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Internal theraputics 1 > Abdominal pain > Flashcards

Abdominal pain Flashcards

1
Q

Excess Syndromes

A
  1. Obstruction of cold evil
  2. Retention of damp heat
  3. Qi stagnation
  4. Blood Stasis
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2
Q

Deficency Syndromes

A

Deficent cold in middle jiao

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3
Q

Obstruction by Cold Evil Signs and Symptoms

A

Sudden acute sharp abdominal pain which is aggrevated by cold and alleviated by warmth, chills, absence of thirst, loose stools or constipation, clear long urination

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4
Q

Obstruction by Cold Evil Tongue and Pulse

A

Thin and white coating

Deep Tight

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5
Q

POT Obstruction by Cold Evil

A

Warm the middle jiao to expel cold

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6
Q

Obstruction by Cold Evil Points

A

SP 15

LI 4

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7
Q

Retention of Damp Heat Signs and Symptoms

A

Sudden severe abdominal pain, on and off, abdominal distension, doesn’t like pressure, dry mouth, bitter taste in mouth, yellow scanty urine, fever, constipation or hesitant loose stools, fullness in chest and epigastrium, belching, acid regurgitation, nausea, vomiting

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8
Q

Retention of Damp Heat Tongue and Pulse

A

Yellow greasy coating

P: Wiry and Rapid

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9
Q

POT of Retention of Damp Heat

A

Clear damp heat

Circulate the intestine to remove stasis

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10
Q

Retention of Damp Heat Points

A

UB 25
SP 6, 9
LI 11
SJ 6

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11
Q

Basic Abdominal Pain Points

A 
REN 12
ST 25
REN 6
ST 36
ST 37
SP 4
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12
Q

Qi Stagnation Signs and Symptoms

A

Wandering abdominal distending pain which refers to epigastrium and hypochondrium or low abdomen, chest tightness, belching, sighing, pain aggrevated by stress

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13
Q

Qi Stagnation Tongue and Pulse

A

Thin Coating

P: wiry or wiry thready

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14
Q

POT for Qi Stagnation

A

Sooth liver and regulate Qi

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15
Q

Qi Stagnation Points

A

REN 17
PC 6
GB 34
LIV 3

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16
Q

Blood Stasis Signs and Symptoms

A

Stabbing fixed abdominal pain that doesn’t like pressure, chronic pain, may have injury history

17
Q

Blood Stasis Tongue and Pulse

A

Dark Purple Tongue

P: Thready and Choppy

18
Q

POT for Blood Stasis

A

Promote blood circulation to remove blood stasis

19
Q

Blood Stasis Points

A

PC 6
SP 10
UB 17
UB 18

20
Q

Deficient cold in the middle jiao

Signs and Symptoms

A

Lingering abdominal pain which is alleviated by warmth and pressure and aggrevated by hunger and overwork, comes on and off, loose stools, intolerance to cold, listlessness, SOB

21
Q

Deficient cold in the middle jiao Tongue and Pulse

A

Pale Tongue with white coating

P: Deep Thready

22
Q

POT for Deficient cold in the middle jiao

A

Tonify Qi, warm the middle jiao to expel the cold

23
Q

Deficient cold in the middle jiao Points

A

UB 20
UB 21
LIV 13

24
Q

Etiology

A
  1. EPFs - cold/heat
  2. Emotional Frustration - qi stag = blood stasis
  3. Irregular diet- retention of food = damp heat
  4. Parasites - worms in intestine
  5. Trauma/surgery = blood stasis
  6. Yang deficiency constitution - malnourishment of zang fu and meridians = accumulation of xie qi
25
Q

Chief Pathology

A

Excess: Blockage of Qi Movement and meridian by
Xie Qi
Deficiency: malnourishment of Zang Fu

26
Q

Organs Involved

A 
Spleen
Stomach
Liver
Gallbladder
Kidney 
Urinary bladder
Large intestine 
Small intestine 
SanJiao
27
Q

Disease Differentation

A
  • get patient to palpate and show where it hurts*

Stomachache vs Abdominal Pain

  • epigastric pain - more areas of pain
  • belching - no stomachache signs
  • hiccup
  • acid reflux
  • hrt burn

Hypochondriac Vs. Abdominal Pain
- liver/GB region

Dysentery Vs. Abdominal Pain

  • Tenesmus
  • Blood/Pus

Abdominal Masses Vs. Abdominal Pain
- Masses/Lumps

External:

  • fixed local pain
  • very severe pain
  • Abdominal pain than fever
  • painful on Palpation
  • decreased abdominal breathing, more chest breathing

Internal:

    • start fever first than abdominal pain*
  • subjective pain ( not many obj symptoms)
  • tender points not localized

Gyno:

  • pregnancy
  • miscarriage
  • leukorrhea
  • pregnancy
28
Q

Abdominal Palpation Tips

A
  • Palpating abdomen put pillow under knees because if legs straight abdominal muscles tighten
  • palpate opposite area of pain
  • palpate lower to upper
  • get patient to do deep slow tummy breathing
  • check for temp, masses, enlarged liver
29
Q

Abdominal Division

A

4 Division:

  1. Upper right abdomen
  2. Upper left abdomen
  3. Lower right abdomen
  4. Lower left abdomen
9 Division: used more in clinic*
#1 & # 3  hypochondriac abdomen 
# 5 Umbilicus abdomen
# 2 Epigastric abdomen 
# 4 & # 6 Lumbar abdomen
# 8 Small abdomen 
# 7 & # 9 Little abdomen   
All areas pain called "Big Abdomen"
30
Q

Pattern Differentiation

A

Excess Vs. Deficiency

  • Pain severe - Dull, lingering pain
  • No pressure - Like pressure
  • Feel lumps - pain when ST empty
  • Pain when stomach full

Heat Vs. Cold
- likes cold - Likes heat

Qi Stag. Vs. Blood Stag

  • Distending/wandering - Fixed/Stabbing
  • Intermittent. - Bruised, purple skin
    - Lump
Location:
Low abdomen (#8):  Kidney, UB
Umbilicus (#5): Parasites
Hypochondriac (#1/3): Liver, GB
Big abdomen (whole ab): Spleen, ST, Lrg Int, Sm Int
  • factor in age, sex, medical history, diet, location, signs/symptoms
31
Q

Treatment Principle

A

Pain due to blockage

  1. Excess remove xie Qi
  2. Deficiency nourish
  3. Herbal
  4. Acupuncture Pts
  5. Warming needle/ Moxa if cold/deficiency pattern
  6. Auricular Acupuncture
  7. Electro acupuncture for pain - 20 min
32
Q

Patient Education

A
  1. Avoid EPF - especially in summer
  2. Don’t expose abdomen
  3. Avoid running after meal
  4. No overeating
  5. Hygiene (parasites)
  6. Emotions: don’t worry/overthink
  7. Diet: greasy food, alcohol, cold food/water, raw

~walking everyday you’ll live till your 99~

33
Q

compare internal and external:

A

internal: fever—> ab pain, subjective pain, uncertain tender spots, moving pain
external: ab pain—> fever, fixed/local pain, very severe, obvious tender spots

34
Q

compare excess and deficiency:

A

shi: sharp/sever pain, pressure is bad, worse on full stomach, nodules
xu: dull/lingering pain, pressure is good, worse on empty stomach

Internal theraputics 1 (17 decks)

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