Appendicitis By Rnpedia.Com

The appendix is located on the right lower side of the abdomen.

Surgery is the definitive treatment for appendicitis. It may be performed as an open surgery or through a laparoscope. Antibiotics are also useful in treating appendicitis, but usually require to be followed by surgery due to recurrence.

The correct answer is surgical removal of inflamed appendix before it ruptures. Appendicitis is the inflammation of the appendix, which can lead to rupture if not treated promptly. The most effective treatment for appendicitis is the surgical removal of the inflamed appendix, known as an appendectomy. This procedure is performed to prevent the appendix from bursting and causing a potentially life-threatening infection. Pain control and antibiotics may be used to manage symptoms and prevent infection, but they are not a definitive treatment for appendicitis.

The inflamed appendix can burst resulting in inflammation of the lining of the abdomen (peritoneum), the condition being called peritonitis.

Increase in WBC counts is suggestive of appendicitis because of bacterial invasion and inflammation. Normal WBC count is 5, 000 – 10, 000/mm3. Other options are normal values.

Symptoms of appendicitis include abdominal pain, nausea, vomiting, loss of appetite, low grade fever, constipation, diarrhea and an inability to pass gas. A swelling may subsequently appear in the abdomen overlying the appendix.

To be exact, the appendix is anatomically located at the Mc Burney’s point at the right iliac area of the right lower quadrant.

WBC increases with inflammation and infection.

The patient's symptoms of periumbilical pain that migrates to the RLQ, along with nausea, vomiting, and a low-grade fever, are highly suggestive of acute appendicitis. The pain worsening with walking, coughing, or a car ride is a classic symptom known as "McBurney's sign." Acute appendicitis is the inflammation of the appendix and is a common surgical emergency that requires immediate intervention to prevent complications such as perforation or abscess formation. Ovarian cyst, volvulus, acute pancreatitis, and acute cholecystitis do not typically present with the same combination of symptoms as described by the patient.

Diet lacking in fiber is a risk factor for appendicitis.

Pain over McBurney’s point, the point halfway between the umbilicus and the iliac crest, is diagnosis for appendicitis. Options b and c are common with ulcers; option d may suggest ulcerative colitis or diverticulitis.

Pain in appendicitis normally starts around the umbilicus but later settles in the right lower abdomen near the appendix. This point is called the McBurney Point and is located midway between the umbilicus and the top of the right pelvic bone.

Other conditions like gall stones, inflammation of gall bladder, stone in the ureter, ruptured ovarian follicle, a ruptured tubal pregnancy, perforation of stomach or duodenal ulcer, and inflammation of the right colon can produce pain similar to appendicitis.

A client with appendicitis is at risk for infection related to inflammation, perforation, and surgery because obstruction of the appendix causes mucus fluid to build up, increasing pressure in the appendix and compressing venous outflow drainage. The pressure continues to rise with venous obstruction; arterial blood flow then decreases, leading to ischemia from lack of perfusion. Inflammation and bacterial growth follow, and swelling continues to raise pressure within the appendix, resulting in gangrene and rupture. Geriatric, not middle-aged, clients are especially susceptible to appendix rupture.

Complications of acute appendicitis are peritonitis, perforation and abscess development.

Peritonitis will cause all of the above symptoms. The peritoneum has a natural tendency to GUARD and become RIGID as to limit the infective exudate exchange inside the abdominal cavity. Hypovolemia and F&E imbalance are caused by severe nausea and vomiting in patients with peritonitis because of acute pain. As inflammation and infection spreads, fever and chills will become more apparent causing elevation in temperature, weakness and sweating. If peritonitis is left untreated, Client will become severely hypotensive leading to shock and death.

If a confirmed diagnosis is made and the pain suddenly without any intervention, the appendix may have ruptured; the pain is lessened because the appendix is no longer distended thus surgery is still needed.

A client with appendicitis is at risk for infection related to inflammation, perforation, and surgery because obstruction of the appendix causes mucus fluid to build up, increasing pressure in the appendix and compressing venous outflow drainage. The pressure continues to rise with venous obstruction; arterial blood flow then decreases, leading to ischemia from lack of perfusion. Inflammation and bacterial growth follow, and swelling continues to raise pressure within the appendix, resulting in gangrene and rupture. Geriatric, not middle-aged, clients are especially susceptible to appendix rupture.

Appendicitis is primarily caused by the obstruction of the lumen, which is the opening, between the cecum and appendix. When this opening gets blocked, it can lead to the inflammation and infection of the appendix, resulting in appendicitis. Inflammation due to an immune response, constipation, and overuse of antibiotics are not the primary causes of appendicitis.

Worms can block the opening of the appendix resulting in appendicitis. In addition, fecaliths, infection or inflammation can also block the opening of the appendix leading to appendicitis.

A fecalith is a hard piece of stool which is stone like that commonly obstructs the lumen. Due to obstruction, inflammation and bacterial invasion can occur. Tumors or foreign bodies may also cause obstruction.

Pre-op care for acute appendicitis typically includes obtaining consent from the patient or their legal guardian, preparing the skin in the area of the surgery, and removing any jewelry that the patient may be wearing. However, an enema is not typically performed as part of the pre-op care for appendectomy. Therefore, the correct answer is "Enema STAT."

Posturing by lying with legs drawn up can relax the abdominal muscle thus relieve pain.

Paralytic Ileus is a mechanical bowel obstruction where in, the patients intestine fails to regain its motility. It is usually caused by surgery and anesthesia. Intusussusception, Appendicitis and Peritonitis also causes paralytic ileus.

During the rectoanal inhibitory reflex, the internal sphincter relaxes, allowing the contents into the anal canal, then the external sphincter contracts and contents are pushed back into the rectum. This reflex helps in the process of defecation by coordinating the relaxation and contraction of the sphincters to allow the passage of stool through the anal canal and then prevent leakage back into the rectum. This reflex occurs multiple times daily to facilitate regular bowel movements.

The portal vein is responsible for carrying venous blood from the intestines to the liver. This vein plays a crucial role in the hepatic portal system, which allows nutrients and other substances absorbed by the intestines to be processed and metabolized by the liver before being distributed to the rest of the body. The other options listed, such as the iliac veins, middle colic vein, inferior mesenteric vein, and superior mesenteric vein, do not perform this specific function of carrying blood from the intestines to the liver.

Client's peristalsis will return in 48 to 72 hours post-op therefore, Fluid and food are witheld until the bowel sounds returns. Remember that ALL PROCUDURES requiring GENERAL and SPINAL anesthesia above the nerves that supply the intestines will cause temporary paralysis of the bowel. Specially when the bowels are traumatized during the procedure, it may take longer for the intestinal peristalsis to resume.

Spinal anesthesia is the most common method used in appendectomy. Using this method, Only the area affected is anesthetized preventing systemic side effects of anesthetics like dizziness, hypotension and RR depression.

Possible causes of an obstructed appendix include inflammatory bowel disease, infection, fecal stasis, calcium salts or undigested fiber-fecaliths, parasites, foreign bodies (FB), and neoplasms. These factors can lead to a blockage in the appendix, resulting in inflammation and potentially leading to appendicitis.

The rectum is the correct answer because it extends from the rectosigmoid junction to the anal canal and is composed of insensitive columnar epithelium. The anal canal is the terminal part of the large intestine, but it is not composed of insensitive columnar epithelium. The colon and large bowel are also parts of the large intestine, but they do not extend all the way to the anal canal.

The superior mesenteric artery supplies blood to the small intestine (other than the duodenum) and the proximal colon. This artery is a major branch of the abdominal aorta and is responsible for providing oxygenated blood to these specific regions of the gastrointestinal (GI) tract. The duodenum, cecum, and rectum are not directly supplied by the superior mesenteric artery.

In a patient with suspected appendicitis, the expected findings include pain with guarding and rebound tenderness, along with pain upon passive flexion of the right hip. The absence of pain upon passive flexion of the left hip is also expected. Additionally, a positive obturator sign is likely to be present.

The appendix is made up of lymphatic tissue. Lymphatic tissue is a type of connective tissue that contains lymphocytes, which are white blood cells involved in the immune response. The appendix is part of the lymphatic system and plays a role in the immune function of the body.

The superior rectal artery supplies blood to the upper and middle rectum. This artery is a branch of the inferior mesenteric artery and is responsible for providing oxygenated blood to the rectal region. It plays a crucial role in maintaining the blood supply to this area of the gastrointestinal tract, ensuring proper functioning and health of the upper and middle rectum.

The correct answer is the celiac artery, superior mesenteric artery, and inferior mesenteric artery. These three major branches of the aorta supply blood to the intestines. The celiac artery supplies blood to the upper part of the intestines, including the stomach, liver, and spleen. The superior mesenteric artery supplies blood to the middle part of the intestines, including the small intestine and the first half of the large intestine. The inferior mesenteric artery supplies blood to the lower part of the intestines, including the second half of the large intestine and the rectum.

In the given question, the correct answer is 10%. This means that approximately 10% of people will experience appendicitis at some point in their lifetime. Appendicitis is a condition characterized by inflammation of the appendix, which is a small organ located in the lower right abdomen. While the exact percentage may vary, studies suggest that around 10% of the population will develop appendicitis, requiring surgical removal of the appendix.

When the appendix is obstructed, the inflamed tissue becomes infected and dies due to the lack of blood supply. As a result, the appendix eventually bursts. The obstruction prevents proper blood flow to the appendix, leading to tissue death and subsequent infection. The pressure buildup caused by the obstruction further contributes to the bursting of the appendix.

The anal canal is a 3-4 cm long structure that starts at the dentate line. It is supported by the internal and external anal sphincters and is composed of sensitive squamous epithelium.

The inferior rectal artery supplies blood to the internal and external anal sphincters. These sphincters are located at the opening of the anus and are responsible for controlling the passage of stool. The blood supply from the inferior rectal artery ensures that these muscles receive the necessary oxygen and nutrients for their proper functioning.

The cecum is the blind sac that is located in the right lower quadrant (RLQ) below the ileocecal valve. It is the first part of the large intestine and serves as a site for the fermentation of indigestible materials and the absorption of water and electrolytes. The appendix, transverse colon, and ascending colon are not blind sacs located in the RLQ below the ileocecal valve.

Pain is not reduced in appendicits. Clients are not given pain medication as to assess whether the appendix ruptured. A sudden relief of pain indicates the the appendix has ruptured and client will have an emergency appendectomy and prevent peritonitis. Demerol and Atropine are used to allay client's anxiety pre operatively.

The correct answer is "mid-transverse colon to rectum." The inferior mesenteric artery is a branch of the abdominal aorta that supplies blood to the lower part of the gastrointestinal (GI) tract. It specifically provides blood to the mid-transverse colon, descending colon, sigmoid colon, and rectum. Therefore, the correct answer indicates the correct range of the GI tract that is supplied by the inferior mesenteric artery.

Hypovolemic shock from fluid shifts is a major factor in acute pancreatitis. The other conditions are less likely to exhibit fluid volume deficit.

The mid-transverse colon is responsible for propelling retrograde waves of contraction that allow the cecum to retain liquid feces and act as a 'fermenting vat'. This means that the mid-transverse colon helps in the process of fermentation and retention of liquid feces in the cecum.

Nausea is typically associated with appendicitis with or without vomiting. Pain is generally felt in the right lower quadrant. Rebound tenderness, or pain felt with release of pressure applied to the abdomen, may be present with appendicitis. Low-grade fever is associated with appendicitis.

The contraction of propulsive waves that move stool distally from the cecum is stimulated by the distention of the colonic wall. When the colonic wall becomes stretched or distended, it triggers a reflex response that initiates the contraction of the smooth muscles in the colon. This contraction helps to propel the stool forward and aids in its movement towards the rectum. Distention of the small intestinal wall, the fermenting vat located in the cecum, or the cecum wall do not directly stimulate the contraction of propulsive waves in the same way as the distention of the colonic wall.

The celiac artery supplies blood to the duodenum, which is the first part of the small intestine. This artery originates from the abdominal aorta and branches off to provide oxygenated blood to various organs in the abdominal region, including the stomach, liver, spleen, and pancreas. The duodenum receives its blood supply from the celiac artery through its branches, ensuring proper oxygenation and nutrient delivery to this important part of the gastrointestinal tract.

The diagnostic features of acute appendicitis include low grade fever less than 100.4F/38C, moderate leukocytosis (10,000-20,000), ultrasound, and CT (with contrast depending on body habitus). CT is also helpful if perforation is suspected to diagnose periappendiceal abscess.

The middle rectal artery supplies blood to the lower rectum.

During defecation, the movement of feces into the rectum triggers the voluntary relaxation of the pelvic floor and external sphincter mechanism. This allows for the passage of feces through the anus. Additionally, there is a voluntary increase in intra-abdominal pressure, which aids in the expulsion of feces. The rectoanal inhibitory reflex, on the other hand, is not involved in the initiation of defecation but rather helps to prevent the involuntary release of feces. Voluntary contraction of the external sphincter is also not part of the initiation process, as it would impede the passage of feces.