GNRN 115 Fall 2025 - GI_GU

Assessment of the GI/GU System

Introduction

  • Assessment focuses on the gastrointestinal (GI) and genitourinary (GU) systems.
  • Presented by Professor Anna Chen at Touro College & University System.

Gastrointestinal (GI) System

GI Anatomy and Physiology Review
  • GI Tract Components:
    • Oral Cavity
    • Pharynx
    • Esophagus
    • Stomach
    • Small Intestine
    • Large Intestine
    • Anal Canal
  • Accessory Organs:
    • Teeth
    • Tongue
    • Salivary Glands
    • Liver
    • Gallbladder
    • Pancreas
  • Main Functions of the GI System:
    • Ingestion and digestion of food
    • Nutrient absorption
    • Secretion of water and enzymes
    • Excretion of waste products
Digestive Processes
  • Propulsion:
    • Swallowing in the oropharynx
    • Peristalsis: rhythmic contraction of the muscles to propel food through GI tract.
  • Ingestion of Food: Initiated in the oral cavity, continuing through the esophagus, stomach, small intestine, and large intestine.
  • Absorption:
    • Nutrients and water absorbed into blood vessels and lymph vessels in the small intestine.
    • Water absorbed in blood vessels in the large intestine.
  • Defecation: elimination of feces through the anus.
Organ Functions in the Digestive Process
  • Mouth:
    • Ingests food
    • Chews and mixes food
    • Begins chemical breakdown of carbohydrates
  • Pharynx:
    • Moves food to the esophagus.
  • Esophagus:
    • Propels food to the stomach.
  • Stomach:
    • Mixes and churns food with gastric juices to form chyme.
    • Begins chemical breakdown of proteins and lipids through various secretions (e.g., lingual lipase).
  • Small Intestine:
    • Main site for digestion and absorption.
    • Physical digestion via segmentation.
  • Large Intestine:
    • Absorbs leftover water, electrolytes, and vitamins.
    • Propels feces towards the rectum for elimination.
  • Accessory Organs' Functions:
    • Liver: produces bile salts for lipid emulsification.
    • Gallbladder: stores and releases bile.
    • Pancreas: produces digestive enzymes and bicarbonate to neutralize acidic chyme.
Techniques and Methods in GI Assessment
Patient Preparation
  • Ask the patient to empty the bladder.
  • Position: lie supine with knees bent to relax abdominal muscles and arms at sides.
Examination Order
  1. Inspection
  2. Auscultation
  3. Percussion
  4. Palpation
  • Note: Understand organ positioning and observe for signs of patient discomfort.
Divisions of the Abdomen
  • Common Methods:
    • Quadrants
    • Regions
  • Abdominal Quadrants:
    • Right Upper Quadrant (RUQ): liver, transverse colon, gallbladder, etc.
    • Left Upper Quadrant (LUQ): stomach, spleen, left kidney, etc.
    • Right Lower Quadrant (RLQ): appendix, cecum, right ovary, etc.
    • Left Lower Quadrant (LLQ): descending and sigmoid colon, left ovary, etc.
Clinical Signs in Abdominal Assessment
  • Abdominal Pain Types:
    • Visceral Pain: vague, deep, crampy; associated symptoms may include nausea.
    • Parietal Pain: sharp and localized; from inflammation of peritoneum.
    • Referred Pain: pain felt in an area other than the origin; e.g., spleen pain may refer to the left shoulder.
GI Assessment Questions
  • Subjective Assessment:
    • Past GI, kidney, bladder conditions (e.g., ulcers, gallbladder disease).
    • Any abdominal surgeries.
    • Current medications, herbs, or supplements.
    • Presence of abdominal pain, associated symptoms like fever or nausea, bowel patterns, appetite/weight changes.
GI Inspection
  • Visual abdominal examination for:
    • Shape (flat, rounded, distended, scaphoid)
    • Scars, striae, masses, abnormal movements
    • Color changes (e.g., jaundice)
    • Signs of ventilation (e.g., dilated veins)
Specific Signs of Abdominal Issues
  • Rovsing's Sign: pain in RLQ upon palpation in LLQ, indicative of appendicitis.
  • McBurney's Point: tenderness in RLQ on palpation indicates appendicitis.
  • **Psoas and Ob