abdomen
-organ between diaphragm and pelvis
-contains many organs and organ systems: digestive, reproductive, endocrine, regulatory
solid abdominal organs
spleen, liver, pancreas, kidneys
hollow abdominal organs
stomach, gallbladder, duodenum, large intestine, small intestine, bladder
peritoneum
the membrane that lines the abdominal cavity and covers the organs within it
-parietal: lines abdominal cavity
-visceral: covers each organ
retroperitoneal space
the area posterior to the peritoneum between the peritoneum and the back
-organs: kidneys, pancreas, aorta, bladder, rectum
visceral pain
a poorly localized, dull, or diffuse pain that arises from the abdominal organs, or viscera
-colic pain: may result from distention/contraction of hollow organs
-persistent pain: originates from solid organs
parietal pain
a localized, intense pain that arises from the parietal peritoneum, the lining of the abdominal cavity
-sharp and constant pain
referred pain
perception of pain in skin or muscles at distant locations
-abdomen has many nerves from different parts of the nervous system
-nerve pathways overlap as they return to the spinal cord
-pain sensation is transmitted from one system to another
tearing pain
-sharp pain that feels as if body tissues are being torn apart
-originates in the aorta
-separation of layers of this large blood vessel caused by aneurysm
appendicitis
-infection of appendix
-appendectomy is usually indicated
-signs and symptoms: persistent right lower quadrant, pain often referred to umbilical region, rupture of appendix (sudden/sever increase in pain, contents released into abdomen causes severe perit
peritonitis
-irritation of peritoneum, usually caused by foreign material in peritoneal space
-parietal peritoneum is sensitive, especially to acidic substances
-irritation causes involuntary contraction of abdominal muscles
-signs and symptoms: abdominal pain and ri
cholecystitis/gallstones
-inflammation of the gallbladder
-often cause by blockage of its outlet by gall stones
-symptoms often worsened by ingestion of fatty foods
-signs and symptoms: sharp right upper quadrant, epigastric pain, pain referred to shoulder
pancreatitis
-inflammation of pancreas
-common with chronic alcohol abuse
-signs and symptoms: epigastric pain, often referred to back or shoulder
gastrointestinal bleeding
-hemorrhage within the lumen of the GI tract
-may be minor to severe
-blood eventually exits (mouth or rectum)
-often painless
-gastric ulcers (holes in GI system from highly acidic gastric juices) can cause severe pain and peritonitis
-signs and symptoms
abdominal aortic aneurysm
-weakening of inner wall of the aorta
-tears and separates from outer layers
-weakened vessel bulges, may continue to grow
-may eventually rupture
-signs and symptoms: progressive abdominal pain, radiates to back, palpable abdominal mass (possibly pulsati
hernia
-hole in abdominal wall, allowing tissue or parts of organs to protrude under skin
-may be precipitated by heavy lifting
-may cause strangulation of tissue or bowel obstruction
-may require surgical repair
-signs and symptoms: sudden onset of abdominal pa
renal colic
-severe pain caused by kidney stones traveling down the ureter
-signs and symptoms: severe/cramping/intermittent pain in flank, frequently referred to groin, nausea, vomiting
cardiac involvement
-pain of myocardial infarction can produce: nausea, vomiting, epigastric pain, indigestion
-always consider the possibility of a cardiac emergency as a cause of abdominal symptoms
scene size-up
-protect self from blood-borne pathogens
-be aware of odors
-determine if patient's condition is medical, trauma or both
assessment
-general impression
-ABC's
-level of consciousness
-history of present illness: OPQRST
-past medical history: SAMPLE
-physical exam: inspection (distention, discoloration, protrusions), palpation (rigidity, pain, guarding)
-baseline vitals then every five
specific questions for female patients
-where in your cycle are you?
-is your period late?
-are you experiencing vaginal bleeding?
-is your flow normal?
-have you experience this pain?
-are you using birth control?
additional geriatric information
-decreased ability to perceive pain
-more serious causes of abdominal pain
-more likely to be life-threatening
-may be complicated by medications