Paramedic Test #8 - Chapter 20 - Abdominal and GI Emergencies

Rhythmic contractions that help to transport food from the mouth to the stomach.  

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. 

Valve that acts as a doorway connecting the esophagus and the stomach.  

Joins the small and large intestine.

Cecum, appendix

Ascending colon - water reabsorption, formation of feces, bacterial digestion of food. 

• Transverse colon
• Descending colon
• Sigmoidal colon
• Rectum

Duodenum - major site for chemical breakdown of food, major site of water, fat, protein, carbohydrate and vitamin absorption

Jejunum

Illeum

Coffe ground emesis, caused from digesting blood by stomach acids, then vomited.  

Stool and blood that are incorporated together in the same substance.  Bleeding from the lower GI tract.

Black, tarry, stick and odorous stool.  Bleeding from the upper GI tract. 

Buildup of fluid in the abdomen. 

Bowel forcefully trying to overcome bowel obstructions. 

Empty, hollow sounds in the abdominal cavity from gas - typical. 

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

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

Pressure applied to the right upper quadrant to help detect gall bladder problems.

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 

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

Increase pressure in the portal veins, caused by the inability of blood to flow normally through the liver, can lead to rupture.

Esophogeal condition in which severe hemorhage can occur.  Junction with stomach tears - vomiting, pressure increase in the stomach.

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.

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

When a weak area in the colon (diverticulum) begins to have small outcroppings that turn into pouches.  When pouches become inflamed.  

Severe right lower quadrant with coughing - method of evaluating patient for peritonitis.  

Abnormal connection between two cavities.  

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. 

Inflammation of the colon.  Thinning of the wall of the colonm weakened rectum.  Bloody diarrhea, hematochezia, and mild to severe abdominal pain.  

Similar to Ulcerative Colitis, but whole GI tract can be involved.  

Infection with fever, abd pain, n/v.  Generally through fecal/oral, contaminated water.

Liver failure. 

Liver disfunction, leading to brain dysfunction. 

Telescoping of the intestines into themselves.  

Twisting of the intestinges. 

Protrusion of an organ or structure into adjacent cavity.  

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

Hypertrophy of the pyloric sphincter.  Food can't pass through to small intestine, causing projectile vomiting, dehydration.