6/24/2023 0 Comments Er nurses patterson![]() ![]() ![]() Somatic sensory nerves provide sensation to the parietal peritoneum. Midgut structures, small bowel, and appendix, to the periumbilical area and hindgut, large bowel and rectum, to the lower abdomen. Pain from embryonic foregut structures such as the stomach, liver, pancreas, and gallbladder radiate to the epigastrium. The pain is often midline, poorly localized, deep, and dull. These nerves are sensitive to mechanical distention, inflammation, ischemia, and the intense, smooth muscle contraction seen in colic. Visceral nerves are part of the autonomic nervous system and innervate the viscera. The classic presentations of appendicitis, cholecystitis, pancreatitis, and diverticulitis, are in large part the result of the dual innervation of the abdomen, both visceral and somatic. Age is associated with some diseases: older patients are more likely to present with diverticulitis, cholecystitis, and vascular emergencies. Anatomic abnormalities include malrotation of the gut. Causes include infection (appendicitis, diverticulitis) and obstruction (appendicitis, cholecystitis). The pathophysiology of each disease entity is beyond the scope of this review. ![]()
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