GI and Hepatic Recap

Inspection, Auscultation, Percussion, Palpation

listen for 3 minutes
if you don't hear anything - emergent, obstruction likely

inflammation of the gallbladder

infection or obstruction in gallbladder or bile ducts

fever, n/v, jaundice, anorexia, pain in URQ or RIght shoulder, pain increases with deep breath, fat intolerance

cholecystectomy - remove!

place your fingers where the gallbladder is, and ask the patient to inhale - Painful

10-19 yr old, more common in boys and men

Right lower quadrant abdominal pain
anorexia
nausea and vomiting
periumbilical pain that migrates to Right LQ
Fever

appendectomy
antibiotics

poke and it hurts, near appendix

palpate on opposite side, and they feel it near their appendix

put pt into hip extension, and they have pain

put pt into IR and Knee flexion - feel pain

Right lower quadrant pain

IBS has no tissue abnormality, and treated with diet mainly and motility and anti diarrheal
IBD is chronic intestinal inflammation, auto immune, and treated with steroids, anti inflammatories, and immunosupressants

immune effects, bone strength decreases, high amount of osteoporosis, muscle weakness, tendinopathies and muscle belly weakness

lack of movement in the intestines, caused by air

partial or total obstruction

necrosis, peritonitis

not moving, anesthesia, narcotics (stop your bowels)

abdominal distention with increased bowel sounds, constipation, previous abdominal surgery

throwing up blood

blood in stool

Bright red blood per rectum

dark stool

shock, angina

Tooth loss/decay
decreased taste sensation
decreased saliva
decreased digestive enzymes
decreased gastric absorption
decreased motility in large intestine

inflammation in that part of the colon, diverticulosis is the little pockets/holes without the inflammation yet
diverticulosis is not a problem on its own

decreased volume and blood flow
increased oxidative stress
increased inflammatory response
decreased mitochondrial function
decreased regenerative function

for GERD, take the top part of your stomach and wrap it

for chronic inflammatory bowel disease, if you have an obstruction can create a new route

create a bypass for waste to come out of

reversal of procedure of ileostomy/colostomy

often used for cancer, remove a large part of the stomach
need a huge diet change after, watch pt's nutrition

band attaches to a port outside the stomach, with saline can increase tightening of the band to give pt the feeling of fullness sooner so they eat less

really bad cancer, pouch from stomach directly to jejunum, bypass the duodenum
impacts absorption of nutrients