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Abdomen and gastrointestinal, Study notes of Anatomy

Anatomy

Chapter 18 Abdomen and gastrointestinal info

Typology: Study notes

2022/2023

Uploaded on 11/12/2025

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Concept overview:!
Elimination: represents mechanism that facilitate the excretion of waste products from the body!•
Elimination has a close relationship with nutrition, specifically foods and fluids consumed!•
Adequate fluid and electrolyte balances affect elimination processes, and impaired elimination can •
disrupt fluid and electrolyte imbalances as well as acid-base balance!
!
Anatomy and physiology:!
The abdominal cavity, the largest cavity in the •
human body, constrains the stomach, small and
large intestines, liver, gallbladder, pancreas,
spleen, kidneys, ureters, bladder, adrenal glands,
and major vessels!
In women the uterus, Fallopian tubes, and •
ovaries are also located within the abdominal
cavity!
Lying outside the abdominal cavity, but a vital •
part of the gastrointestinal system is the
esophagus!
!
Peritoneum, musculature, and connective tissue:!
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Alimentary tract:!
Mouth: !•
teeth chew food that is mixed with saliva from three pairs of salivary glands, beginning the ◦
breakdown of carbohydrates !
Esophagus: !•
connecting the pharynx to the stomach is the esophagus, a tube about 10 inches and extending ◦
just posterior to the trachea through the mediastinal cavity and diaphragm. !
The usual ph of the esophagus is between 6 and 8!◦
Stomach: !•
hollow, flask-shaped, muscular organ located directly below the diaphragm, in the upper left ◦
quadrant.!
Contents from the esophagus enter the stomach through the lower esophageal sphincter and ◦
mix with the digestive enzymes and hydrochloride acid to break down proteins and fats as well
as continue the digestion of carbohydrates !
The stomach also liquefies food into chyme and propels it into the duodenum of the small ◦
intestine !
The usual ph of the stomach is 2 to 4!◦
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Concept overview:

  • Elimination: represents mechanism that facilitate the excretion of waste products from the body
  • Elimination has a close relationship with nutrition, specifically foods and fluids consumed
  • Adequate fluid and electrolyte balances affect elimination processes, and impaired elimination can disrupt fluid and electrolyte imbalances as well as acid-base balance Anatomy and physiology:
  • The abdominal cavity, the largest cavity in the human body, constrains the stomach, small and large intestines, liver, gallbladder, pancreas, spleen, kidneys, ureters, bladder, adrenal glands, and major vessels
  • In women the uterus, Fallopian tubes, and ovaries are also located within the abdominal cavity
  • Lying outside the abdominal cavity, but a vital part of the gastrointestinal system is the esophagus Peritoneum, musculature, and connective tissue: Alimentary tract:
  • Mouth: teeth chew food that is mixed with saliva from three pairs of salivary glands, beginning the breakdown of carbohydrates
  • Esophagus: connecting the pharynx to the stomach is the esophagus, a tube about 10 inches and extending just posterior to the trachea through the mediastinal cavity and diaphragm. The usual ph of the esophagus is between 6 and 8
  • Stomach: hollow, flask-shaped, muscular organ located directly below the diaphragm, in the upper left quadrant. Contents from the esophagus enter the stomach through the lower esophageal sphincter and mix with the digestive enzymes and hydrochloride acid to break down proteins and fats as well as continue the digestion of carbohydrates The stomach also liquefies food into chyme and propels it into the duodenum of the small intestine The usual ph of the stomach is 2 to 4

The pyloric sphincter regulates the outflow of chyme into the duodenum

  • Small intestines: The longest section of the alimentary tract, is about 21 feet long beginning at the pyloric office and joining the large insetting at the ileocecal valve 3 sections: duodenum, Jejunum, and ileum The duodenum occupies the first 1 foot and forms a C-shaped curve around the head of the pancreas. The usual ph ranges from 6 to 7. Absorption occurs through the intestinal villi of the duodenum, Jejunum (8ft) and ilium (12ft) The ileocecal valve between the ileum and the large intestine prevents back flow of fecal material
  • Large intestine: 5 feet long, consisting of cecum, appendix, colon, rectum, and anal canal. The ileal contents empty into the cecum through the ileocecal valve: the appendix extends from the base of the cecum 3 parts: ascending, transverse, and descending The end of the descending colon turns medically and inferiority to form the S shaped sigmoid colon Ph is 6.7, the large intestine absorbs water and electrolytes. Stool is formed in the large intestine and held until defecation Accessory organs:
  • Liver: The largest organ in the body is the liver, weighing 3.5 pounds. It lies right under the right diaphragm, spanning over the upper updraft of the abdomen from the fifth intercostal space to slightly below the costal margin The liver is divided into right and left lobes Functions: bile production and secretion for the digestion and absorption of fats and fat solvable vitamins, production of clotting factors and fibrinogen, synthesis of most plasma proteins (albumin and globulin), and detoxification of a variety of substances, including drugs and alcohol
  • Gallbladder: Attached to the inferior surface of the liver is the gallbladder, a pear shaped sac 3 inches long. It concentrates and stores bile produced in the liver The cystic duct combines with the hepatic duct to form the common bile duct, which drains bile into the duodenum
  • Pancreas: The pancreas lies in the upper left abdominal cavity immediately under the left lobe of the liver, behind the stomach Both endocrine and exocrine functions Endocrine secretions include the release of insulin, glucagon, somatostatin, and gastric for carbohydrate metabolism Exocrine secretions contain bicarbonate and pancreatic enzymes that flow into the duodenum Lipase breaks down fats, amylase breaks down carbohydrates, and protease breaks down proteins for absorption
  • Spleen: Highly vascular, concave, encapsulated organ approximately the size of a fist, in the upper left quadrant of the abdomen between the stomach and the diaphragm Two systems: the white pulp(consisting of lymphatic nodules and diffuse lymphatic tissue) and the red pulp (consisting of venous sinusoids) Functions: removal of old or agglutinated erythrocytes and platelets and activation of B and T lymphocytes

More common in men, rates are higher in Hispanic Americans, African Americans, and Asian/ pacific islanders Geography: more common in japan, china, southern and Eastern Europe, and south and Central American Infection: helicobacter pylori infection is a major cause of this cancer Diet: eating large amounts of smoked foods, salted fish and meat, and pickled vetgables increase risk Smoking: the rate of proximal stomach cancer is doubled in smokers Previous stomach surgery Blood type, family history

  • Colorectal cancer: Age: commonly diagnosed in people over 50 years old Diet: high in red or processed meats increases risk Psychical acitvity: lack or physical activity increases risk Weight: being overweight increases risk Smoking: long term smokers are more likely than non smokers to develop and die from colorectal cancer Alcohol: heavy use increases risk Family history: having a first- degree relative with colorectal cancer increases risk Anatomic correlates of the quadrants of the abdomen:
  • Right upper quadrant: Liver and gallbladder Pylorus Duodenum Head of pancreas Right adrenal gland Portion of the right kidney Portions of ascending and trasnverse colon
  • Right lower quadrant: Lower pole of right kidney Cecum and appendix Portion of ascending colon Bladder (if distended) Right ureter Right ovary and salpinx Uterus (if enlarged) Right spermatic cord
  • Left upper quadrant: Left lobe of liver Spleen Stomach Body of pancreas Left adrenal gland Portion of left kidney Portion of trasnverse and descending colon
  • Left lower quadrant: Lower pole of left kidney Sigmoid colon Portion of descending colon Bladdder (if distended) Left ureter Left ovary and salpinx

Uterus( if enlarged) Left spermatic cord Differentiation of abdominal pain:

  • Gastroesophageal reflux: Any age, mid epigastric, may radiate to jaw Heart burn, regurgitation, angina relived by antacids Aggravating:Recumbency, bending, stooping Related symptoms: weight loss Treatment: antacids, sitting up while eating
  • gastroenteritis: Any age, diffuse, cramping Aggravating: food Symtopms: nausea, vomiting, fever, diarrhea Some relief with vomiting or diarrhea Findings: hyperactive BS
  • Gastritis: Alcoholism Epigastric location, constant, burning Aggravating: alcohol, food, salicylates Symptoms: hemorrhage, nausea, vomiting, anorexia Treatment: antacids Findings: epigastric tenderness
  • Peptic ulcer 30-40 years, more men than women Location: epigastrium gastric 1-2 hours after meals, duodenal 2-4 hours after meals, pain in back Burning cramping Aggravating: gastric, food if perforated, duodenal: empty stomach Symtpoms: nausea, vomiting, weight loss, can precipitate asthma attack Treatment: gastric: antacids, duodenal: antacids, food Findings: epigastric tenderness
  • Pancreatitis: Alcoholism, cholelithiasis Location: LUQ, epigastric; radiates to back Sudden onset, steady, severe, knifelike Aggravating: food, lying supine Symtpoms: nausea, vomiting, diarrhea, diaphoresis, fever Treatment: in a knee chest position Findings: abdominal distention, lower BS, LUQ tenderness
  • Appendicitis: At any age, peak 10 to 20 years Location: umbilical moving to RLQ Colicky Aggravating: moving, coughing, sneezing, deep inhalation Symtpoms: nausea, vomiting, fever Treatment: removed, lying still with right leg flexed Findings: muscle guarding, tenderness in RLQ
  • Cholecystitis or cholelithiasis: Adults, more women than men Location: RUQ or epigastric radiates to R shoulder Severe, progressing to constant Aggravating: fatty foods, alcohol

Type 2 diabetes Yellow discoloration of eyes or skin (jaundice):

  • When did you first notice the discoloration or your skin or eyes?
  • Is the yellow discoloration of your skin or eyes associated with abdominal pain, loss of appetite, nausea, vomiting, or fever?
  • In the last year, have you had a blood transfusion or tattoos? Are you using an IV drugs?
  • Do you eat raw shellfish? Have you traveled abroad in last year?
  • Has the color of your urine or stools changed? Risk factors:
  • Bladder cancer: Smoking: the greatest risk for this cancer is smoking Workplace exposures: aromatic amines, Benzedrine and beta-naphthylamine can cause this cancer Not drinking enough fluids Race: whites are two times more likely to develop this cancer than African and Hispanic Americans Age: risk increases with age Gender: men get this cancer more often women Chronic bladder irritation and inflammation: urinary tract infections, kidney and bladder stones, and bladder catheters left in place a long time are linked to this cancer Genetics and family history Problems with urination:
  • Describe the change in your urination. Have you felt any pain or burning when urinating?
  • Have you had any related signs or symptoms such as fever, chills, and back pain?
  • Describe the color of your urine? Is there blood in your urine?
  • Have you had any unexplained weight gain? Have you noticed swelling in your ankles at the end of the day or shortness of breath? Are you urinating less? Colorectal cancer
  • Recommendations to reduce the risk of colorectal cancer (primary) Consume diet high in fruits, vegetables, and whole grain foods; limit intake of high fat foots Participate in moderate to vigorous activity’s for 30 minutes 5 days or more a week Attain and maintain a healthy weight Do not smoke Limit alcohol to no more than 2 drinks per day for men and one drink per day for women
  • Screening recommendations (secondary prevention) Fecal occult blood test annually Flexible sigmoidoscopy every 5 years Colonoscopy ever 10 years Computed tomography (CT) colonoscopy (virtual colonoscopy) every 5 years For individuals with higher risk, screening should begin earlier

Common problems and conditions:

  • Gastroesophageal reflux disease: Clinical findings: patients complain of heart burn occurring more than twice weekly, regurgitation, Dysphagia, which may interrupt sleep Symtpoms are aggravated by lying down, bending, and stooping and relieved by sitting up, antacids, and eating Peptic ulcer disease:
  • An ulcer in the lower end of the esophagus, in the stomach, or in the duodenum is termed peptic ulcer Cholecystitis with cholelithiasis:
  • Inflammation of the gallbladder is termed cholecystitis and is usually associated with gallstones, a condition cholelithiasis
  • Clinical findings: the primary symptoms is pain in right RUQ in the upper abdomen that may radiate the right shoulder or scapula
  • Related symptoms may include nausea, vomiting, restlessness, and diaphoresis Urinary tract infections:
  • These infections may involve the urethra (urethritis), urinary bladder (cystitis), or renal pelvis (pyelonephritis)
  • Most UTS originate from the patients own intestinal tract and ascend through the urethra to the bladder
  • Clinical findings: symptoms of cystitis include dyslexia, frequency (more than every two hours), urgency and suprapubic pain
  • By contrast, older adults report non localized abdominal discomfort and may have cognitive impairment
  • Symptoms of acute pyelonephritis vary from fatigue to sudden onset of fever, chills, vomiting, and flank pain

C. Uses the left hand to life the rib cage away from the abdominal organs D. Uses the pads of the fingertips to depress the abdomen

  1. A nurse inspect the abdomen for skin color, surface charecteristics, and surface movements. What part of the abdominal assessment does the nurse perform next? A. Palpate lightly for tenderness and muscle tone B. Auscultation for bowel sounds C. Palpate deeply for masses or aortic pulsation D. Percussion for tones
  2. A patient reports having abdominal fullness and having vomited several times yesterday and today. What question is appropriate for the nurse to ask in response to this information? A. Has there been a change in the amount of the distention? B. Did you have heartburn before the vomiting? C. What did the vomitus look like? D. Have you noticed a change in the color of your urine or stools?