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34 Cards in this Set

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