Paramedic Test #8 - Chapter 20 - Abdominal and GI Emergencies
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What is peristalsis?
Rhythmic contractions that help to transport food from the mouth to the stomach.
What is the portal vein?
Intertwined around the esophagus, a large vein created by the intersection of blood vessels from the GI system. Transports blood to the liver for nutrient processing.
What is the cardiac sphincter?
Valve that acts as a doorway connecting the esophagus and the stomach.
What is the iliocecal valve?
Joins the small and large intestine.
What are the parts of the large intestine?
Ascending colon - water reabsorption, formation of feces, bacterial digestion of food.
- Transverse colon
- Descending colon
- Sigmoidal colon
What are the parts of the small intestine?
Duodenum - major site for chemical breakdown of food, major site of water, fat, protein, carbohydrate and vitamin absorption
What is hematemesis?
Coffe ground emesis, caused from digesting blood by stomach acids, then vomited.
What is hematochezia?
Stool and blood that are incorporated together in the same substance. Bleeding from the lower GI tract.
What is melena?
Black, tarry, stick and odorous stool. Bleeding from the upper GI tract.
What is ascites?
Buildup of fluid in the abdomen.
What is hyperperistalsis?
Bowel forcefully trying to overcome bowel obstructions.
What is tympanic?
Empty, hollow sounds in the abdominal cavity from gas - typical.
What are bowel sounds?
Normal - soft gurgles - normal movement
Borborygmi - loud gurgles, ofter heard without a stethoscope - hyperperistalsis
Decreased - Quiet sounds occurring at less than 1 sound per 15 to 20 seconds - hypoperistalsis
Absent - no sounds after 2 min of listening - bowel obstruction
What are different type of bowel pain?
Visceral - hollow organs - difficult to localize, burning, cramping, gnawing, superficial
Parietal / Rebound - peritoneum - steady, achy pain, easier to localize, increases with movement - inflammation of the peritoneum
Somatic - peripheral nerve tracts - localized, deep - irritation of or injury to tissue, causing activation of peripheral nerve tracts
Referred - peripheral nerve tracts - originates in abdomen, refers to other locations - usually occurs after an initial visceral, parietal, or somatic pain
What is Murphy's sign?
Pressure applied to the right upper quadrant to help detect gall bladder problems.
What are the electrolyte imbalances?
Hyponatremia - low sodium - swelling of cells - muscle cramps, weakness
Hypernatremia - high sodium - shrinking of cells from excess water loss - coma, convulsions
Hypokalemia - low potassium - more stim required to fire nerve/muscle cells - muscle cramps, weakness, paralysis, heart failure, prolong QT interval, flattened T-waves
Hyperkalemia - high potasium - less stim required to fire nerve/muscles - muscle weakness, cramps, bradycardia, asystole, shortened QT interval, tented T-waves
Gastro bleeds by organ
Esophagus - inflamation, varices, tear (Mallory Weiss syndrome), cancer, gastroesophageal disease (GERD) - upper GI - melana, hematemesis
Stomach - ulcers, cancer, inflamation(gastritis) - upper GI - melana, hematemesis
Small intestine - ulcer - cancer, irritable bowel disease - upper or lower GI - melana, hematemesis
Large intestine - infections, inflammation, colorectal polyps, cancer, diverticular disease - lower GI bleed - hematochezia - fresh blood, usually from the lower GI tract.
Rectum - hemorrhoids - lower GI bleed - hemotochezia
What is portal hypertension?
Increase pressure in the portal veins, caused by the inability of blood to flow normally through the liver, can lead to rupture.
What is MAllory-Weiss syndrome?
Esophogeal condition in which severe hemorhage can occur. Junction with stomach tears - vomiting, pressure increase in the stomach.
What is PUD?
Peptic Ulcer disease - the protective layer of mucous in either the stomach or small intestine has been eroded and acid is eating into the organ.
What are the biliary tract disorders?
Inflammation of the gall bladder.
Choleangitis - inflamation of the bile duct
Cholelithiasis - gall stones
Cholecystitis - Inflammation of the gall bladder
Acalculus cholecystitus - inflammation of gall bladder without gall stones
What is diverticulitis?
When a weak area in the colon (diverticulum) begins to have small outcroppings that turn into pouches. When pouches become inflamed.
What is Dunphy's sign?
Severe right lower quadrant with coughing - method of evaluating patient for peritonitis.
What is a fistula?
Abnormal connection between two cavities.
What is pancreatitis?
Inflammation of the pancreas. Common causes are alcoholism, gallstones. Pain in RPQ and radiation common to back. Can cause hemorrhage. Cullen sign - umbilical, Grey Turner sign - bruising in the flanks.
What is ulcerative colitis?
Inflammation of the colon. Thinning of the wall of the colonm weakened rectum. Bloody diarrhea, hematochezia, and mild to severe abdominal pain.
What is Crohn's disease?
Similar to Ulcerative Colitis, but whole GI tract can be involved.
What is acute gastroenteritis?
Infection with fever, abd pain, n/v. Generally through fecal/oral, contaminated water.
What is cirrhosis?
What is hepatic encephalopathy?
Liver disfunction, leading to brain dysfunction.
What is intussusception?
Telescoping of the intestines into themselves.
What is volvulus?
Twisting of the intestinges.
What is a hernia?
Protrusion of an organ or structure into adjacent cavity.
Different types of hernias?
Reducible - return to its original location
Incarcerated - trapped in its new position
Strangulated - trapped and squeezed to the point where blood supply is cut off
Incisional - intestinal contents herniate through an incision.
Common abdominal hernia areas are epigastric, umbilical, inguinal, and femoral
What is pyloric stenosis?
Hypertrophy of the pyloric sphincter. Food can't pass through to small intestine, causing projectile vomiting, dehydration.
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