Appendicitis

Question 1

appendicitis

Answer 1

inflm of wall of appendix

Question 2

appendix location

Answer 2

right lower abd and attached to the cecum (beginning of large intestine)

Question 3

fx of appendix

Answer 3

stores good bacteria to regenerate normal flora after a diarrheal illness

Question 4

etiology

Answer 4

• idiopathic

- 2 theories of obstruction

Question 5

2 theories of obstruction (etiology)

Answer 5

1) twisting of bowel or appendix blocks the entrance and exit of secretions and blood flow
2) intraluminal obstruction d/t fecalith blocking case of appendix

Question 6

fecalith

Answer 6

hard fecal particle

Question 7

pathology (7 steps)

Answer 7

1. lumen obstruction causes drainage into cecum to be blocked
2. goblet cells secreted on inner lining of appendix in large amounts of mucin and builds up
3. build-up of mucus inc d/t blocked drainage and causes an inc in pressure within appendix
4. pressure pushes onto the outer wall and the blood vessels get pinched shut and cause venous stasis and lack of blood flow
5. ischemia results and infarction eventually occurs if obstruction not alleviated
6. bacteria stored in appendix moves to resulting necrotic tissue and causes an infection within appendix wall (appendicitis)
7. infection leads to inflm of appendix wall causing swelling and exudate production

Question 8

mnfts

Answer 8

• nausea episodes
• pain (referred pain, rebound pain, guarding pain, pain intensifies)
• fever and elevated WBC

Question 9

referred pain w/ abrupt onset located where

Answer 9

epigastric or periumbilical regions

Question 10

rebound pain

Answer 10

palpate and release, on release there is pain

Question 11

protected/guarding pain

Answer 11

pain when not bent over

Question 12

McBurney’s Point

Answer 12

anterior superior aspect of iliac crest, draw line to umbilicus and about 1/3 of distance to umbilicus is base of appendix attaches to cecum

Question 13

Dx

Answer 13

• Hx and Px
• U/S and CT scan (determine size)
• McBurney’s Point

Question 14

Tx

Answer 14

• IV fluids
• Abx (for infect in appendix wall)
• appendectomy ASAP if needed (any delay –> perforation and peritonitis)