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34 Cards in this Set
- Front
- Back
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Define Acute Abdomen
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Nontraumatic disorder that presents in the abdomen.
Surgery MAY be needed, but is NOT required |
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Difference between acute abdomen and surgical abdomen?
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Surgical abdomen MUST have surgery.
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What type of pain fibers are involved with visceral pain?
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C fibers
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What type of pain fibers are involved with parietal pain?
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C and Delta fibers
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What type of pain fibers are involved with Referred pain
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Afferent fibers from posterior spinal cord
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What are the causes of visceral pain?
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1. distention
2. ischemia 3. inflammation |
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How would you describe VISCERAL pain?
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1. Slow onset + lasts a long time
2. Dull (NOT sharp) 3. Diffuse (NOT localized) |
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How would you describe Parietal Pain?
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1. Acute onset
2. Sharp (not dull) 3. Localized |
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Why is there referred pain?
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Organs share DRG fibers with somatic innervation. So pain in one organ causes pain away from primary site.
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what are 7 categories that give clues about the history of acute abdomen?
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1. Onset + Progression
2. Colic (come and go) 3. GI: Anorexia N/V/D/C Blood 4. Menstrual hx 5. Drugs 6. FH 7. Travel |
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What is the first part in taking a detailed physical exam for acute abdomen?
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Observe:
Note overall appearance -lying still or moving in pain -position -dehydrated |
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What is the second part in taking a detailed physical exam for acute abdomen?
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Vital signs:
-Low vs. High Fever -HR -BP (Hypotensive) |
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Differential for a low fever?
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Diverticulitis
appendicitis acute cholecystitis |
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Differential for a High Fever?
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Pneumonia
UTI Septic Cholangitis gynecologic infection |
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What could Tachycardia and Hypotension mean with acute abdomen?
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Advanced dz with Peritonitis
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What determines the urgency of diagnostic work up for acute abdomen?
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1. Appearance
2. Vitals |
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What is the 3rd part in taking a detailed physical exam for acute abdomen?
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Exmaine Abdomen
1. scars 2. hernias 3. masses 4. abdomen wall defects 5. contour |
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What are the 3 CONTOURS of the abdomen?
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1. scaphoid
2. flat 3. distended |
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What can abdominal DISTENTION indicate?
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1. Intestional Obstruction
2. ileus 3. Fluid: ascites, blood, or bile |
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What is the 4th part in taking a detailed physical exam for acute abdomen?
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Auscultation: for presence or absence of bowel sounds
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What do Quiet Bowel sounds indicate?
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Ileus
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What do hyperactive Bowel sounds indicate?
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gastroenteritis
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What do Quiet AND high-pitched hyperactive Bowel sounds indicate?
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peristaltic rushes in small bowel obstruction
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What are additional things that can be determined during auscultation of the abdomen?
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1. tenderness/guarding by pressing with stethoscope
2. bruits |
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What is the 5th step in acute abdomen evaluation?
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Palpation to assess
1. facial expression for pain |
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Tenderness in the RUQ indicates what?
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inflammed gallbladder
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Tenderness in the RLQ indicates what?
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Appendicitis
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Where is McBurney's Point?
+ what does tenderness here indicate? |
RLQ.
1/3 of the way from iliac crest to belly button Appendicitis |
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Tenderness in the LLQ indicates what?
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Diverticulitis
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Tenderness in all quadrants indicates what?
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Peritonitis
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What is guarding?
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detection of muscle spasm upon palpation
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what are the different types of guarding?
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Voluntary and Involuntary
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How can you differentiate voluntary from involuntary guarding?
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1. Voluntary: ask to take breathe in and relax.
2. repeat exam. if they do not tense then this is voluntary 3. if they are STILL TENSE equals involuntary |
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what does involuntary guarding indicate?
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peritonitis
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