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GASTROENTEROLOGY 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

When taking a patient history what technique should you use?

A

SOCRATES

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3
Q

What do the letters of SOCRATES stand for?

A 
Site
Onset
Character
Radiation
Associations
Time course
Exacerbating/relieving factors
Severity
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4
Q

What are the abdominopelvic regions top to bottom, left to right?

A

Left hypochondriac region
Epigastric region
Right hypochondriac region

Left lumbar region
Umbilical region
Right lumbar region

Left iliac region
Hypogastric/superpubic region
Right iliac region

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5
Q

What are the abdominopelvic quadrants top to bottom, left to right?

A

Right upper quadrant (RUQ)
Left upper quadrant (LUQ)
Right lower quadrant (RLQ)
Left lower quadrant (LLQ)

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6
Q

What vertebrae level is the transpyloric plane and what structures are present?

A

L1

Pylorus of stomach
Neck of pancreas
Fundus of gallbladder
Renal hilum
Duodenojejunal flexure
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7
Q

What vertebrae level is the subcostal plane and what structures are present?

A

L3

Origin of inferior mesenteric artery

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8
Q

What vertebrae level is the supracristal plane and what structures are present?

A

L4

Bifurcation of the aorta

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9
Q

What structures are present in the left hypochondriac region?

A

Pancreas

Spleen

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10
Q

What structure is present in the right hypochondriac region?

A

Gallbladder

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11
Q

What structures are present in the epigastric region?

A

Stomach
Duodenum
Pancreas

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12
Q

What structure is present in the left lumbar region?

A

Kidney

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13
Q

What structure is present in the right lumbar region?

A

Kidney

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14
Q

What structures are present in the umbilical region?

A

Small bowel
Caecum
Retroperitoneal structures

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15
Q

What structures are present in the left iliac region?

A

Sigmoid colon

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16
Q

What structures are present in the right iliac region?

A

Appendix

Caecum

17
Q

What structures are present in the hypogastric/superpubic region?

A

Transverse colon
Bladder
Uterus and adnexae

18
Q

What is the blood supply/nerve innervation for sensation of the foregut and what structures comprise it?

A

Celiac trunk/T5-T9

Distal oesophagus –> proximal half of 2nd part of duodenum

19
Q

What is the blood supply/nerve innervation for sensation of the midgut and what structures comprise it?

A

Superior mesenteric artery/T10-T11

Distal half of 2nd part of duodenum –> proximal 2/3 of transverse colon

20
Q

What is the blood supply/nerve innervation for sensation of the hindgut and what structures comprise it?

A

Inferior mesenteric artery/L1-L2

Distal 1/3 of transverse colon –> rectum

21
Q

What is the character of visceral pain?

A

Dull, crampy, burning

Hard to localise

22
Q

What is the character of parietal pain?

A

Sharpe, ache

Easy to locate

23
Q

How does pain from inflammation in abdomen present?

A 
Constant pain (aching) made worse by movement
Persists until inflammation subsides
24
Q

How does pain from obstruction of a muscular tube in abdomen present?

A 
Colicky pain (gripping)
Fluctuates with severity
Move to try and get comfortable
25
Q

How does pain from prolonged obstruction of a hollow viscus causing distension in abdomen present?

A

Constant stretching pain - originally colicky but changes
Different from inflammatory ache

Patients who have this can have ischaemia which is emergency

26
Q

How does ureteric pain usually present?

A

Colicky

27
Q

How does liver pain usually present?

A

Constant

28
Q

How does gall bladder pain usually present?

A

Colicky

29
Q

How does spleen pain usually present?

A

Constant

30
Q

How does kidney pain usually present?

A

Constant

31
Q

How does intestinal pain usually present?

A

Colicky

32
Q

What different about biliary colic pain compared to the rest?

A

Maintains a high intensity and gently fluctuates

33
Q

How does right hypochondriac pain radiate?

A

Through to the back and right

34
Q

How does left hypochondriac pain radiate?

A

Through to the back and left

35
Q

How does epigastric pain radiate?

A

Straight through to the back

36
Q

How does right/left lumbar pain radiate?

A

In loin and radiates to groin

37
Q

How does umbilical pain radiate?

A

Doesn’t normally radiate

38
Q

How does lower abdominal pain radiate?

A

Rarely radiates

39
Q

Does small bowel pain radiate?

A

No but it may move when somatic or when visceral nerves become irritated

GASTROENTEROLOGY 2 (7 decks)

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