Gastrointestinal Tract Assessment
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Gastrointestinal Tract Assessment

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Questions and Answers

What is a sign of confusion that may be related to liver dysfunction?

  • Cognition issues (correct)
  • Sleep disturbances
  • Muscle spasms
  • Vision problems
  • Which symptom is commonly associated with the accumulation of bile salts in the skin?

  • Cyanosis
  • Pale skin
  • Jaundice (correct)
  • Redness
  • What is the significance of assessing upper right quadrant pain in liver assessment?

  • Indicates issues with the gallbladder
  • Could suggest kidney stones
  • Points to digestive tract problems
  • May signal liver inflammation or disease (correct)
  • What is the purpose of checking for ascites during a liver assessment?

    <p>To evaluate fluid accumulation due to liver dysfunction</p> Signup and view all the answers

    Which assessment method might be used to evaluate the liver span?

    <p>Percussion</p> Signup and view all the answers

    What is one of the primary functions of the spleen?

    <p>Production of lymphocytes</p> Signup and view all the answers

    Which symptom is commonly associated with potential spleen issues?

    <p>Nausea or vomiting</p> Signup and view all the answers

    Which of the following is an endocrine function of the pancreas?

    <p>Production of insulin and glucagon</p> Signup and view all the answers

    What should be noted during the inspection of a patient possibly having a splenic issue?

    <p>Diaphoresis and fever</p> Signup and view all the answers

    What assessment technique is used to identify an abnormal bulge in the spleen?

    <p>Palpation</p> Signup and view all the answers

    What is the primary function of the gall bladder?

    <p>To store and concentrate bile</p> Signup and view all the answers

    Which symptom is NOT typically associated with gall bladder issues?

    <p>Excessive thirst</p> Signup and view all the answers

    What factor primarily triggers referred pain from gall bladder issues?

    <p>Fatty meals</p> Signup and view all the answers

    Which of the following is a common complication of cholelithiasis?

    <p>Cholecystitis</p> Signup and view all the answers

    What finding is associated with the absence of bile salts in stool?

    <p>Grey-colored stool</p> Signup and view all the answers

    Which symptom may suggest irritation of the abdominal area?

    <p>Nausea/vomiting</p> Signup and view all the answers

    What sign can indicate severe abdominal conditions through bruising around the umbilicus?

    <p>Cullen Sign</p> Signup and view all the answers

    Decreased bowel sounds may indicate which of the following conditions?

    <p>Abdominal distension</p> Signup and view all the answers

    What is a common assessment step for detecting kidney issues?

    <p>Checking for flank pain</p> Signup and view all the answers

    What does the Grey Turner Sign indicate?

    <p>Bruising in the flanks</p> Signup and view all the answers

    In assessing urinary history, which symptom is significant?

    <p>Urinary frequency changes</p> Signup and view all the answers

    What is one of the primary functions of the kidneys?

    <p>Excretion of waste products</p> Signup and view all the answers

    What condition may result in undernutrition and weight loss?

    <p>Renal failure</p> Signup and view all the answers

    What is the primary function of the oral cavity in the gastrointestinal tract?

    <p>Mastication and initiation of a bolus</p> Signup and view all the answers

    Which area may indicate gastric ulcers when experiencing pain?

    <p>Mid upper quadrant</p> Signup and view all the answers

    Which special test for appendicitis involves increased pain with pressure at a specific point?

    <p>McBurney's point</p> Signup and view all the answers

    When palpating the left lower quadrant, which symptom can indicate appendicitis?

    <p>Worsening pain in the RLQ</p> Signup and view all the answers

    What condition is characterized by blood or mucus in stools?

    <p>Inflammatory bowel syndrome</p> Signup and view all the answers

    Which gastrointestinal organ is primarily responsible for the absorption of nutrients?

    <p>Small intestine</p> Signup and view all the answers

    Which symptom is NOT typically associated with the early stages of appendicitis?

    <p>Severe rectal bleeding</p> Signup and view all the answers

    Which of the following indicates the presence of bowel sounds during auscultation?

    <p>Presence in all quadrants</p> Signup and view all the answers

    Study Notes

    Gastrointestinal Tract

    • The oral cavity is where the initial breakdown of food occurs through mastication, forming a bolus, and the introduction of digestive enzymes.
    • The stomach temporarily stores food, further mechanically breaks it down (grinding), and produces enzymes and specialized cells for digestion.
    • The small and large intestines are responsible for further/final breakdown, digestion, absorption, and elimination of waste.

    Assessment of the GI Tract

    • Pain:
      • Right or Left or Mid Upper Quadrants: Gastric ulcers
      • Epigastric: Epigastric hernia, heartburn, GERD
      • Right Mid Abdomen: Constipation
      • Umbilical Region: Early appendicitis, umbilical hernia, bowel pain
      • Left Mid: Diverticulitis, inflammatory bowel syndrome
      • Right Lower Quadrant: Appendicitis, constipation, inguinal hernia
      • Mid Lower: Diverticular disease, inflammatory bowel
      • Right Lower: Diverticulitis and inguinal hernia
    • Other History:
      • Nausea or vomiting
      • Appetite
      • Heartburn
      • Diarrhea or constipation or any changes in bowel function
      • Cramping
      • Blood/mucous in stools

    Inspection

    • Contour: Symmetry, discolouration

    Auscultation

    • Presence of Bowel Sounds in 4 quadrants

    Percussion

    • Dullness vs. general tympany

    Palpation

    • Lumps, bumps, masses

    Special Tests for Appendicitis

    • McBurney’s Point: Right abdomen between the umbilicus and the iliac crest – increased pain with pressure.
    • Rovsing’s Sign: Palpation of the LLQ causes pain in the RLQ.
    • Rebound Tenderness: Removal of pressure rather than the application of pressure causes pain.

    Liver

    • Primary Functions:
      • Cognition
      • Skin
      • Medication toxicities
      • S/S of Infection
      • Ascites and Third spacing of fluids
      • Nutritional Status
      • Abnormal Bleeding

    Assessment of the Liver

    • Assessments:
      • Upper right quadrant pain
      • Right shoulder pain (referred pain)
    • Special Tests:
      • Inspection: Ascites, spider angioma, contour of abdomen related to ascites
      • Auscultation: Of abdomen in general
      • Percussion: To find the liver span
      • Palpation: Gentle palpation from the umbilicus upwards with a flat hand

    Gallbladder

    • Primary Functions:
      • Stores and concentrates bile from the liver
      • Excretes bile into the duodenum via the cystic duct
      • Bile is required for the breakdown and absorption of fats
      • Some involvement in the removal of waste from the liver to the intestine.

    Assessment of the Gallbladder

    • Common Issues:
      • Stones (cholelithiasis)
      • Infections (cholecystitis)
    • History Questions:
      • Nausea/vomiting
      • Fever/chills
      • Jaundice
      • Changes in colour of stools (usually to grey – no bile salts to colour them)
    • Pain and Referred Pain:
      • Upper right or mid abdomen
      • Radiation to the right shoulder or mid back, especially after eating a fatty meal
    • Assessment:
      • Inspection
      • Auscultation
      • Percussion
      • Palpation: Tenderness to RUQ
    • Special Tests:
      • Signs of Peritoneal Irritation
      • Guarding
      • Rigidity and tenderness

    Spleen

    • Primary Functions:
      • Production of lymphocytes (B and T cells)
      • Removal of old or damaged red blood cells
      • Can be a reservoir for blood in trauma or hemorrhage
      • Retains iron, which is needed for the production of hemoglobin

    Assessment of the Spleen

    • History Questions:
      • Left Upper Quadrant abdominal pain
      • Bloating or early satiety
      • Nausea or vomiting
      • Problems with either diarrhea or constipation
    • Inspection:
      • Can you see a bulge or is the abdomen misshapen?
    • Auscultation:
      • Cannot normally hear anything
    • Percussion:
      • Look for abnormal dullness in the ULQ at the costal margin
    • Palpation:
      • Palpate laterally to identify an abnormal bulge – follow the edge along until you feel the ledge (normally not palpable)

    Pancreas

    • Primary Functions:
      • Exocrine Function: Production and release of enzymes that aid in the digestion of food.
      • Endocrine Function: Regulation of blood glucose through the production and excretion of insulin and glucagon.

    Assessment of the Pancreas

    • History:
      • Pain: Upper left or mid abdominal pain with radiation to the mid back or chest, may be reduced by leaning forward and exacerbated by cough, movement, or even deep breathing.
      • Nausea/vomiting
      • Flatulence, diarrhea, steatorrhea
      • Abdominal distention
      • Undernutrition, weight loss
      • Fatigue
    • Inspection:
      • Patient may be diaphoretic, febrile, tachycardic, and tachypneic.
    • Auscultation:
      • Decreased bowel sounds.
    • Percussion:
      • Not specified
    • Palpation:
      • Not specified
    • Special Tests:
      • Grey Turner Sign: Bruising to flanks
      • Cullen Sign: Bruising around the umbilicus
      • These signs are rare and have a poor prognosis.

    Kidneys

    • Primary Functions:
      • Regulation of electrolyte and fluid balance
      • Regulation of blood pH
      • Production of hormones important for red blood cell production, calcium regulation, and blood pressure regulation
      • Excretion of waste products from the blood

    Assessment of the Kidneys

    • History:
      • Urinary history: Volume, changes in patterns, hematuria, pyuria, colour and odour, retention or no voiding.
      • History of illness related to renal/urinary disease: Infections (including recent strep infections), cancers, BPH, renal calculi.
      • Pain assessment: Normally flank pain
      • Edema (usually dependent edema)
      • Blood pressure changes
    • Physical Assessment:
      • Inspection: Flank areas, look for swelling, bruising.
      • Auscultation: Listen as CVA for bruits and at upper abdomen for renal arteries.
      • Percussion: CVA tenderness.
      • Palpation: Kidneys are deep palpation so you don’t have to do this, palpation of the bladder.

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    Description

    This quiz covers key concepts related to the gastrointestinal tract, including the anatomy and functions of the oral cavity, stomach, and intestines. Additionally, it assesses knowledge on various gastrointestinal pain indicators and their associated conditions. Test your understanding of digestive health and pathologies.

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