Term
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Definition
Pathogenesis common to these diseases is:
● Too much acid as well as imbalance of acids/ bicarbonate/ mucus
● Helobacterium pylori (chronic cases)
Incidence:
● Males= 35%
● Females= 25%
● 5-10% of the individuals affected are symptomatic
Etiology: smoking, heavy alcohol use, NSAIDs, Heliobacter infection (Table 6-3 in your text has a great list of NSAID’s with their generic and brand names – nice review!)
Possible presentation:
● Pain in the epigastric or right upper quadrant, may radiate to back
● Black, tarry stool
● Pallor
● Fatigue
● Vomiting blood (more serious)
Aggravating factors: pain is worse at night or on empty stomach
Relevance for physical therapy:
● Consider when presented with lower thoracic or rib cage complaints |
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Term
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Definition
Gallstones come in various shapes and sizes. They irritate the lining of the gallbladder and cause occlusion of the outflow tract.
● Pathogenesis: unclear
● Incidence: 10% of Americans, though much higher in obese females. Incidence increases with age.
● Presentation: frequently asymptomatic, but can present with
o pain in the right upper quadrant, radiating to back
o pain in the scapula and right shoulder
o pain in the neck
o nausea and vomiting
o fever
o tenderness, or mass in the right upper quadrant |
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Term
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Definition
Hepatitis is inflammation of the liver, most often caused by infection. The disease may vary from being subclinical to being life-threatening.
Pathogenesis: viral infection, alcoholism
Presentation of viral hepatitis:
● Fatigue
● Anorexia
● Right shoulder pain
● Headache
● Arthralgias
● Tenderness of the right upper quadrant
Presentation of alcoholic hepatitis:
● Jaundice
● Muscle wasting
● Gynecomastia
● Abdominal bloating
Relevance for the physical therapist: hepatitis is communicable, so be aware of the routes of infection:
● Hepatitis A: fecal-oral
● Hepatitis B and C: percutaneous, oral-oral, veneral |
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Term
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Definition
Colon cancer is the second most frequently diagnosed cancer in the USA, after skin cancer. It primarily seen in individuals >50 years of age, more common in males than females, blacks than white.
Pathogenesis/ risk factors:
● Previous inflammatory bowel disease
● Other previous cancer
● Heavy alcohol use, gallstones, trauma
● History of colorectal cancer or polyps
● A strong family history of colorectal cancer or polyps
● Obesity
Lifetime incidence: 5-6%
Symptoms:
● Progressive constipation
● Bleeding
● Nonspecific complaints: weakness, malaise, weight loss |
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Term
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Definition
Diverticulitis is an inflammation of pouches in the colon, containing trapped feces, most frequently in the descending or sigmoid colons.
Pathogenesis / risk factors: >40 years of age
Clinical presentation:
● Left lower quadrant pain
● Change in stool pattern
● May be associated low back, pelvis, or left leg pain |
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Term
| Enlargement of spleen (splenomegaly) |
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Definition
Pathology/ risk factors:
● Infectious mononucleosis
● Cancer (leukemia and lymphoma)
● Mainly young people
Presentation:
● Flank pain
● Left upper quadrant pain
● Mid-back pain |
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Term
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Definition
● A protrusion of abdominal contents through an opening in the abdominal wall
B. Common Sites
1. inguinal area:
● inguinal hernia
● direct femoral hernia
● indirect femoral hernia
2. diaphragm (hiatal hernia)
3. umbilicus
4. scars (incisional hernia)
C. Epidemiology
1. 10% to 15% of the population has a hernia at any one time
2. male to female ratio is 12 to 1
3. at 75 years-of-age, 45% of individuals will have a hernia
D. Clinical Presentation
1. onset frequently insidious
2. pain located in the groin with or without a mass
3. pain worse with walking and straining |
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