Abdominal Emergencies: Identifying and Managing Acute Conditions, Exams of Gastroenterology

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EMT Chapter 26 Abdominal Emergencies

1. peritoneum: Thin membrane lining the abdominal cavity and covering each organ
2. parietal peritoneum: the outer layer of the peritoneum that lines the interior of the abdominal wall/is attached to the abdominal wall
3. visceral peritoneum: the inner layer of the peritoneum that surrounds the organs of the abdominal cavity
4. retroperitoneal (behind peritoneum): kidneys, pancreas, and part of aorta lie in space
5. inferior: bladder and part of rectum lie to peritoneum
6. visceral pain: - Pain that originates from organs within abdomen

• Fewer nerve endings allow for only diffuse sensations of pain
• Frequently described as "dull" or 'achy'
• Intermittent, crampy, or colicky pain may result from hollow organs
• Persistence or constant pain often originates from solid organs

7. parietal pain: - Pain that originates from the parietal peritoneum

• Many nerve endings allow for pain that is easier to locate and describe

• Frequently described as "sharp"
• Pain is often constant and localized to a specific area

8. tearing pain: - Not the most common type of abdominal pain

• Originates in the aorta or stomach
• Separation of layers of aorta caused by aneurysm
• Retroperitoneal location of aorta causes pain to be referred to back
• Ulcers in stomach can also cause tearing pain

9. referred pain: - Perception of pain in skin or muscles at distant locations

• Abdomen has many nerves from different parts of nervous system
• Nerve pathways overlap as they return to spinal cord
• Pain sensation is transmitted from one system to another

10. appendicitis: Infection of appendix
11. appendicitis: Signs and symptoms:

• Nausea and sometimes vomiting
• Pain often initially referred to umbilical region, followed by persistent RLQ pain
• Rupture of appendix: Sudden, severe increase in pain Contents releasing into abdomen causes severe peritonitis.

12. peritonitis: - Irritation of peritoneum, usually caused by foreign material in peritoneal space

• Irritation causes involuntary contraction of abdominal muscles
• Signs and Symptoms: abdominal pain and rigidity

13. cholecystitis/gallstones: - Inflammation of the gallbladder

• Often caused by blockage of bile flow by gallstones
• Symptoms often worsened by ingestion of fatty foods

14. cholescystitis/gallstones: Signs and Symptoms:

• Severe RUQ or epigastric pain
• Pain often referred to shoulder

15. pancreatitis: - Inflammation of the pancreas

• Common in patients w chronic alcohol abuse
• Signs and symptoms Epigastric pain Often referred to back and/or shoulder

16. gastrointestinal (GI) bleeding: - Bleeding within the GI tract, from

esophagus to rectum

• May be minor to severe
• Blood eventually exits (mouth or rectum)
• Often painless
• Gastric ulcers can cause severe pain and peritonitis

17. gastric ulcers: holes in GI system from highly acidic gastric juices
18. gastrointestinal bleeding: Signs and Symptoms:

• Dark-colored stool (maroon to black), often "tarry"
• Frank blood from rectum
• Vomiting "coffee-ground" appearing blood
• Vomiting of frank blood
• Pain can be absent to severe.

19. abdominal aortic aneurysm: - Ballooning or weakening of inner wall of aorta

• Tears and separates from outer layers (dissection)
• Weakened vessel bulges, may continue to grow
• May eventually rupture

20. abdominal aortic aneurysm: Signs and symptoms;

• Progressive (often sharp or tearing) abdominal pain

• Frequently radiates to back
• Rupture causes rapid onset of excruciating abdominal and back pain
• Signs of shock usually present
• Possible inequality in pedal pulses

21. hernia: - Hole in the muscle layer of abdominal wall, allowing tissue or parts or organs (commonly intestines) to protrude up against skin

• May be precipitated by heavy lifting
• May cause strangulation of tissue or bowel obstruction
• Require transport to hospital for evaluation

22. hernia: Signs and symptoms:

• Sudden onset of abdominal pain, often following lifting
• Palpable mass or lump on abdominal wall or crease of groin

23. renal colic: - Severe flank pain caused by kidney stones traveling down the ureter

• Signs and symptoms -- Severe pain in flank or back -- Frequently radiates to groin -- Nausea, vomiting

24. ectopic pregnancy: - implantation of the fertilized egg in any site

other than the normal uterine location

• rupture can cause life-threatening internal bleeding

25. referred pain: pain that is felt in a place other than where it originates
26. MI: condition where patient may suffer from acute epigastric pain
27. parietal pain: What type of pain is also referred to as peritoneal tenderness?
28. mid-upper abdomen: acute myocardial infarction also presents with dull, cramping pain in the
29. right upper quadrant: quadrant of the abdomen containing the liver and gall- bladder
30. liver: organ that helps regulate carb levels and detoxify the blood
31. small intestin: organ that aids in absorption of nutrients from the intestinal tract
32. left lateral recumbent position: A patient with abdominal pain and experienc- ing airway problems should be transported in this position