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BRS Year 2 > Abdominal pain > Flashcards

Abdominal pain Flashcards

1
Q

how do most intra abdominal diseases present?

A

pain alone

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2
Q

what are the two most important parts of SOCRATES for abdominal pain?

A

site

character

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3
Q

what is SOCRATES?

A 
site
onset
character
radiation
associations
time course
exacerbating/relieving factors
severity
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4
Q

what are the abdominopelvic regions?

A 
9 
R hypochondriac
epigastric
L hypochondriac
R lumbar
umbilical
L lumbar
R iliac
hypogastric
L iliac
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5
Q

what are the abdominopelvic quadrants?

A

RUQ
LUQ
RLQ
LLQ

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6
Q

what are the important planes of the abdomen?

A

transpyloric
subcostal
supracristal

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7
Q

what vertebral level does the transpyloric plane lie at?

A

L1

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8
Q

what structures are crossed by the transpyloric plane?

A 
stomach pylorus
neck of pancreas
fundus of gallbladder
renal hilum
duodenojejunal flexure
end of spinal cord
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9
Q

what vertebral level does the subcostal plane lie at?

A

L3 aka end of subcostal margin

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10
Q

what structures are crossed by the subcostal plane?

A

origin of inferior mesenteric artery

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11
Q

what vertebral level does the supracristal plane lie at?

A

L4

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12
Q

what important structure lies beneath the supracristal plane?

A

biFOURrcation of aorta L4

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13
Q

what important viscera underlies the right hypochondriac region?

A

gallbladder

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14
Q

what important viscera underlies the epigastric region?

A

stomach
duodenum
pancreas

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15
Q

what important viscera underlies the left hypochondriac region?

A

pancreas

spleen

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16
Q

what important viscera underlies the right and left lumbar region?

A

kidneys

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17
Q

what important viscera underlies the umbilical region?

A

small bowel
caecum
retroperitoneal structures

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18
Q

what important viscera underlies the right iliac region?

A

appendix

caecum

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19
Q

what important viscera underlies the hypogastric region?

A

transverse colon
bladder
uterus and appendages

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20
Q

what important viscera underlies the left iliac region?

A

sigmoid colon

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21
Q

what are the boundaries of the foregut?

A

distal oesophagus to proximal half of 2nd part of duodenum

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22
Q

what are the boundaries of the midgut?

A

distal half of 2nd part of duodenum - proximal 2/3 of transverse colon

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23
Q

what are the boundaries of the hindgut?

A

distal 1/3 of transverse colon - rectum

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24
Q

what is the innervation of the parietal peritoneum?

A

somatic so well localised

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25
Q

what is the character of parietal peritoneum pain?

A

sharp, localised, aches

26
Q

what is the innervation of the visceral peritoneum?

A

autonomic
sympathetic T1-L2
parasympathetic - CN III, VII, IX, X, S2-4

27
Q

what is the character of visceral peritoneum pain?

A

dull, crampy, burning and comes from embryological origin

28
Q

what is the innervation of sensation for the foregut?

A

T5-T9

so epigastrium

29
Q

what is the innervation of sensation of the midgut?

A

T10-11

so umbilical

30
Q

what is the innervation of sensation of the hindgut?

A

L1-2

so hypogastrium

31
Q

what is the innervation of sensation of the hindgut?

A

L1-2

so hypogastrium

31
Q

what is the innervation of sensation of the hindgut?

A

L1-2

so hypogastrium

31
Q

what is the innervation of sensation of the hindgut?

A

L1-2

so hypogastrium

32
Q

where is the site of foregut pain?

A

epigastrium

33
Q

where is the site for midgut pain?

A

umbilical

34
Q

where is the site for hindgut pain?

A

hypogastrium

35
Q

how does inflammatory abdominal pain present?

A

constant pain
made worse by movement
persists until inflammation subsides

36
Q

how does obstruction of a muscular tube present in pain?

A

colicky, gripping pain
fluctuates in severity
people move to try to get comfortable

37
Q

how does prolonged obstruction of a hollow viscus, causing distention, present in pain?

A

constant, stretching pain
different ache from inflammatory ache
(should suspect ischaemia)

38
Q

how do biliary, uteric and intestinal colic differ?

A

biliary - fairly fast and small fluctuations in intense pain
uteric - slightly slower, large fluctuations between intense and manageable pain
intestinal - medium sized fluctuations, not too intense

39
Q

where does gallbladder pain radiate to?

A

through the back and right

shoulder/scapular pain possible

40
Q

where does stomach and duodenal pain radiate to?

A

straight through to the back of epigastric region

41
Q

where does pancreatic pain radiate to?

A

through the back epigastric or left side

42
Q

how is pancreatitis pain often relieved?

A

through leaning forward

43
Q

where does kidney pain often radiate?

A

in loin and radiates to groin

44
Q

where does small bowel, caecum and retroperitoneal structures pain radiate to?

A

doesnt normally radiate at all

45
Q

what regions of the abdomen (upper, central, lower) normally don’t radiate?

A

lower - appendix, caecum, transverse colon, sigmoid colon, bladder, uterus

46
Q

where is pain from deep pelvic structures often felt/radiate to?

A

lower back/perineum

47
Q

what conditions present with pain in the RUQ?

A

gallstones
cholangitis
hepatitis
liver abscess

48
Q

what conditions present with pain in the epigastric region?

A

oesophagitis
peptic ulcers/perforated ulcers
pancreatitis
biliary tract disease

49
Q

what conditions present with pain in the LUQ?

A

splenic abscess
acute splenomegaly
splenic rupture

50
Q

what conditions present with pain in the right lumbar region?

A

renal colic
pyelonephritis
ovarian cyst/mass/torsion

51
Q

what conditions present with pain in the umbilical region?

A

early appendicitis
mesenteric adenitis
meckels diverticulitis

52
Q

what conditions present with pain in the left lumbar region?

A

renal colic
pyelonephritis
ovarian cyst/mass/torsion

53
Q

what conditions present with pain in the RLQ?

A 
late appendicitis
crohns disease
ovarian cyst/torsion
ectopic pregnancy
hernias
renal colic
54
Q

what conditions present with pain in the hypogastric/suprapubic region?

A

urinary retention
cystitis
uterine fibroid
endometriosis

55
Q

what conditions present with pain in the LLQ?

A 
diverticulitis
ulcerative colitis
constipation
pelvic inflammatory disease
ectopic pregnancy
hernias
renal colic
56
Q

what is biliary colic?

A

stones in neck of gallbladder/cystic duct

gallbladder contracts against them to try to force bile out

57
Q

what is acute cholecystitis?

A

inflammation of the gallbladder wall

can be result of gallstones in ducts

58
Q

what is ascending cholangitis?

A

inflammation of bile ducts

BRS Year 2 (67 decks)

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