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