Chapter 19 EMT Basic

function of liver (name 5-6)

- makes poisonous substances produced by digestion harmless
- help blood clotting and plasma
- storage of sugar or starch for immediate use by body for energy
- can be easily injured due to size
- lots of blood flow
- creates glucose stores
- secretes bile and aids in digestion of fats
- filters toxic functions

duodenum

- 12 inches long - part of small intestine that receives food from the stomach and mixed with secretions from pancreas and liver for digestion

what is in the abdominal cavity

gastrointestinal, genital, and urinary system

what type of organs is in the abdominal cavity

solid and hollow organs

gastrointestinal system

- responsible for digestion process

main digestive organ

stomach

what begins with digestion

• food is chewed and saliva breaks down food and swallowed into esophagus then stomach

what does pancreas release

amylase, bicarbonate, insulin, glucagogen

amylase

breaks down starches into sugar

jejunum

- absorbs digestive products - does msot of the work - large part of small intestine

ileum

- absorbs nutrients that were not absorbed earlier - absorbs bile acids so they can be returned to the liver for future use and vitamin B12 for making nerve cells and red blood cells

peritoneal fluid

bathe and lubricate organs in abdominal cavity

where is peritoneum in abdomen

abdominal cavity and organs

peritonitis

• foreign material such as blood, pus, or bile in peritoneum -> inflammation

what is the cause of secondary hypertension

kidney disease and can be chronic

blood flow in kidneys

high

acute abdomen

- sudden onset of abdominal pain - often associated with severe, progressive pain - associated with peritonitis

what is peritonitis associated with

- nausea, vomiting, diarrhea - loss of blood fluid in abdominal cavity

signs and symptoms of peritonitis

• tachycardia

• hypotension

• abdominal pain

• signs of shock

• fever based on cause

• normal vital signs

what does peritonitis cause

ileus

ileus

• paralysis of muscular contractions - retained gas and feces causes distention - stomach empties by emesis - digestion is abdnormal

diverticulitis

- inflammation of small pockets at weak areas in the muscle walls -> fecal matter becomes caught and trapped in diverticula - rarely bleeding - diameter of colon narrows -> constipation and bowel obstruction

cholecystsitis

- inflammation of the gallbladder -> high body temperature - can rupture -> irritate other parts of body such as diaphragm and bowel

acute appendicitis

temperature is normal until appendix ruptures and contaminates peritoneal cavity

parietal peritoneum

supplied by the same nerves that supply the skin of the abdomen such as pain, touch, pressure, heat, cold -> localize pain

two types of nerves that supply the peritoneum

parietal and visceral peritoneum

visceral peritoneum

- supplied by the autonomic nervous system - can't localize pain - stimulated when distention or contraction of hollow abdominal organs activates stretch receptors

ulcers aka

peptic ulcer disease

peptic ulcer disease

• protective layer of mucus on stomach and duodenum erodes, allowing acid to eat into the organ - may lead to gastric bleeding and peritonitis

signs and symptoms of peptic ulcer disease

- burning or gnawing pain in stomach - nausea, vomiting, belching, heartburn

severe signs and symptoms of ulcers

hematemesis and melena

burnring or gnawing pain in stomach in ulcers

- diminishes when eating and reemerges 2-3 hours later -> upper abdomen

nonsteroidal anti-inflammatory drugs (NSAID)

asprin and ibuprofen

causes of ulcers

result of infection of stomach with helicobacter pylori bacteria

more common population for ulcers

older population as they use NSAID and immune system is weaker

complications of ulcers

- occur from bleeding or perforation -> hole through wall of stomach

gallstones

- form and block outlet gallbladder - cause pain and lead to cholecystitis

signs and symptoms of cholecystitis

- nausea, vomiting, indigestion, bloating, gas, belching

people who are at higher risk of cholecystitis

women, older adults, obese people, people of scandinavian, native america, hispanic

when do cholecystitis produce symptoms

about 30 minutes after fatty meal in night

where is pain in cholecystitis

- constant, severe pain in right upper or midabdominal region - refer to right upper back, shoulder, or flank - increase or may come and go

pancreatitis

- inflammation of pancreas - sepsis or hemorrhage may occur

how is pancreatitis caused

obstructing gallstone, alcohol abuse, or other diseases

pancreatitis signs and symptoms

pain in upper left and right quadrants, nausea, vomiting, abdominal distention

when is pain from pancreatitis worse

after eating

appendicitis

- inflammation or infection in appendix -> frequent cause of acute abdomen - cause tissues to die or rupture, causing abscess, peritonitis, shock

signs and symptoms of appendictis

nausea, vomiting, anorexia, fever, chills, rebound tenderness

where appendictis patients might feel pain

- center in navel -> generalized ,dull pain -> localize to right lower quadrant of abdomen -> referred pain

gastrointestinal hemorrhage

- bleeding within gastrointestinal tract - may be acute or chronic

when can gastrointestinal hemorrhage occur

upper or lower GI tract

bleeding in the upper GI tract

occurs from esophagus to upper small intestine

esophagus problems in upper GI bleeding

- esophagitis - esophageal varices secondary to liver failer - mallory-weiss tear

mallory-weiss tear

excessive retching or vomiting

esophagitis

- lining of the esophagus becomes inflamed by infection or gastroesophageal reflex disease

gastroesophageal reflex disease aka

acid reflux disease

gastroesophageal reflex disease

sphincter between esophagus and stomach opens, allowing stomach acid to go to esophagus and cause heartburn

signs and symptoms of esophagitis

pain in swallowing, heartburn, nausea, vomiting, sores in mouth

how many people have esophagitis

60 million, 18% of population

esophageal varices

- pressure within blood vessels surrounding esophagus increases and drains into liver -> blood flow backs up and capillary network in esophagus leaks

signs and symptoms of esophageal varices

- fatigue - weight loss - jaundice - anorexia - edema - abdominal pain - hematemesis - upper GI bleed

main cause of liver damage

alchol as damages cirrhosis and slows blood flow

cirrhosis

interior of liver

rupture of esophageal varices

- pain/discomfort in epigastric region or sternum - difficult swallowing, emesis, low bp, shock - hematemesis and melena if bleeding is less likely

mallory-weiss syndrome

- junction between esophagus and stomach tears -> severe bbleeding

principle symptom of mallory-weiss syndrome

vomiting or violent coughing

risk facors of mallory-weiss syndrome

alcholism and eating disorders

gastroenteritis

- infection from bacterial or viral organisms (contaminated food or water) are caused by noninfectious conidtions combined with diarrhea, nausea, and vomiting

noninfectious conditions of gastroenteritis

- adverse reactions to medications, toxin exposure, chemotherapy

principal symptom of gastroenteritis

diarrhea

other signs and symptoms of gastroenteritis (mention 5)

foul odor, odorless, abdominal cramps, nausea, vomit, fever, anorexia, shock if loss of fluid volume

main symptom of diverticulitis

abdominal pain in left side of lower abdomen

signs and symptoms of diverticulitis

• fever - malaise - body aches - chills

diverticulosis

most common cause of lower GI bleeding -> bright red and painless

hemorrhoids

- created by swelling and inflammation from increased pressure or irritation of blood vessels surrounding rectum

how does hemorrhoids happen

- pregnancy, straining at stool, constipation, diarrhea

what forms from hemorrhoids

- bright red blood during defecation but can control - itching and small mass on rectum from bleeding

internal hemorrhoids

painless, hig in rectum

external hemorrhoids

painful, visible, low in rectum

cystitis

bladder infection

what causes cystitis

bacterial infection

when is cystitis common

women

when is cystitis serious

if infection spreads to kidney or reports of urgency and frequency of urination

cystisis

- midline lower abdominal pain - hematuria and pain around bladder - tenderness when palpaing bladder above pubic bone - urinary retention

urinary retention

urethra is inflamed

what happens when kidneys fail

uremia results

uremia

can't remove waste from body, stays in blood

kidney stones

- formed when chemicals crystallize in urine - grow over time and cause blockage if going into ureter, swelling - prevents urine from passing

signs and symptoms of kidney stones

- radiate to groin, discomfort to flank - nausea and vomiting, hematuria after removed

acute kdiney failreu

- sudden decrease in kidney function - reversible with prompt diagnosis and treatment

chronic kidney failer caused by

\diabetes or hypertension -> loses kidney function and need

chronic kidney failrue

- irreversible - progressive, develops over months/years - eventually dialysis or transplant is required

CKF signs and symptoms when untreated

- LOC, lethargy, nausea, headaches, cramps, face and extremity edema - seizures and coma - high incident of heart disease

lower quadrant pain for females

may relate to ovaries, fallopian tubes, or uterus

where is aorta

immediately behind peritoneum

common symptom of aortic aneurysm

tearing back pain as aneurysm is expanding and tearing

hernias

- protrusion of an organ or tissue through an opening into body cavity where it does not belong - may not always produce noticeable mass or lump

strangulation

• contents may become compressed by surrounding tissue -> compromise blood supply

• immediate surgery

hernia is a result of

- congenital defect around ubilicus - surgical wound that has failed to heal properly - natural weakness in area

what can decrease nausea and anxiety

low flow oxygen

what is the only definite treatment for chronic kidney failer

dialysis