Abdominal and pelvic autonomics and Pain Flashcards
Sympathetic and parasympathetic affect on the Gastrointestinal tract, via the longitudinal and circular muscle fibers, sphincter muscles, and glands
Longitudinal and circular muscle fibers:
- parasympathetics increase motility
- sympathetics decrease motility
sphincter muscles:
- PNS: relaxation
- SNS: contraction
glands:
- PNS: increase secretions
- SNS: decrease secretions
Sympathetic and parasympathetic affect on splenic capsule
Splenic capsule:
- PNS: no effect
- SNS: contraction
Sympathetic and parasympathetic affect on pancreas via endocrine and exocrine
Endocrine pancreas:
- SNS: insulin secretion
- PNS: no effect
Exocrine pancreas:
- SNS: no secretion
- PNS: increase secretion
Sympathetic and parasympathetic affect on liver
Glycogenolysis/gluconeogenesis:
- SNS: increase
- PNS: no effect
Sympathetic and parasympathetic affect on Urinary bladder via detrusor vesicae, and functional bladder sphincter
Detrusor vesicae:
- SNS: relaxation
- PNS: contraction
Functional bladder sphincter:
- SNS: contraction
- PNS: inhibit contraction
Sympathetic and parasympathetic affect on seminal vesicle and ductus deferens
Seminal vesicle and ductus deferens:
- SNS: contraction (ejection)
- PNS: no effect
Sympathetic and parasympathetic affect on Uterus
Uterus
- SNS: contraction or relaxation depending on hormone state
- PNS: no effect
Sympathetic and parasympathetic affect on Arteries
Arteries
- SNS: Vasoconstriction
- PNS: Vasodilation of the arteries of the penis and clitoris (erection)
Sympathetic and parasympathetic affect on suprarenal glands
Suprarenal glands:
- SNS: release adrenalin
- PNS: no effect
Sympathetic and parasympathetic affect on Urinary tract
Kidney:
- SNS: Vasoconstriction inhibiting urine formation
- PNS: Vasodilation
Pathology based on pain in the: Right Hypochondriac area
- Gallstones
- cholangitis
- hepatitis
- liver abscess
Pathology based on pain in the: epigastric area
- Esophagitis
- peptic ulcer
- perforated ulcer
- pancreatitis
Pathology based on pain in the: left hypochondriac area
- Spleen abscess
- acute splenomegaly
- spleen rupture
Pathology based on pain in the: umbilical region
- early apendicicits
- mesenteric adentitis
- meckels diverticulitis
- lymphomas
Pathology based on pain in the: right/left flank or lumbar area
- ureteric colic
- pyelonephritis
Pathology based on pain in the: right inguinal area
- Apendicitis late
- crohns disease
- cecum obstruction
- ovarian cyst
- ectopic pregnancy
- hernias
Pathology based on pain in the: hypogastric or pubic area
- Testicular torsion
- urinary retention
- cystitis
- placenta abruption
Pathology based on pain in the: left inguinal area
- Diverticulitis
- ulcerative colitis
- constipation
- ovarian cyst
- hernias
what does retroperitoneal pain mean?
Retroperitoneal structures are the kidneys, pancreas, and aorta
pathology involving these structures frequently involve surrounding tissues and patient gets pain in the back
what does it mean if their is Colicky pain?
Intermittent cramp like pain
caused by obstruction of hollow muscular organs
- bowel obstruction
- stone in ureter
- stone in neck of gall bladder
GItract: foregut, midgut, or hindgut
urinary tract: loin to groin
Signs of gastric ulcer
Foregut visceral pain
worse on eating and patient tends to avoid meals
signs of perforated gastric ulcer
Foregut chronic visceral pain
sudden severe pain spreading all over abdomen
signs of generalized peritonitis
signs of acute cholecystitis
Foregut visceral pain
somatic pain in right upper quadrant
- referred pain to right shoulder
- nausea and vomiting
- fever
- tender right upper quadrant
- positive murphys sign
signs of acute appendicitis
Midgut visceral pain
somatic pain in right lower quadrant
nausea and vomiting
fever
tender right lower quadrant
if appendix has ruptured, patient will have signs of localized peritonitis in right ower quadrant
signs of an adhesive small bowel obstruction
- History of previous abdominal surgery
- midgut visceral colicky pain
- vomiting
- no flatus or bowel action
- possible dehydration
- distended soft abdomen; non-tender
- increased bowel sounds
signs of passage of a kidney stone
- Sudden onset of very severe colicky pain from loin to groin
- severe back pain
- patient writhing with pain and pacing about it
- possible hematuria
- afebrile
- soft abdomen
- tender renal angle
signs of obstructing cancer of descending colon
- older age patient
- weight loss
- hindgut visceral colicky pain
- no flatus or feces
- distended abdomen
- possible mass to feel in left quadrant
- increased bowel sounds
signs of a ruptured ectopic pregnancy
- woman of childbearing age
- missed her last menstrual period
- sudden onset of severe pain in hypogastrium radiating to sacral area
- afebrile
- localized peritonitis in suprapubic (hypogastric area)
- tenderness in rectouterine pouch on DRE or vaginal examination
signs of a leaking aortic aneurysm
- elderly male with history of atherosclerotic disease such as hypertension or cardiac disease
- sudden onset of severe back pain
- pale and shocked; hypotensive
- tender epigastrium
- palpable impulse from aneurysm in epigastrium
