35 terms

Outdoor Emergency Care (5th Edition): Chapter 16

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What hollow organs are contained in the abdominal and pelvic cavities?
Stomach, gallbladder, small and large intestines, appendix, ureters, urinary bladder
Peritonitis
inflammation of the peritoneum (membrane lining the abdominal cavity and surrounding the organs within it)
Causes of peritonitis
-perforated peptic ulcer
-ruptured appendix
-perforated diverticulum
-gangrenous bowel
-pelvic inflammatory disease
-gangrenous gallbladder
-abdominal trauma and wounds
What solid organs are contained in the abdominal and pelvic cavities?
Liver, pancreas, spleen, ovaries
Liver
Chemical organ that makes proteins, synthesizes blood clotting chemicals, produces bile to aid in digestion of fat
Pancreas
Produces digestive enzymes to regulate the level of sugar in the blood
Spleen
Organ near the stomach that produces, stores, and eliminates blood cells
Ovaries
Produce eggs for reproduction
Four Quadrants of the abdomen
right upper, left upper, right lower, left lower
Kidneys
Filter blood from the renal arteries and produce urine as waste
Ureter
A duct leading from the kidney to the urinary bladder.
Acute abdomen
A condition of sudden onset of pain within the abdomen, usually indicating peritonitis; immediate medical or surgical treatment is necessary.
Peritoneum
Double-layered membrane surrounding the abdominal organs. Contains both sensory and visceral nerves
Sensory nerves
Nerves that carry information from the sense receptors to the spinal cord and brain.
Visceral nerves
a collection of nerves that convey impulses between a part of the central nervous system and a viscus, such as an internal organ in the chest or abdomen
Parietal Pain
a localized, intense pain that arises from the parietal peritoneum, the lining of the abdominal cavity
Visceral Pain
a poorly localized, dull, or diffuse pain that arises from the abdominal organs, or viscera
Referred Pain
pain that is felt in a location other than where the pain originates
Appendicitis
Cause: Inflammation of the appendix r/t obstruction of lumen by stool, tumors or foreign bodies.

S/S: N/V, fever, pain in RLQ, rebound tenderness, abd. muscle guarding
Tx: Surgery
Critical: Perforation/rupture will likely lead to peritonitis
Guarding
Involuntary muscle contractions (spasms) of the abdominal wall in an effort to protect an inflamed abdomen; a sign of peritonitis.
Pancreatitis
• Caused by an injury or damage to pancreatic cells and ducts, causing a leakage of pancreatic enzymes into the pancreatic tissue
• Most cases caused by gallstones blocking the common duct or alcohol abuse
• Alcohol stimulates production of pancreatic enzymes and thus can cause acute or chronic pancreatitis.
• These enzymes cause autodigestion of pancreatic tissue and leak into the bloodstream to cause injury to blood vessels and other organs
• Also leads to an inflammatory response which can become systemic and cause multiorgan failure
• Clinical manifestations
• Epigastric pain radiating to the back
• Fever, tachycardia, hyperglycemia, elevated serum lipase and amylase levels, leukocytosis (high wbcs)
• Severe:
• hypotension, respiratory distress, abdominal distension
• 20% of cases are severe and of those 10-30% will die
• Complications include infection and necrosis
• Chronic pancreatitis has same manifestations but is usually less severe.
• Most common cause is long-term alcohol abuse
Hepatitis
Caused by Hepatitis A virus(HAV): fecal-oral transmission, hepatitis B virus(HBV): spread by bodily fluid contact, and hepatitis C virus(HCV): spread by bodily fluid contact, treated with antiviral medication, Hepatitis B&A vaccines available.
Cholescystitis
Cause: Gallstone blocking duct that exits gallbladder.
Symptoms: Inflammation of gallbladder, backing up bile
Assessment: Tenderness/pain in right upper quadrant, abdomen, jaundice
Pyelonephritis
Cause: Bacterial infection of kidneys/ureter
Symptoms: Decreased kidney function, shock, death
Assessment: Appearance of being ill, severe abdominal, flank, or back pain; fever, warm skin, chills, nausea, pain or increased frequency of urination, abdominal urine (discolored, smelly)
Nephrolithasis
Cause: Salts in the kidney collect into kidney stones
Symptoms: Kidney stones become trapped in ureters. Urine flow is blocked, causing significant pressure and pain.
Assessment: Severe distress & pain, "tearing"/"stabbing" pain
Bowel obstruction
Cause: Ileus, segment of the small or large intestine becoming blocked
Symptoms: Solids and liquids cannot move through the digestive tract
Assessment: Constipation, fever, abdomen bloated/distended
perforated bowel
Cause: Bowel obstruction, excess stomach fluid, ulcerative disease, trauma, weakness of intestinal wall
Symptoms: Hole/tear in intestines, contents leaking into abdominal cavity
Assessment: Intense, visceral pain which worsens with movement and deep inspiration
Peptic Ulcerative Disease
Causes: Excess stomach acid creates a defect of lining of esophagus, stomach, or duodeum.
Symptoms: Inflammation of stomach or esophagus, "heartburn" symptoms, gastritis/esophagitis
gastritis
inflammation of the stomach caused by irritants such as aspirin, excessive coffee, tobacco, alcohol, or an infection
GERD
gastro esophageal reflux disease. Backflow of the contents of the stomach into the esophagus
rebound tenderness
pain that increases when pressure (as from a hand) is removed
gastroenteritis
Causes: Bacterial, viral, parasitic infection, excessive alcohol/aspirin/ibuprofen use
Symptoms: Cramping abdominal pian, bloating, nausea, vomiting, diarrhea, dehydration
Assessment: Pain in upper quadrants
Colic
spasm in any hollow or tubular soft organ, especially in the colon, accompanied by pain
Problems with an unconscious vomiting patient
Could inhale their own vomit
Indigestion
symptoms resulting from difficulty in digesting food