstruction in adults.
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colon cancer (other causes- diverticulosis and volvulus)
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amt of peristalsis in ileus
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little
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Amt of peristalsis in obstruction
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present
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Bowel sounds in ileus
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few
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Bowel sounds in obstruction
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present---maybe rushing
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Pain in ileus
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continuous
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Pain in obstruction
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cramping
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Air on abdominal film with ileus
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small bowel AND colon
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Air on abdominal film with obstruction
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SBO- air in small bowel; colon- dilated colon
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Cause of small bowel obstruction
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Small Intestine- adhesions, incarcerated hernia; Colon- cancer, volvulus
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Exception to not treating abdominal pain with narcotics.
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Renal colic
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Instances when you do urgent surgery
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perforated hollow organ, appendicitis, ectopic pregnancy, incarcerated hernia, bowel obstruction
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Bleeding injuries requiring immediate surgery
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penetrating injuries, ectopic pregnancy with much bleeding, ruptured AAA
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Steps to take when a person need same day immediate surgery
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correct hypovolemia and electrolytes, pre op Ab, NG suction if vomiting persists while NPO, written consent, anesthesia and OR personnel contacted
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