TAILIEUCHUNG - Ebook bates' pocket guide to physical examination and history taking (7th edition): Part 2

(BQ) Part 2 book "Bates' pocket guide to physical examination and history taking" presents the following contents: The abdomen, the peripheral vascular system, male genitalia and hernias, female genitalia, the anus, rectum, and prostate, the musculoskeletal system, the nervous system,. and other contents. | CHAPTER The Abdomen 11 The Health History Common or Concerning Symptoms Gastrointestinal Disorders Abdominal pain acute and chronic Indigestion nausea vomiting including blood loss of appetite early satiety Dysphagia and or odynophagia Change in bowel function Diarrhea constipation Jaundice Urinary and Renal Disorders Suprapubic pain Dysuria urgency or frequency Hesitancy decreased stream in males Polyuria or nocturia Urinary incontinence Hematuria Kidney or flank pain Ureteral colic PATTERNS AND MECHANISMS OF ABDOMINAL PAIN Be familiar with three broad categories Visceral pain occurs when hollow abdominal organs such as the intestine or biliary tree contract unusually forcefully or are distended or stretched. May be difficult to localize Varies in quality may be gnawing burning cramping or aching Visceral pain in the right upper quadrant RUQ from liver distention against its capsule in alcoholic hepatitis 179 180 Bates Pocket Guide to Physical Examination and History Taking When severe may be associated with sweating pallor nausea vomiting restlessness. Parietal pain from inflammation of the parietal peritoneum. Steady aching Usually more severe Usually more precisely localized over the involved structure than visceral pain Referred pain occurs in more distant sites innervated at approximately the same spinal levels as the disordered structure. Pain from the chest spine or pelvis may be referred to the abdomen. Visceral periumbilical pain in early acute appendicitis from distention of inflamed appendix gradually changes to parietal pain in the right lower quadrant RLQ from inflammation of the adjacent parietal peritoneum. Pain of duodenal or pancreatic origin may be referred to the back pain from the biliary tree to the right shoulder or right posterior chest. Pain from pleurisy or acute myocardial infarction may be referred to the upper abdomen. THE GASTROINTESTINAL TRACT Ask patients to describe the abdominal pain in their own words especially timing of the pain

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