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52 Cards in this Set
- Front
- Back
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epigastric pain, may radiate to the back; can be relieved by food and antacids; n/v, belching, bloating, heartburn
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PUD and dyspepsia
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epigastric pain, may radiate to the back or other parts of the abdomen, may be poorly localized; steady,persistant pain; acute onset. lying down aggravates. leaning forward (guarding) relieves. N/V, abd distention, fever. h/o episodes, alcohol. inflamation of pancreas.
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acute pancreatitis
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fibrosis of the pancreas secondary to recurrent inflammation. aggravated by alcohol and fatty meals. releived by leaning forward.
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chronic pancreatitis.
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sudden obstruction of the cystic duct or common bile duct by a gallstone. Epigastric or RUQ pain that may radiate to the R scapula. steady aching. NOT colicky. anorexia. n/v.
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biliary colic, renal/ intestinal colic
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Usually caused from obstruction of the cystic duct by a gallstone, RUQ or upper abd pain that may radiate to scapula. Steady, aching, gradual onset. aggravated by jarring and deep breathing. anorexia, N/V, fever.
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acute cholecystitis.
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Usually found in the LLQ, starts as cramping then becomes steady pain. a saclike mucosal outpouching through the colonic muscle. fever, constipation. initial brief diarrhea.
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acute diverticulitis
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poorly localized periumbilical pain, usually followed by right lower quadrant pain. increasing pain,possible cramping. aggravated by mvmt or cough. anorxia. n/v.
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acute appendicitis
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most commonly caused by adhesions following sx or hernias. periumbilical or upper abdominal cramping. paroxysmal. vomiting of bile and mucus.
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acute mechanical small intestine obstruction
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lower abdominal or generalized pain and cramping. paroxysmal onset. early obstipation. late vomiting.
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acute mechanical colon obstruction
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abrupt periumbilical pain, then diffuse. from cramping to steady. then persistant. vomiting, diarrhea. (sometimes blood) constipation, shock. blood supply blocked from thrombosis or embolus.
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mesenteric ischemia
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a condition that is aggravated when you attempt to start the swallowing process. acute or gradual onset + variable course depending on underlying disorder.Neurologic evidence of stroke, bulbar palsey or other neuro-muscular conditions.
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Transfer dysphagie due to motor disorders affecting the pharyngeal muscles.
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aggravated by eating solid foods, releived by regurgitation of the bolus. intermittent.
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mechanical narrowing of the mucosal rings and webs.
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Patients c a long h/o heartburn and regurg. symptoms aggravated by solid foods. intermittent and may become slowly progressive. Only relief is regurgitation of bolus.
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esophageal stricture: mechanical narrowing.
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there is pain in the chest and back c weight loss, especially late in course of illness. intermittent at first. aggravated by solid foods c progression to liquids.
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esophageal cancer: mechanical narrowing.
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p presents with chest pain that mimics angina pectoris or MI and lasts minutes to hours. possibly heartburn. relieved by repeated swallowing, straightening the back, Valsalva maneuv.. aggravated by solids or liquids.
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Diffuse esophageal spasm: motor didorders.
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a common disorder of bowel motility. alternating diarrhea and constipation. small, hard stools, often c mucus. periods of diarrhea. cramping abdominal pain. stress may aggravate.
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IBS
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Name several drugs that can cause constipation.
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opiates, anticholinergics, antacids containing calcium or aluminum...
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often affects young people c soft to water, often blood containing stools. insidious to acute onset. crampy lower or generalized abdominal pain caused by inflammation of the mucosa and submucosa of the rectum and colon w/ ulceration. unknown etiology.
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ulcerative colitis.
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chronic inflammation of the bowel wall, typically involving the terminal ileum, bile salt deficiency. small, soft to loose or watery stool. no blood. crampy periumbical or RUQ enteritits or diffuse colitis pain. anorexia. low grade fever,
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Chron's Dz of the small bowel.
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defective absorbtion of fat, including ADEK; bulky, soft, light yellow to gray, floats in toilet. insidious onset. anorex, fatigure, distention, nutritional def, edema
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malabsorption syndromes w/ voluminous diarrheas
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deficiency in intestinal lactase causing watery diarrhea of large volume. follows ingestion of milk/products, relieved by fasting. crampy abdominal pain, distention, flatulence.
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lactose intolerance: osmotic diarrheas
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black, tarry stools, sticky & shiny. + (pos) occult blood tests. signifies that at least 60 mL of blood in the GI tract
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melena.
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selected causes of melena
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peptic ulcer, gastritis or stress ulcers, esophagel or gastirc varices, reflux esophagitis Mallory-Weiss tear. recent ingestion of alcohol, NSAID's, body trauma, sx.
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caused by ingestion of iron, bismuth salts like Pepto Bismol, licorice or even choc. chip cookies resulting in black, nonsticky stools.
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non pathological black/bloody stools
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when the urethral sphincter is weakened so that transient increase in intra-abdominal pressure raise the bladder pressure to levels that exceed urethral resistance.
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Stress Incontinence: pelvic floor weakness
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detrusor contractions are stronger than normal and overcome the normal urethral resistance. typically a small bladder.
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urge incontinence.
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detrussor contractions are insufficient to overcome urethral resistance. typically a large bladder, even after voiding.
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overflow incontinence.
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this is a functional inability to get to a toilet in time b/c of impaired health or enviornmental conditions.
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functional incontinence
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drugs may contribute to any type of incontinence listed: sedatives, anticholinergics, symp. blockers, potent diuretics
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incontinence secondary to meds.
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A separation of the two rectus abdominis muscles, through which abdominal contents form a midline ridge when the patient raises head and shoulders. repeated in pregnancies, obesity, chronic lung disease. it has no clinical consequences.
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Diastasis Recti
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a protrusion through a defective umbilical ring is most common in infants but also occurs in adults. closes spontaneously in infants
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umbilical hernia
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upon auscultation, you hear a grating sound with respiratory variation. it's a rare finding. they indicate inflammation of the peritoneal surface of an organ, as from a liver tumor, chlamydial perihepatitis. if accompanied by systolic bruit, suspect liver carcinoma.
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friction rubs. heard over hepatic and splenic areas.
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a rare, soft humming noise with both systolic and diastolic components. it indicates increased collateral circulation between portal and systemic venous systems, as in hepatic cirrhosis.
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Venous hum
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a cause of abdominal pain and tenderness, when unilateral it may mimic acute cholecystitis or appendicitis. Rebound tenderness and rigidity are less common, chest signs are usually present.
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acute pleurisy: unilateral or bilateral, upper or lower abdomen.
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tenderness of fallopian tubes, frequently bilateral, is usually maximal just above the inguinal ligaments. Rebound tenderness and rigidity may be present. on pelvic exam, motion of the uterus causes pain.
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acute salpingitis
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tenderness associated with peritoneal inflammation is more severe than visceral tenderness. Muscular rigidity and rebound tenderness are frequently but not necessarily present.
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tenderness of peritoneal inflammation
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local causes of peritoneal inflammation, maximal signs in the RUQ. check murphy's sign
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acute cholecystitis.
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local causes of peritoneal inflammation, epigastric tenderness and rebound tenderness are usually present, but the abdominal wall may be soft.
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acute pancreatitis
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RLQ tenderness, just below the middle of the line joining the umbilicus and the anterior superior iliac spine, also right flank.
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acute appendicitis
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peritoneal inflammation that most often involves the sigmoid colon and then resembles a left-sided appendicitis
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acute diverticulitis
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an easily palpable right liver lobe, projects downward to the iliac crest. especially in people with a lanky build. represents a variation in shape, not an increase in liver volume or size
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Riedel's Lobe
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what are the anatomical landmarks for the spleen?
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against the diaphragm at the level of the 9th, 10th and 11th ribs, mostly posterior to the left midaxillary line.
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stimulated by contraction of the detrusor muscle, this organ accommodates roughly 300mL of urine filtered by the kidneys into the renal pelvis and the ureters
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bladder
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the angle formed by the lower border of the 12th rib and the transverse processes of the upper lumbar vertebrae, defines the region to assess for kidney tenderness
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Costovertebral angle
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a sense of burning or warmth that is retrosternal and may radiate from the epigastrium to the neck. Suggests gastric acid into the esophagus, often precipitated by a heavy meal, lying down or bending forward. also, alcohol, citrus juices or aspirin .
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heartburn. if chronic, consider reflux esophagitis.
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belching, but not bloating or excess flatus.
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aerophagia. if no other symptoms
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p reports vomiting with a fecal odor, suspect?
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small bowel obstruction, gastrocolic fistula
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brownish or blackish vomitus c a "coffee-grounds" appearance (aka hematemesis) suggests?
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blood altered by gastric acid, as in duodenal/peptic ulcer, esophageal/gastric varices, gastritis
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a general term that describes pain felt when hollow abdominal organs contract unusually forcefully or are distended or stretched.
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visceral pain. depending on location, indicates organs affected.
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more severe than visceral pain, it originates in the parietal peritoneum and is caused by inflammation. a steady ache, and more precisely localized over the involved structure.
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parietal pain.
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difficulty swallowing, with the sense that food/liquid is sticking, hesitating or "won't go down right"
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dysphagia. may result from esophageal disorders
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pain on swallowing. may be a sharp, burning pain suggesting mucosasl inflamm. OR squeezing, cramping pain suggests a muscular cause.
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odynophagia
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