Abdominal Pain Flashcards
What are the 2 most significant properties of pain?
- site
- character
What does SOCRATES stand for?
Site Onset Character Radiation Associations Time Exacerbating factors Severity
What are the 4 abdominopelvic quadrants?
Right Upper
Right Lower
Left Upper
Left Lower
What are the 9 adbominopelvic regions?
- right hypochondriac
- epigastric
- left hypochondriac
- right lumbar
- umbilical
- left lumbar
- right iliac
- hypogastric
- left iliac
What is in the transpyloric plane?
- pylorus of the stomach
- neck of the pancreas
- fundus of the gall bladder
- renal hilum
- duodenojejunal flexure
- end of the spinal cord (adult)
What do most intra-abdominal diseases present with?
pain alone
Where is the intertubercular plane?
passes through the iliac fossa, around L5
Where is the transpyloric plane?
L1
Where is the subcostal plane?
L3
What happens at the subcostal plane?
the origin of the inferior mesenteric artery
Where is the supracristal plane?
L4
What happens at the supracristal plane?
Bifurcation of the aorta
What happens at the transpyloric plane?
origin of the superior mesenteric acid
What tends to cause pain in the right hypochondriac region?
gallbladder
What tends to cause pain in the epigastric region?
stomach, duodenum and pancreas
What tends to cause pain in the left hypochondriac region?
pancreas/spleen
What tends to cause pain in the right lumbar region?
kidney (right)
What tends to cause pain in the umbilical region?
- small bowel
- caecum
- retroperitoneal structures
What tends to cause pain in the left lumbar region?
kidney
What tends to cause pain in the right iliac region?
- appendix
- caecum
What tends to cause pain in the hypogastric region?
- transverse colon
- bladder
- uterus
- ovaries
What tends to cause pain in the left iliac region?
sigmoid colon
What is in the foregut?
distal oseophagus to the proximal half of the 2nd part of the duodenum
What is in the midgut?
distal half of the 2nd part of the duodenum to the proximal 2/3 of the transverse colon
- small bowel
- appendix
- caecum
- ascending colon
What is in the hindgut?
distal 1/3 of the transverse colon to the rectum
What supplies the foregut?
the celiac trunk
What is the celiac trunk comprised of?
- hepatic artery
- splenic artery
- left gastric artery
What supplies the midgut?
superior mesenteric artery
What supplies the hindgut?
inferior mesenteric artery
What does the parietal peritoneum cover?
- anterior abdominal wall
- posterior abdominal cavity
What does the visceral peritoneum cover?
covers the organs themselves
What 2 structures are extra/retroperitoneal?
- pancreas
- duodenum
What supplies the parietal peritoneum cover?
- phrenic nerves
- sensation to the central tendon of the diaphragm (C3, C4 and C5)
Why do diaphragmatic problems cause right shoulder pain?
cause sensation in both the diaphragm and the right should is done by the phrenic nerves (C3,4,5)
Where does the phrenic segmental innervation of the parietal peritoneum originate?
T6-L2
What supplies the umbilicus?
T10
What provides parasympathetic innervation of the visceral peritoneum?
- the vagus nerve (CNX)
- parasympathetic sensation from S2-S4
Where does the sympathetic innervation of the visceral peritoneum originate?
T1-L2