abdominal pain

Question 1

what do most intra abdominal diseases present with alone

Answer 1

pain

-

Question 2

what are the 2 most signifiant properties of pain

Answer 2

site and character

Question 3

what does socrates stand for

Answer 3

site
onset
character
radiation?
associated symptoms
time course 
exacerbating/relieving symptoms
severity

Question 4

what are the abdominopelvic regions divided by

Answer 4

mid clavicular lines
transpyloric plane - L1
inter spinous spine

Question 5

what are the 9 abdominopelvic regions

Answer 5

right hypochondriac
epigastric
left hypochondriac
right lumbar
umbilical
left lumbar
right iliac
hypogastric region
left iliac

Question 6

what do we find at transpyloric plane, L1

Answer 6

pylorus of stomach
neck of pancreas
fundus of gallbladder
renal hilum
duodenojejunal flexure
end of adult spinal cord

Question 7

what do we find at subcostal plane, L3

Answer 7

Origin of Inferior Mesenteric Artery

Question 8

what do we find at supracristal plane, L4

Answer 8

bifurcation of aorta

Question 9

what is included in foregut

Answer 9

distal oesophagus down to proximal half of 2nd part of duodenum
- supplied by celiac trunk

Question 10

what is included in midgut

Answer 10

distal half of 2nd part of duodenum to proximal 2/3 of transverse colon
- supplied by superior mesenteric artery

Question 11

what is included in hindgut

Answer 11

distal 1/3 of transverse colon to rectum

- supplied by inferior mesenteric artery

Question 12

what is parietal peritoneum supplied by

Answer 12

somatic
phrenic nerve. - provides sensation from central tendon of diaphragm
nerve segmental innervation is from t5 to l2

Question 13

what is visceral peritoneum supplied by

Answer 13

automatic
parasympathetic innervation from vagus nerve and from s2-s4
sympathetic chain t6-l2

Question 14

what are the 2 categories most painful conditions in abdomen fall into

Answer 14

inflammation or obstruction of muscular tube

Question 15

what might you see with inflammation of abdomen

Answer 15

constant pain - aching
made worse by movement
persists until inflammation subsides

Question 16

what symptoms do you see with obstruction of muscular tube

Answer 16

colicky pain - gripping
fluctuates in severity
move positions to get comfortable

Question 17

what do we see with prolonged obstruction of hollow viscus that causes distension

Answer 17

constant stretching pain
different from ache of inflammation and not colicky
- ischaemia?

Question 18

when does colicky pain usually become constant

Answer 18

when something is becoming ischaemic

Question 19

where does pain in right hypochondriac region e.g gallbladder radiate to

Answer 19

through to back and right

sometimes

Question 20

where does pain in epigastrium radiate to

Answer 20

straight through to back

Question 21

where does pain in left hypochondriac region radiate to

Answer 21

through to back and left

Question 22

where does pain in right lumbar region e.g kidney radiate to

Answer 22

in loin and radiates to groin

Question 23

where does pain in umbilical region radiate to

Answer 23

doesnt usually radiate

Question 24

where does pain in right lumbar region radiate to

Answer 24

in loin and radiates to groin

Question 25

where does pain in right /left iliac or hypogastricregion radiate to

Answer 25

rarely radiates | deep structures sometimes to lower back/perineum

Question 26

what causes colicky abdominal pain

Answer 26

visceral sensation

Question 27

what might be diagnosis if pain in ruq

Answer 27

gallstones cholangitis hepatitis liver abscess

Question 28

what might be diagnose if pain in epigastric region

Answer 28

``` oesophagitis peptic ulcer perforated ulcer pancreatitis biliary tract disease ```

Question 29

what might be diagnosis if pain in luq

Answer 29

splenic abscess acute splenomegaly splenic rupture

Question 30

what could be diagnosis if pain in left lumbar region

Answer 30

``` renal colic pylenonephritis ovarian cyst ovarian mass ovarian torsion ```

Question 31

what could be diagnosis id pain in umbilical

Answer 31

apendicitis mesenteric adenitis meckels diverticulitis

Question 32

what could be cause of pain in llq

Answer 32

``` diverticulitis uc constipation ovarian cyst/torion pid ectopic pregnancy hernias renal colic ```

Question 33

what could be cause of pelvic pain

Answer 33

urinary retention cystitis uterine fibroid endometriosis

Question 34

what could be cause of pain in rlq

Answer 34

``` appendicitis crohns ovarian cyst/torsion ectopic preg hernias renal colic ```