testing for ulnar artery patency before doing a radial artery ABG

hold radial and ulnar arteries with hand in a fist, open first and release ulnar artery see if it works

1.JVD

2. muffled heart sounds

3. decreased blood pressure

Seen in cardiac tamponade

1. mental status changes

2. petechiae (axilla/thorax)

3. dyspnea

Seen in fat emboli syndrome

-metastatic disease to the pouch of douglas or rectovesical pouch

-palpable on rectal exam

1. Emesis then no emesis

2. epigastric distention

3. failure to pass NgT

Seen with gastric volvulus

1. flushing

2. diarrhea

3. right sided heart failure

1. fever

2. jaundice

3. RUQ pain

cholangitis

hypocalcemia

(facial nerve tap leads to facial twitching)

-enlarged nontender gallbladder seen with CBD obstruction

-most often seen with pancreatic cancer

-(not seen in acute cholecystitis b/c of scarred gallbladder)

1. hypertension

2. bradycardia

3. irregular respiration

seen in ICP

differentiates intra-abdominal mass from abdominal wall mass

Abdominal wall mass is felt when muscles are tense

1. Anterior anal fistulae travel in a straight path

2. posterior ones travel in a curved path

crunching sound on heart auscultation

results from air in mediastinum

wall tension = pressure x radius

so colon tends to perforate at cecum because of increased radius

painful/impossible inspiration when URQ is palpated

seen in acute cholecystitis

1. fever

2. jaundice

3. RUQ pain

4. mental status change

5. shock/sepsis

seen with suppurative cholangitis

1. cholelithiasis

2. hiatal hernia

3. diverticulae

1. stasis

2. abnormal endothelim

3. hypercoaguability

risks for thrombosis

bronchospasm

flushing

diarrhea

right sided heart failure

leads to muscle necrosis

often seen in calf

pulse may still be present

hyperosmolar chyme dumps into SI, usually after vagotomy and gastric drainage

it leads to autonomic instability, abdominal pain, diarrhea