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DISORDERS
Vidi Orba Busro
DEPARTEMENT OF INTERNAL MEDICINE
DIVISION OF GASTROENTEROHEPATOLOGY
FK UNSRI
DEFINITION
Diagnostic Procedure
SOAP
S Subjective (identity, symptoms,
clinical history, genetics)
O Objective (signs, laboratory,
radiologic, etc)
A Assesment (diagnostic & DD)
P Planning (treatment, supporting
examination)
Anatomical
- topography
- vascularization and innervation
Physiological
- organ function
- metabolism
RHC
TOPOGRAPHY
Abdominal regions
nine regions system or
four regions system
EPI
RL
UMB
RI
LHC
LL
LI
SP
Organ Function
Esophagus
- swallowing
Gaster & Duodenum
- digestive and absorbtion
Liver
- anabolism and catabolism
- detoxification
- eritropoesis extramedullar
- bile secretion
Pancreas
- hormone secretion
- enzyme secretion
Colon
- reabsorbtion
- faecal formation
Rectal
- faecal reservoar
Symptoms
1.
Abdominal Pain
Abdominal Pain
- the most common symptom
- location, type, cont. or intermitten,
spread, referred
- location depend on topographyc
- due to : GIT ,TUG, Gyn, MSC, & CV
- intermittent pain related to luminar
organ
(colic)
- referred pain depend on innervasion
1.
2. Abdominal Distention
3. Dysphagia
Difficulty swallowing
Due to pain, obstruction, abn. peristalsis
or impaired reflex (nerve)
Organ involved esophagus or
oropharynx
Most common case: Stricture esophagus
malignancy, GERD, multiple sclerosis
4. Odinophagia
Pain of swallowing
Organ involved esophagus
Due to inflammation process
5. Heartburn
6. Hiccup or Singultus
7. Vomitus &
Regurgitation
8. Bloating
9. Hematemesis
10. Melena
11. Diarrhea
12. Constipation
13. Hematoschezia
Signs
1. Mental Change
2. Icteric or Jaundice
Ikterik
jaundice
3. Gynecomastia
4. Spider
Nevi/Angioma
5. Palmar Erythema
6. Ascites
Ascites
7. Meteorismus
8. Pain palpation
Depend on tophographic
Types: Murphys sign, Ludwigs
sign, CVA percussion pain,
epigastric pain, Mc Burtneys
pain, defanse muscular,
suprapubic pain
9. Hepatomegaly
LIVER SPAN
MCL
PERCUSSION
NL < 12-13 CM
PERCUSSION
2-3 CM DURING
INSPIRATION AND
EXPIRATION
SCRATCH TEST
COPD
PALPATION
PALPATION
10. Splenomegaly
Patognomonis sign of
encephalopathy hepatic
Tremor of wrist joint after full
extension
Case Simulation