Chapter 26 - Abdominal Emergencies

Peritoneum

The membrane that lines the abdominal cavity and covers the organs within it

Parietal peritoneum

part of the peritoneum that lines and attaches to the abdominal wall

Visceral peritoneum

part of the peritoneum that covers the organs

Extraperitoneal space

Area outside of the peritoneum

Retroperitoneal space

Area posterior to the peritoneum between the peritoneum and the back

Organs that are in the retroperitoneal space

Kidneys, Uterus, Pancreas

Visceral pain

Poorly localized, dull, or diffuse pain that arises from the abdominal organs

Parietal pain

Localized, intense pain that arises from the membrane that lines the abdomen

Tearing pain

Sharp pain that feels as if body tissues are being torn apart

Referred Pain

Pain that is felt in a location other than where the pain originates

Pain that is described as dull and persistent often originate from ___ (Hollow/Solid) organs

Solid

Pain that is described as crampy, colicky, or intermittent often originate from ___ (Hollow/Solid) organs

Hollow

What is the first thing that should be done as part of the physical assessment of the abdomen?

Inspection

You arrive on scene to a​ 54-year-old male complaining of abdominal pain. He states he does not want to go to the hospital but simply wants you to check his vital signs. As you assess your​ patient, which assessment finding would lead you to believe he is suffering an acute myocardial​ infarction?

Dull, cramping pain in his mid-upper abdomen

You are on scene with a​ 47-year-old female patient complaining of​ "stomach pain" but who tells you that she thinks​ she's having a​ "heart attack." She states she has a history of​ "gallstones, high blood​ pressure, and kidney​ stones." What assessment finding would lead you to believe that the patient may be suffering a myocardial​ infarction?

Acute epigastric pain

Your patient is a​ 58-year-old male who is complaining of a sudden onset of​ severe, constant abdominal​ pain, radiating to the lower back. He describes the pain as​ "tearing." When you palpate the​ area, you note a pulsating abdominal mass. You​ suspect:

An abdominal aortic aneurysm

You respond to a scene where a​ 67-year-old male presents as​ pale, cool, and diaphoretic. He states he has severe midabdominal pain that began​ "about an hour​ ago." What assessment finding would lead you to suspect a large arterial GI​ bleed?

Bright red vomitus

You are treating a patient who has​ sudden-onset stomach pain. The​ 56-year-old male patient states he was mowing his yard when he began having​ sharp, stabbing pain in his epigastric region. He feels it may be from the lunch he ate 15 minutes prior to your arrival. What is the best way to manage this​ patient?

Treat for MI

After exposing the abdomen of a patient experiencing abdominal​ pain, you​ would:

Palpate the abdominal quadrants

A patient with abdominal pain and experiencing airway problems should be transported​ in:

Left lateral recumbent position

What is a potential problem of asking a patient directly if she is​ pregnant?

She may not know

For a female of childbearing age who is experiencing abdominal​ pain, you​ should:

Ask questions regarding menstruation or pregnancy while assuring patient’s privacy