1b Abdominal Pain

Question 1

Pain in the right hypochondriac region refers to which organs?

Answer 1

Gall Bladder and liver

Question 2

Pain in the epigastric region refers to which organs?

Answer 2

Stomach, duodenum and Pancreas

Question 3

Pain in the left hypochondriac region refers to which organs?

Answer 3

Pancreas

Question 4

Pain in the right lumbar region refers to which organs?

Answer 4

Kidney

Question 5

Pain in the umbilical region refers to which organs?

Answer 5

Small bowel

Question 6

Pain in the left lumbar region refers to which organs?

Answer 6

Kidney

Question 7

Pain in the right iliac region refers to which organs?

Answer 7

appendix and caecum

Question 8

Pain in the hypogastric region refers to which organs?

Answer 8

Uterus, bladder and adnexae

Question 9

Pain in the left iliac region refers to which organs?

Answer 9

Sigmoid colon

Question 10

What is the blood supply to the foregut?

Answer 10

Coeliac trunk

Question 11

What is the blood supply to the midgut?

Answer 11

Superior Mesenteric Artery

Question 12

What is the blood supply to the Hindgut?

Answer 12

Inferior Mesenteric Artery

Question 13

What is the site of referred pain from the diaphragm?

Answer 13

Phrenic nerve has sensory supply and covers diaphragm and right shoulder àsites of referred pain

Question 14

What is the visceral sensory innervation in the foregut?

Answer 14

T5-T9

Question 15

What is the visceral sensory innervation in the midgut?

Answer 15

T10-T11

Question 16

What is the visceral sensory innervation in the hindgut?

Answer 16

L1-L2

Question 17

What is the innervation of parietal peritoneum?

Answer 17

Somatic

Question 18

What is the innervation of visceral?

Answer 18

Autonomic - so sympathetic / parasympatheti c

Question 19

What is the site of pain when the visceral peritoneum is involved?

Answer 19

Embryological origin

Question 20

What is the site of pain when the parietal peritoneum is involved?

Answer 20

Well-localised

Question 21

What is the character of pain when the visceral peritoneum is involved?

Answer 21

Dull, crampy, Burning

Question 22

What is the character of pain when the parietal peritoneum is involved?

Answer 22

Sharpe ache

Question 23

What are some examples of causes of colicky pain?

Answer 23

Kidney stones, gallstones in ducts, bowel obstruction

Question 24

What are some examples of constant abdominal pain?

Answer 24

Liver problem, spleen problem, pyelonephritis

Question 25

What might be the cause of abdominal pain which is constant, worsened by movement and continual?

Answer 25

INFLAMMATION Constant pain ('aching') * Made worse by movement (always ask this) * Persists until inflammation subsides

Question 26

What might be the cause of abdominal pain which is Colicky pain ('gripping'), Fluctuates in severity - intense then relaxes and patients may move to try and get comfortable?

Answer 26

Obstruction of a muscular tube:

Question 27

What is a key warning sign in abdominal pain?

Answer 27

A change in the type of pain the patient is experiencing

Question 28

What is the differences between the types of colicky pain?

Answer 28

* ureteric colic - relatively frequent and very intense pain * intestinal colic - more frequent and less intense pain * biliary 'colic' - patients describe as being constant as pain lasts a long time before it relaxes

Question 29

How does pain from the gall bladder radiate?

Answer 29

Through to the back and to the right

Question 30

How does pain from the pancreas radiate?

Answer 30

Through to the back and to the left

Question 31

How does pain from the stomach and duodenum radiate?

Answer 31

straight through to the back

Question 32

How does pain from the kidney usually radiate?

Answer 32

In the loin, to the groin

Question 33

Pain from which structures usually doesn't radiate?

Answer 33

Small Bowel Caecum retroperitoneal Structures

Question 34

Colicky pain becomes constant. What does this suggest?

Answer 34

The bowel is becoming ischaemic

Question 35

Pain shifting from the center to the right iliac fossa. Worse on movement. Nausea?

Answer 35

Appendicitis

Question 36

What is the most common cause of a small bowel obstruction?

Answer 36

Adhesion - scarring tissue

Question 37

Central colicky pain, with vomiting and no bowel movements, passing gas relieves pain?

Answer 37

Small bowel obstruction

Question 38

Colicky pain, sudden onsent, starting in the loin, radiating to the groin, cannot find a comfortable position, very severe pain?

Answer 38

Uteretic colic / kidney stones

Question 39

Sudden onset colicky pain in the right shoulder after eating fatty foods?

Answer 39

Biliary colic - Gallbladder * Fits in with stone * Fat stimulates CCK release and gallbladder contraction * More painful

Question 40

What other condition can give a loin to groin presentation besides kidney?

Answer 40

Abdominal aortic aneurysm