“Four Quadrants, Zero Clarity? Let’s Fix That”

GastroIntestinal System

The gastrointestinal system is also known as the gastrointestinal tract, the digestive system, or the alimentary canal, which is approximately 10m long.

There are various structures and organs are included:-

• Mouth

• Pharynx

• Oesophagus

• Stomach

• Small intestine

• Large intestine

There are various accessory organs that enhances the functions of gastrointestinal system:

• Salivary glands

• Liver

• Gall bladder

• Pancreas

Quadrants in Abdomen:

• Right upper Quadrant (RUQ)

• Left Upper Quadrant (LUQ)

• Right Lower Quadrant (RLQ)

• Left Lower Quadrant (LLQ)

Right upper Quadrant (RUQ) :

• Right lobe liver

• Gall bladder

• Pylorus

• Duodenum

• Head of pancreas

• Hepatic flexure colon

• Aspects of ascending and transverse colon

Left upper quadrant ( LUQ) :

• Left liver lobe

• Stomach

• Body of pancreas

• Splenic flexure of colon

• Aspects of transverse and descending colon

Right lower quadrant (RLQ):

• Caecum and appendix

• Aspects of ascending colon

Left lower quadrant (LLQ):

• ·Sigmoid colon

• Aspects of descending colon.

It is important to get a detailed history and perform physical examination techniques, for instance, inspection, palpation, percussion and auscultation.

Focused gastrointestinal assessment may include the following:

• Chief complaint

• Present health status

• Past health history

• Current lifestyle

• Psychosocial status

• Family history

• Physical assessment

Past health history:

• Ask patient about any previous abdominal surgery and trauma.

• Ask patient about past history of gastrointestinal disorders, for instance,

• Gall bladder disease

• Inflammatory bowel disease

• Hernias

• Appendicitis

Medication history:

• Ask patient about the history of previous medications. Some medications may have some gastrointestinal side effects. Ask patient if they are taking any opioids and non-steroidal anti-inflammatory drugs and antibiotics.

• Maybe they are taking any over the counter medications.

Social History :

• Ask the patient about the frequency of alcohol consumption, cigarette smoking and their caffeine intake due to the reason for liver cirrhosis and gastric ulcers.

Family history:

It is important to seek family history as some disorders may be hereditary, for instance, Crohn’s disease.

Nutritional assessment:

• Unintentional weight loss

• Receiving any chemotherapy

• Weight gain

• Food allergies

• Multiple medications

• Decreased appetite

Physical examination:

There are various skills used by the nurses including the following :

• Inspection

• Auscultation

• Percussion

• Palpation