4Function of organsDigestionStomachSmall intestineLarge intestine (colon)LiverGallbladderPancreas
5Digestion Stomach: Hollow organ; expands as it fills with food Small intestine: Hollow organ where food absorption takes place; Divided into 3 parts: Duodenum, jejunum, ileumLarge Intestine; hollow organ; removes water from waste productsStomach: Hollow organ; expands as it fills with foodSmall intestine: Hollow organ where food absorption takes place; Divided into 3 parts: Duodenum, jejunum, ileumLarge Intestine; hollow organ; removes water from waste products
6LiverBile secretion for breakdown of fatsGallbladderStores bile before release into the intestinePancreasReleases enzymes that breakdown food into absorbable molecules. Takes place in the small intestine
8Peritoneumforms the lining of the abdominal cavity or the coelom — it covers most of the intra-abdominal (or coelomic) organs. It is composed of a layer of mesothelium supported by a thin layer of connective tissue. The peritoneum both supports the abdominal organs and serves as a conduit for their blood and lymph vessels and nerves.
9The outer layer, called the parietal peritoneum, is attached to the abdominal wall. The inner layer, the visceral peritoneum, is wrapped around the internal organs that are located inside the intraperitoneal cavity.The potential space between these two layers is the peritoneal cavity; it is filled with a small amount (about 50 ml) of slippery serous fluid that allows the two layers to slide freely over each other.
20EnteritisEnteritis is an inflammation of the small intestine caused by a bacterial or viral infection. The inflammation frequently also involves the stomach (gastritis) and large intestine (colitis).
21LLQPart of descending colonSigmoid colonLeft ovary and Fallopian tube
26Visceral PainDull and persistentUsually originating from solid organsIntermittent, crampy, or colickyPain comes from hollow organs
27Parietal painAlso called peritoneal painMay be caused by internally bleedingMay be sharp and localizedMay worsen when patient moves
28Tearing painAAAtearing pain in the backReferred painFelt somewhere other than where it originatesMI-indigestion
29Assessment and CareScene Size-upProtect yourself from vomitOdorsShockMOI
30Initial AssessmentLOCABCsSigns of shockAMSAnxietyPaleCool, moist skinRapid pulse and respirationsPosition of patientO2
31S A M P L EO P Q R S TTime: How long have you had the painHas it changed over time
32Female patientsWhere are you in your menstrual cycle?Period late?Vaginal bleeding?If menstruating, is flow normal?PMHx
33Is pregnancy possible?Ectopic pregnancy is a priority pt., rapid transport.
34GeriatricDecreased ability to perceive painMedications for HTN or heart conditions that would prevent increased pulse when in shock
35Beta BlockersStimulation of β1 receptors by epinephrine induces a positive chronotropic(changes heart rate) and intropic(force of muscular contractions) effect on the heart and increases cardiac conduction velocity and automaticity.AtenololMetoprolol
36Physical Exam of the Abdomen InspectDistensionBloatingDiscolorationProtrusions
37PalpateLocalize pain prior to palpatingpalpate that area lastObserve for guardingCarefully palpate a mass ONCEVSSerial vs
38CareABCsO2Transport decisionPosition of comfortOngoing assessment q 5 min.Alert for vomiting; suctionCalmNothing by mouthAMS or unresponsive; left lateral recumbentElevate legs for shock
39AppendicitisNausea and sometimes vomitingPersistent pain RLQGallstonesSudden epigastric/RUQ painMay rotate to shoulder or backMay worsen by eating food high in fat
40PancreatitisPain may radiate to back and shouldersCan be present with signs of shockInternal bleedingDigestive tract; coffee ground emesisRectal; black, tarry stoolsParitoneal cavity; abd pain and tenderness
41AAASharp, tearing pain radiating to the backShockDifference between femoral and pedal pulsesHerniaPainful protrusionKidney stonesSevere flank pain radiating to anterior groinNausea and vomiting