1. LUQ
    spleen, pancreas, stomach, kidney, colon,
  2. RUQ
    liver, gallbladder, pancreas, duodenum, kidney, colon
  3. RLQ
    appendix, ascending colon, small intestine, ovary, fallopian tube
  4. LLQ
    small intestine, descending colon, ovary, fallopian tube
  5. 3 central areas of ABD
    • epigastric - above the umbilical area
    • periumbilical - around the umbilical area
    • suprapubic - above the pubic area
  6. dull poorly localized pain that originates in the walls of hollow organs.
    Visceral pain
  7. inflammation of the peritoneum, which lines the abdominal cavity
  8. sharp, localized pain that originates in walls of the body such as skeletal muscles.
    Somatic pain
  9. pain that originates in a region other than where it is felt.
    Referred pain
  10. ecchymosis in the periumbilical region
    Cullin’s sign
  11. ecchymosis in the flank
    Grey Turner’s sign
  12. Gastrointestinal disease risk factors 5
    • 1. Excessive alcohol consumption
    • 2. Excessive smoking
    • 3. Increased stress
    • 4. Poor bowel habits
    • 5. ingestion of caustic substances
  13. 3 types of GI pain
    visceral , somatic, referred
  14. Pain from hollow organs tends to be _______
    vague and nondescript
  15. Pain from solid organs tends to be ______
  16. pain that originates in a region other than where it is felt
    Referred pain
  17. Patients with severe abd pain present as
    still as possible in fetal position
  18. An ominous sign is
    abdomen distention
  19. If you ascultate the abdomen you must do it before
  20. Highest priority when treating a patient with abdominal pain
    secure ABC’s
  21. Persistent abdominal pain lasting longer than 6 hours always
    requires transport
  22. Upper GI bleed
    bleeding within GI tract proximal to ligament of Treitz
  23. Ligament of Treitz
    ligament that supports the duodenojejunal junction
  24. Mallory-Weiss tear
    esophageal laceration, usually secondary to vomiting
  25. Hematemesis
    bloody vomit
  26. dark, tary, foul smelling still indicating the presence of partially digested blood
  27. Sengstaken-Blakemore tube
    three lumen tube used in treating esophageal bleeding
  28. swollen vein of the esophagus
    Esophageal varix
  29. Portal
    pertaining to the flow of blood into the liver
  30. degenerative disease of the liver
  31. These should be avoided in prehospital treatment cases of suspected esophageal varices 2
    Combitube, nasogastric tube
  32. Acute gastroenteritis
    – sudden onset of inflammation of the stomach and intestines
  33. Hematochezia
    bright red blood in the stool
  34. Chronic gastroenteritis
    nonacute inflammation of the GI mucosal
  35. Most cases of gastroenteritis are _______
  36. viral
  37. Peptic ulcer
    erosion caused by gastric acid
  38. Zollinger-Ellison syndrome
    condition that causes the stomach to secrete excessive amounts of hydrochloric acid and pepsin
  39. Lower GI bleeding
    bleeding in the GI tract distal to the ligament of Treitz.
  40. Major causes of lower GI hemorrhage 4
    • 1 diverticulosis
    • 2 colon lesions
    • 3 rectal lesions
    • 4 inflammatory bowel disorder
  41. Lower GI diseases 5
    • 1. ulcerative colitis
    • 2. Crohn’s disease
    • 3. Diverticulitis
    • 4. Hemorrhoids
    • 5. Bowel obstruction
  42. Pancolitis
    ulcerative colitis spread throughout the entire colon
  43. Proctitis
    ulcerative colitis limited to the rectum
  44. Colic
    acute pain associated with cramping or spasms in the abdominal organs
  45. Patients with ulcerative colitis are increased risk for developing ______
    colon cancer
  46. Crohn’s disease
    idiopathic inflammatory bowel disorder associated with the small intestine
  47. Diverticulitis
    – inflammation of diverticula
  48. Diverticulosis
    presence of diverticula, with or without associated bleeding
  49. Diverticula
    small outpouchings in the mucosal lining of the intestinal tract
  50. Most common presentation of diverticulitis is ___
    colicky pain usually on lower left side with low grade fever, nausea, vomiting, and tenderness
  51. Hemorrhoid
    small mass of swollen veins in the rectum
  52. Hemorrhoids rarely cause _______
    massive hemorrhage
  53. Bowel obstruction
    blockage of the hollow space within the intestines
  54. Hernia
    protrusion of an organ through its protective sheath
  55. Intussusception
    condition that occurs then part of an intestine slips into the part just distal to itself
  56. Volvulus
    twisting of the intestine on itself
  57. union of normally separate tissue surfaces by a fibrous band of new tissue
  58. area of dead tissue caused by lack of blood
  59. Appendicitis
    inflammation of the vermiform appendix at the juncture of the large and small intestine
  60. Is eventually treated in the operating room more frequently than any other abdominal emergency
  61. common site of pain from appendicitis, 1 to 2 inches above the anterior iliac crest in a direct line with the umbilicu
    McBurney point
  62. Gall bladder pain occurs in which quadrant
    - How it feels
    • RUQ or epigastrum
    • - colicky
  63. Acute pancreatitis is most often due to
    alcohol abuse or gall stones
  64. Possible caused of LUQ pain
    • - pancreatitis
    • - gastritis
  65. Possible causes of LLQ pain
    • - diverticulitis
    • - ectopic pregnancy
    • - ovarian torsion
  66. Possible causes of RUQ
    • - Cholecystitis - refers to a painful inflammation of the gallbladder's wall.
    • - Hepatitis C - is a viral disease that leads to swelling (inflammation) of the liver
    • - gallstones
    • Chlamydia - is a disease caused by the bacteria Chlamydia trachomatis. It is most commonly sexually transmitted
  67. Possible causes of RLQ pain
    • - ectopic pregnancy -pregnancy implants
    • outside the uterine cavity
    • - appendicitis
  68. Possible causes epigastric pain
    • - drug usage
    • - lactase deficiency
    • - dyspepsia
    • - pancreatic cancer
    • - GERD
    • - MI
  69. Possible causes for Periumbilical pain
    • - appendicitis
    • - constipation
    • - mesenteric adenitis
    • peritonitis
  70. mesenteric adenitis
    swollen abdominal lymph nodes
  71. – inflammation of peritoneum that can be due to the spilling of organ contents into the space
  72. Six major causes of upper GI bleed
    • 1. peptic ulcer disease – erosions caused by gastric acid.
    • 2. Gastritis - inflammation of the lining of the stomach, and has many possible causes. The main acute causes are excessive alcohol consumption or prolonged use of NSAIDs such as aspirin ibuprofen.
    • 3. varix rupture – swollen vein of the esophagus that ruptures
    • 4. Mallory-Weiss tear - occurs in the mucus membrane of the lower part of the esophagus or upper part of the stomach, near where they join. The tear may bleed. It is usually caused by forceful long term vomiting or coughing.

    • 5. Esophagitis - any inflammation, irritation, or swelling of the esophagus. It is frequently caused by the backflow of acid-containing fluid from the stomach to the esophagus, a condition called gastroesophageal reflux.
    • 6. duodenitis
  73. AKA gall bladder attack is inflammation of the gall bladder and is usually caused by gall stones.
  74. – inflammation of the colon caused by infection, poor blood supply, or autoimmune reactions. Its most common symptoms are abdominal pain and diarrhea
  75. enlarged veins of esophageal varices form when blood flow to your liver is slowed. Caused by portal pressure (portal hypertension) Often these varices rupture and hemorrhage
    Esophageal varices
  76. What is the management of upper GI bleed?4
    • - place patient in left lateral recumbent or high semi-Fowler’s position to prevent aspiration.
    • - give high flow, high concentration oxygen by non rebreather.
    • - establish 2 large bore IVs, one with blood tubing for possible transfusion and volume replacement 0.9 percent NaCl. - you can give a 20cc/kg fluid bolus to begin treating hemorrhagic hypovolemia
  77. What is the management of lower GI bleed?5
    • - watch airway and oxygenation status closely
    • - if hypoventilation or inadequate respiration develop, give high flow oxygen by nonrebreather or positive pressure ventilation.
    • - establish IV and give fluid based on patients hemodynamic status
    • - place in a comfortable position and offer psychological support and transport.
    • - consider use of PASG if hemodynamic instability develops during transport.
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