Abdominal pain Flashcards
What are the 4 goals to achieve with abdominal pain
Early diagnosis
Pain control
Treating cause
Communicating with the patient
In what quadrant is pain rare?
Left upper quadrant
What is shifting pain
When pain starts in one area and moves to another
Appendicitis
How would a patient describe visceral pain?
Pinpoint it
How would a patient describe somatic pain
General
It is pain all over the peritoneal cavity
Where does pain present if it is from the foregut?
The epigastric region
Where does pain present if it is in the midgut
In the periumbilical region
Where does pain present if it is in the hindgut?
In the superpubic region
What are 3 structures that would give pain in the upper region
Gall Bladder
Stomach
Duodenum
Pancreas
What 3 structures can give central pain
Kidneys
Small bowel
Caecum
What 5 structures can give lower pain
Appendix and caecum Transverse colon Bladder Uterus Sigmoid colon
What does colicky pain suggest
Obstruction
What does throbbing pain suggest
Inflammation
What can make the pain worse
Walking
Coughing
Going over bumps in the car
Breathing
What can pain radiation indicate?
Indicates the source
Indicates the extent of the disease
Where can gall bladder pain radiate to and what is the character of the pain
Shooting pain on the shoulder
When is it best to give pain relief and what is used?
Immediately,
Prior to examining the patient
IV morphine
How do we apply a painful stimuli
In a graded fashion: breathing up to coughing
What is peritonism
Tenderness to percuss
What is guarding of the abdomen?
conscious or involuntary guarding
Rigid
In what 3 ways can we identify the very sick patient?
Extreme pain and tenderness
High pulse rate
Low blood pressure
Why should we not rely on high WCC for appendicitis
The increase in white cells occurs quite late on
