NUR 416 Lecture Notes - Lecture 12: Hypovolemia, Fecolith, Peritonitis
23 Apr 2020
School
Department
Course
Professor
Document Summary
Most common cause of emergency abdominal surgery in childhood. Etiology: obstruction of the lumen of the appendix. Acute obstruction blocks outflow of mucous secretions: causes increased pressure within the lumen, blood vessels compress, leads to ischemia, ulceration, & necrosis, causes perforation. Fecal & bacterial contamination of the peritoneal cavity. Inflammation spreads throughout the abdomen: peritonitis, progressive inflammation results in functional intestinal obstruction of the small bowel as intense gi reflexes severely inhibit bowel motility. Electrolyte imbalance & hypovolemic shock develop as a restful of loss of extracellular fluid into peritoneal cavity. Classic pattern: periumbilical pain followed by. Pain begins as colicky cramping, pain around the umbilicus. As inflammation progresses, pain localizes to the rlq: most common point of tenderness is mcburney point, 2/3 distance from umbilicus to anterosuperior iliac spine. Rebound tenderness may be present, but isn"t specific to appendicitis. Rovsing sign: pain in the rlq occurs with palpation/percussion in other abdominal quadrants.
