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GI lectures > Abdominal Pain and the Likely Source > Flashcards

Abdominal Pain and the Likely Source Flashcards

1
Q

what are the components of the large intestine?

A

colon: caecum, appendix, ascending colon, transvrse colon, descending colon, sigmoid colon
rectum
anal canal
anus

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2
Q

what is included in the foregut?

A

oesophagus to mid-duodenum
liver + gall bladder
spleen
1/2 of pancreas

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3
Q

what is included in the midgut?

A

mid-duodenum to proximal 2/3rds of transverse colon

1/2 of pancreas

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4
Q

what is included in the hindgut?

A

distal 1/3rd of transverse colon to proximal 1/2 of anal canal

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5
Q

what are the 4 quadrants of the abdomen?

A

right/left upper
right/left lower
(separated at level of umbilicus)

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6
Q

what are the 9 regions of the abdomen?

what divides them?

A 
right/left hypochondrium
right/left lumbar
right/left inguinal
epigastric, umbilical, pubic down the middle
2 mid-clavicular planes
subcostal plane
transtubecular plane
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7
Q

what are the muscles of the anterolateral abdominal wall?

A 
rectus abdominus (6 pack)
external obliques, internal obliques, transversus abdominis
rectus abdominis
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8
Q

what is the function of the anterolateral abdominal wall muscles?

A

contract to guard organs in threat of injury or peritonitis

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9
Q

describe the peritoneum

A

thin, transparent, semi-permeable, serous membrane

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10
Q

abdominal organs develop into the peritoneum like a fist into a balloon, true of false?

A

true

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11
Q

what are the functions of the peritoneum?

A

lines walls of abdominopelvic cavity (parietal) and organs (visceral)
forms peritoneal cavity containing lubricating fluid to help gut move

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12
Q

how can peritonitis occur?

A

blood, pus or faeces (due to trauma) can enter peritoneal cavity and travel around causing inflammation of peritoneum

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13
Q

what are intraperitoneal organs?

A

completely surrounded inperitoneum, barely mobile

stomach, liver/gall bladder, spleen, parts of small and large intestine

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14
Q

what are organs with a mesentery?

A

covered in visceral peritoneum which wraps behind the organ to form a double layer which attaches it to body wall (mesentery) making it mobile
small intestine

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15
Q

what are retroperitoneal organs?

A 
only anterior surface covered in peritoneum as resting on body wall
kidneys
adrenal gland
pancreas
ascending/descending colon
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16
Q

name 3 formations of peritoneum which form due to rotation of GI tract during development

A

mesentery
omentum
peritoneal ligaments

17
Q

what are the components and function of mesentery?

A

attach organs tomposterior body wall providing high mobility

contain blood/lymph vessels, nerves, lymph nodes and fat

18
Q

what are the 3 mesenterys?

A

mesentery proper: small intestine
transverse and sigmoid mesocolon
mesoappendix

19
Q

describe the structure and function of the greater omentum

A

4 layered apron like structure that hangs over organs

attaches greater curvature of stomach to transverse colon

20
Q

describe the structure and function of the lesser omentum

A

double layered
2 parts: attaches liver to stomach and liver to duodenum
has a free edge which contains portal triad
dives peritoneal cavity into greater/lesser sac

21
Q

how do the greater and lesser sac communicate?

A

via the omental foramen (foramen of winslow)

22
Q

what lies in the free edge of the lesser omentum?

A

the portal triad (bile duct, hepatic artery, portal vein)

23
Q

what are the 2 ligaments of the lesser omentum?

A 
hepatogastric ligament
hepatoduodenal ligament (free edge)
24
Q

what are the 2 ligaments of the greater omentum?

A

gastrosplenic ligament

slenorenal ligament

25
Q

what are the male/female pouches of peritoneum that drape over the pelvic organs?

A 
male = rectovesical pouch
female = vesico-uterine pouch, recto-uterine pouch (pouch of douglas)
26
Q

what is ascites and what causes it?

A

collection of fluid in the peritoneal cavity

caused by cirrhosis/portal hypertension

27
Q

how is ascites drained and where is this done?

A

abdominocentesis

needle placed lateral to rectus sheath to avoid inferior epigastric artery

28
Q

what is visceral/somatic pain like?

A 
visceral = dull, aching
somatic = sharp, stabbing
29
Q

what nerves supply the organs of the abdominal cavity?

A 
visceral afferents (sensory)
enteric nervous system
autonomic motor nerves (parasympathetic/sympathetic)
30
Q

what nerves supply the abdominal wall?

A

somatic sensory
somatic motor
sympathetic nerve fibres

31
Q

how do sympathetic nerves get from CNS to abdominal organs?

A

leave spinal cord at T5-L2
enter sympathetic chains
leave chains within abdominopelvic splanchic nerves
synapse at prevertebral ganglia anterior to branches of abdominal aorta
Post synaptic sympathetic nerves pass from prevertebral ganglia onto surface of abdominal aorta branches
These nerves take part in periarterial plexuses as they hitch a ride with the arteries and their branches to the organs

32
Q

how do sympathetic nerves get from the CNS to the adrenal gland?

A 
leave spinal cord (T10-L1)
enter abdominopelvic splanchnic nerves
don't synapse at prevertebral ganglia
carried with periarterial plexuses to the adrenal gland
synapse directly onto cells
33
Q

how does the parasympathetic vagus nerve get from the CNS to the abdominal organs?

A

presynaptic parasympathetic nerve fibres enter abdominal cavity on the surface of the oesophagus (vagal trunks)
travel into the periarterial plexuses around abdominal aorta
carried to walls of organs where they synapse in ganglia

34
Q

which regions does pain in the foregut, midgut and hindgut refer to?

A 
foregut = epigastric
midgut = umbilical
hindgut = pubic
35
Q

how do visceral afferents get from abdominal organs to CNS?

A 
run alongside sympathetic fibres back to the spinal cord
Foregut = T6-T9
Midgut = T8-T12
Hindgut = T10-L2
Pain is therefore felt in the dermatomes
36
Q

what 4 nerves are the somatic motor, somatic sensory and sympathetic nerves supplying the body wall conveyed within?

A 
thoracoabdominal nerves (7th-11th intercostal nerves)
subcostal nerve (T12 anterior ramus)
Iiohypogastric nerve (half of L1 anterior ramus)
Ilioinguinal nerve (other half of L1 anterior ramus)
37
Q

why does appendicitis start as dull and achy in the umbilical then becomes sharp and stabbing in the right iliac region?

A

pain from midgut radiates to umbilical region (due to visceral afferents entering spinal cord there)
as appendix gets more inflamed it irritates the parietal peritoneum in the right iliac fossa causing sharp pain there

GI lectures (75 decks)

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