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Acute Abdomen
- Acute abdominal pain; may be severe, and it can have any number of causes
- May arise from the cardiac, pulmonary, gastrointestinal, hematologic, genital, urinary, reproductive, or other body systems
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Abdominal Cavity
Located below the diaphragm and extends to the top of the pelvis
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Peritoneum
- Lines the abdominal cavity
- Two layers: visceral peritoneum and the parietal peritoneum
- The visceral peritoneum is the innermost layer and is in contact with the abdominal organs, whereas the parietal peritoneum is the outermost layer
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Abdominal Aorta
The portion of the descending aorta that extends from the thoracic portion of the aorta to the distal point where the aorta divides into the iliac arteries. Arteries branching from the abdominal aorta supply the abdominal organs
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Left Upper Quadrant (LUQ)
Contains most of the stomach, the spleen, the pancreas, and part of the large intestine. The left kidney is behind the abdominal lining
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Right Upper Quadrant (RUQ)
Contains most of the liver, the gallbladder, and part of the large intestine. The right kidney is behind the abdominal lining
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Right Lower Quadrant (RLQ)
Contains the appendix, part of the large intestine, and the female reproductive organs
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Left Lower Quadrant (LLQ)
Contains part of the large intestine and the female reproductive organs
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Solid Organs
- Spleen
- Liver
- Pancreas
- Kidneys
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Hollow Organs
- Stomach
- Gallbladder
- Duodenum
- Large intestine
- Small intestine
- Bladder
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Vascular Structures
- The large blood vessels found in the abdominal cavity
- Portions of the descending aorta and the inferior vena cava
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Visceral Pain
- Occurs when the organ itself is involved
- Also associated with nausea and vomitting
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Parietal Pain or Somatic Pain
- Associated with irritation of the peritoneal lining
- Pain more severe and more localized
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Referred Pain
Visceral pain that is felt elsewhere in the body
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Peritonitis
- Irritation and inflammation of the peritoneum
- Occurs when blood pus, bacteria, or chemical substances leak into the peritoneal cavity
Signs and symptoms: abdominal pain or tenderness, nausea, vomiting, diarrhea, fever and chills, lack of appetite (anorexia), positive Markle (heel drop or heel jar) test
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Appendicitis
- An inflammation of the appendix that commonly causes an acute abdomen.
- Usually caused by a blockage in the intestines and results in inflammation and irritation
Signs and symptoms: abdominal pain or cramping, nausea, vomiting, low-grade fever and chills, lack of appetite, abdominal guarding, positive Markle test
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Pancreatitis
- Inflammation of the pancreas may cause sever pain in the middle of the upper quadrants.
- Sometimes radiates to the back
- Ingestion of alcohol, gallstone, infection
Signs and symptoms: abdominal pain, nausea, vomiting, abdominal tenderness and distension, mild jaundice, severe abdominal pain with radiation, fever, rapid pulse, and signs of shock
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Cholecystitis
- Inflammation of the gallbladder, commonly associated with the presence of gallstones
- Blockage of opening of gallbladder to small intestine
Signs and symptoms: Sudden onset of abdominal pain located from middle of upper quadrants to RUQ, tenderness upon palpation of RUQ, belching or heartburn, nausea and vomiting
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Gastrointestinal Bleeding
- Upper gastrointestinal bleeds frequently caused by peptic ulcers, gastric erosion, and varices. More prevalent in adult males
- Lower gastrointestinal bleeds are frequently caused by diverticulosis and occur more in women
Signs and symptoms: abdominal pain or tenderness, hematemesis (vomiting blood, which can be bright red or look like coffee grounds), hematochezia (bright red blood in the stool normally signifying a rapid onset), melena (dark tarry stools containing decomposing blood normally from the upper gastrointestinal system), altered mental status, weakness, syncope, tachycardia, signs of shock
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Esophageal Varices
Bulging, engorgement, or weakening of the blood vessels in the lining of the lower part of the esophagus
Signs and symptoms: large amounts of bright red hematemesis (vomiting blood), absence of pain or tenderness in the abdomen, rapid pulse, breathing difficulty, pale cool clammy skin, other signs and symptoms of shock, jaundice
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Gastroenteritis
Inflammation of the stomach and small intestines, is commonly associated with the presence of abdominopelvic pain
Signs and symptoms: abdominal pain or cramping, nausea, vomiting, diarrhea, abdominal tenderness, fever and dehydration
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Ulcers
Open wounds or sores within the digestive tract, usually in the stomach or the beginning of the small intestines. Associated with a breakdown of the lining that usually protects the intestine from the digestive fluids
Signs and symptoms: sudden onset of abdominal pain in the LUQ, nausea, vomiting, hematemesis, hematochezia, melena, signs or symptoms of shock, peritonitis with a rigid abdomen
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Intestinal Obstruction
A blockage that interrupts the normal flow of the intestinal contents within the intestines
Signs and symptoms: abdominal pain moderate to severe, nausea, vomiting, constipation, abdominal distension and tenderness, abnormally prominent high-pitched bowel sounds with auscultation
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Hernia
A protrusion or thrusting forward of a portion of the intestine through an opening or weakness in the abdominal wall. Most commonly associated with increased pressure in the abdominal cavity during heavy lifting or straining, causing the peritoneum to be pushed into the weakness or opening
Signs and symptoms: sudden onset of abdominal pain, fever, rapid pulse, tender mass at point of hernia, others similar to intestinal obstruction
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Abdominal Aortic Aneurysm (AAA)
A weakened, ballooned, and enlarged area of the wall of the abdominal aorta
Signs and symptoms: gradual onset of lower lumbar, groin and abdominal pain, rupture associated with sudden onset of severe, constant abdominal pain may radiate to lower back, flank, or pelvis, testicular pain, nausea, vomiting, mottled skin, pale cool clammy, absent femoral or pedal pulse, soft pulsating mass
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Hematologic Emergencies
Involve the blood and its components
Anemia, sickle cell anemia, hemophilia
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Anemia
A reduction of the number of red blood cells in the circulating blood volume
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Sickle Cell Anemia
Hereditary blood disorder, some red blood cells have abnormal hemoglobin that does not carry adequate oxygen
- Bone crisis
- Acute chest syndrome
- Abdominal crisis
- Joint crisis
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Hemophilia
Blood disorder that affects clotting
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Gynecology
The branch of medicine that studies health of the female patient and her reproductive system
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Menarche
Onset of menses or menstrual period
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Dysmenorrhea
Strong uterine cramps that cause the severe pain during menstruation
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Mittelschmerz
- Abdominalpelvic pain in the middle of menstrual cycle
- Caused by irritation of the peritoneum by the small amount of bleeding associated with the rupture of ovarian tissue that occurs with release of the mature ovum
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Ovarian Cyst
A fluid-filled sac that forms inside or on an ovary
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Endometritis
An inflammation of the endometrium
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Endometriosis
A condition in which endometrial tissue grows outside the uterus
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Pelvic Inflammatory Disease (PID)
An infection on the female reproductive tract
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Urology
The branch of medicine that studies the urinary system in females and the genitourinary system in males
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Hematuria
Blood in the urine
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Kidney Stones or Renal Calculi
Crystals of substances such as calcium, uric acid, struvite, and crystine that are formed from metabolic abnormalities
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Kidney Failure or Renal Failure
- Acute Renal Failure (ARF)- period of days and results in significant decrease in urine elimination
- Chronic Renal Failure (CRF)- period of years; accumulation of waste products and fluids
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Dialysis
An artificial process used to remove water and waste substances from the blood when the kidneys fail to function properly
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