B. I.
Pathophysiology: Book-Based
a. Hernia
Modifiable Risk Factors:
>Heavy-lifting
>Excessive coughing/
Non - Modifiable Risk
sneezing (COPD)
Factors:
>Strenuous Activities
> Age
>Constipation
> Sex
>Obesity
> Family History of Hernia
>Pelvic fractures and
trauma
>smoking
Increased
pressure in the
compartment
in the abdomen
is developed
Intra-
abdominal wall
of inguinal
canal becomes
weakened
Preventing
inguinal ring
from closing
Evolves into a
hole or a defect
Fat or part of
the small
intestine slide
through the
inguinal canal
Swollen or enlarged
inguinal area on the
abdomen/ swollen or
enlarged scrotum
Signs & Symptoms:
> A bulge in the area on either side of
the pubic bone
>A burning, gurgling, aching sensation
at the bulge
>Pain or discomfort in the bulge
>Pain and heavy swelling around the
testicles
> A heavy or dragging sensation
>bloated abdomen
b. Ileus / Ileal Perforation
Adhesions: loops of intestine
become adherent to areas that heal
slowly/ scar after abdominal
surgery; produce kinking of an
>SCI, vertebral fractures
>Abdominal surgery
Intussusception: one part of the >Peritonitis
intestine slips into another part
located below it; intestinal lumen >Wound dehiscence
becomes narrowed >G.I. tract surgery
>Thrombosis, embolism
Volvulus: bowel twists & turns on
itself; intestinal lumen becomes
obstructed. Gas and fluid
accumulate in the trapped bowel
Hernia: protrusion of intestine through a
weakened area in the abdominal muscle/
wall; intestinal flow may be completely
obstructed; blood flow to the area may be FUNCTIONAL
obstructed ADYNAMIC
NUEROGENIC
PARALYTIC ILEUS
Tumor: within the intestine, extends
into the intestinal lumen; outside the
intestine, pressure on the wall of the
intestine; intestinal lumen becomes
partially or completely obstructed
Cessation of
peristalsis
MECHANICAL
OBSTRUCTION
Gases and
fluids Bacterial
Borborygmi Activity
accumulate in
the area
Increased contractions
of proximal intestine Distension of
intestine
Increased
intra-luminal Persistent
pressure vomiting
Severe
colicky
abdominal
pain
Inc
secretions into Loss of
hydrogen ions,
the intestine
potassium
Compression
of veins
Metabolic
alkalosis:
Increased venous >Confusion
pressure Hand tremor
>Lightheadedness
>Muscle twitching
> Prolonged
muscle spasms
Decreased
(tetany)
absorption
Edema of the
intestine
Dec. arterial
blood supply
Compression of
terminal branches
of mesenteric
Ischemia
artery
Perforation of Bacteria or
Necrosis necrotic toxins leak
segments into:
Gangrenous
intestinal wall
Blood
Peritoneal
cavity supply
Decreased
bowel Cessation of
sounds peristalsis
Bacteremia,
Peritonitis
Septicemia
Complications:
>Dehydration due to loss of water,
sodium and chloride
> Peritonitis
> Shock due to loss of electrolytes and
dehydration
> Death due to shock
II. Pathophysiology: Client- Based:
a. Hernia
Non - Modifiable Risk Modifiable Risk Factors:
Factors:
>Heavy-lifting
>Age: 45 y/o
>Strenuous Activities
(>30 y/o is at risk)
>Smoking
> Sex: Male
Increased
pressure in the
compartment
in the abdomen
is developed
Intra-
abdominal wall
of inguinal
canal becomes
weakened
Preventing
inguinal ring
from closing
Evolves into a
hole or a defect
Part of the
small intestine
slide through
the inguinal
canal
Swollen or enlarged
mass at inguinal area
on the abdomen
Signs & Symptoms:
> A bulge in the area on the left side of
the pubic bone
>A burning, gurgling, aching sensation
at the bulge
>Pain or discomfort in the bulge
> A heavy or dragging sensation
>Bloated abdomen
b. Ileus / Ileal Perforation
Adhesions: loops of intestine
become adherent to areas that heal
slowly/ scar after abdominal
surgery; produce kinking of an
intestinal loop
—————————————
Volvulus: bowel twists & turns on >Abdominal surgery
itself; intestinal lumen becomes >G.I. tract surgery
obstructed. Gas & fluid accumulate
in the trapped bowel
Hernia: protrusion of intestine
through a weakened area in the
abdominal muscle/wall; intestinal
flow may be completely FUNCTIONAL
obstructed; blood flow to the area ADYNAMIC
may be obstructed NUEROGENIC
PARALYTIC ILEUS
————————————————-
Cessation of
peristalsis
MECHANICAL
OBSTRUCTION
Gases and
fluids Bacterial
Borborygmi
accumulate in Activity
the area
Increased contractions
of proximal intestine Distension of
intestine
Increased
intra-luminal Persistent
pressure vomiting
Severe
colicky
abdominal
pain
Inc secretions
into the
Compression
of veins
Increased venous
pressure
Decreased
absorption
Edema of the
intestine
Dec. arterial
blood supply
Compression of
terminal branches
of mesenteric
artery
Ischemia
Perforation of
Bacteria or
Necrosis necrotic
toxins leak
segments
into:
Gangrenous
intestinal wall
Blood
Decreased
bowel Cessation of
sounds peristalsis
Bacteremia,
Septicemia