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Bioregulatory Systems: Upper GI Tract > Abdominal Pain (Complete) > Flashcards

Abdominal Pain (Complete) Flashcards

1
Q

Most abdominal diseases present usually with which symptom alone?

A

Pain

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2
Q

Most abdominal diseases present with pain alone. However there is likelihood of making a correct diagnosis based on focusing on which 2 things in the history?

A

Site of pain

Character of pain

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3
Q

What acronym is useful in determing cause of abdominal pain in history taking?

A

SOCRATES

Site

Onset

Character

Radiation

Associating

Time course

Exacerbating or relieving factors

Severity

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4
Q

Label the abdominopelvic regions

A
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5
Q

Label the 4 abdominopelvic quadrants

A
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6
Q

Label the horizontal planes of surface anatomy

A
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7
Q

The transpyloric plane is at which vertebral level?

A

L1

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8
Q

List 6 anatomical structures that lie within the transpyloric plane (L1)

A

Pylorus of stomach

Neck of pancreas

Fundus if gallblader

Dueodenojejunal flexure

Hillum of kidney

End of spinal cord (Adult)

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9
Q

What vertebral level is subcostal plane located?

A

L3

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10
Q

What important anatomical structure lies within the subcostal plane (L3)?

A

Origin of inferior mesenteric artery

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11
Q

What vertebral level does the supracristal plane lie on?

A

L4

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12
Q

What important anatomical structure lies at the level of the supracristal plane (L4)?

A

Bifurcation of aorta (Common iliac arteries)

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13
Q

Pain in the right hypochondriac region is mostly a result of which anatomical structure?

A

Gallbladder

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14
Q

Pain in the left hypochondriac region is mostly a result of which anatomical structure?

A

Pancreas

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15
Q

Pain in the epigastrum is mostly a result of which 3 anatomical structure?

A

Stomach

Duodenum

Pancreas

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16
Q

Pain in the right and left lumbar region is mostly a result of which anatomical structure?

A

Kidneys

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17
Q

Pain in the right iliac region is mostly a result of which 2 anatomical structures?

A

Appenidx

Cecum

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18
Q

Pain in the left iliac region is mostly a result of which anatomical structure?

A

Sigmoid colon

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19
Q

Pain in the hypogastric region is mostly a result of which anatomical structure?

A

Colon (Transverse)

Bladder

Uterus

Adnexae (Skin)

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20
Q

Useful pain site diagram

A
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21
Q

What are the 3 main divisions of the gut?

A

Foregut

Midgut

Hindgut

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22
Q

What 3 GI structures are a part of the foregut?

A

Distal oesophagus

Stomach

Proximal half of 2nd part (desecending) duodenum

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23
Q

Which important vessel of the abdominal aorta supplies the foregut?

A

Celiac trunk

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24
Q

What 3 GI structures form the midgut?

A

Distal half of 2nd part of duodenum

Small intestine

Proximal 2/3rds of transverse colon

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25
What GI structures form the hingut?
Distal 1/3rd of transverse colon all the way to rectum
26
What major vessel branching from the abdominal aorta supplies the midgut?
Superior mesenteric artery
27
What major vessel branching from the abdominal aorta supplies the hindgut?
Inferior mesenteric artery
28
What is the main difference between visceral and parietal peritoneum innervation?
Visceral innervation is mainly autonomic (sympathetc and parasympathetic) Parietal innervation is mainly somatic
29
Parietal peritoneal has somatic innervation. What implication does this have on the type of pain experienced?
Pain would be sharp/ache
30
How does parietal and visceral peritoneal pain differ between eachother in terms of character?
Parietal: Sharp/Ache Visceral: Crampy, dull, ache
31
How does parietal and visceral peritoneal pain differ between eachother in terms of site of pain?
Parietal: Well-localised Visceral: Embryological origin (not-well localised)
32
Visceral peritoneum is innervated by sympathetic fibres from which vertebral levels?
T1-L2
33
Visceral peritoneum is innervated by parasympathetic fibres from which vertebral levels?
CN 3, 7, 9, 10, 11 S2-S4
34
The foregut is innervated by autonomic fibres from which vertebral levels?
T5-T9
35
The midgut is innervated by autonomic fibres from which vertebral levels?
T10-T11
36
The hindgut is innervated by autonomic fibres from which vertebral levels?
L1-L2
37
Which abdominopelvic regions do foregut, midgut and hindgut pain displau themselves in mostly?
Foregut: Epigastric pain Midgut: Umbilical pain Hindgut: Hypogastric pain
38
Most painful conditions of the abdomen fall into which 2 categories?
Inflammation Obstruction of muscular tube
39
What is the 3 main signs that abdominal pain may have a inflammatory cause?
Pain is constant Pain worsened by movement Pain continues until the inflammation has subsided
40
What is the 3 main signs that abdominal pain maybe due to muscular tube obstruction?
Pain is collicky ('gripping') Fluctuates in severetiy Move to try and get comfortable
41
**Prolonged** obstruction of a hollow viscus (refers to any large GI organ) can result in **distention** which has a different characteristic of pain. What are the 2 main signs and what should always be suspected for this type of presentation?
Consttant stretching pain Different from ache of inflammation and not colicky in nature Always suspect potential ischaemia
42
What 3 abdominal organs present with **constant** pain in terms of character?
Liver Spleen Kidney
43
What 3 abdominal organs present with colicky pain in terms of character?
Kidneys, Bladder, Ureters (If obstructionl like stone) Small and large intestine Gallbladder (Duct obstructions)
44
Memorise diagram
45
Diagram showing differences in colic pain intensity between abdominal organs
46
How does gallbladder pain tend to radiate?
Radiates through the back and to the right
47
How do epigastric pain tend to radiate?
Straight through the back
48
How does pancreas (left hypochondriac) pain tend to radiate?
Through back and to the left
49
How does right and left lumbar (kidney) pain tend to radiate?
Through loin and to the groin
50
How does umbilical pain tend to radiate?
Doesnt tend to radiate
51
How does the left and right iliac and hypogastric region pain tend to radiate?
Rarely radiates and if pain is from deep pelvic structures, pain tends to be referred to lower back/perineum
52
For abdominal pain, if there is radiation of pain, what does it indicated?
Signifies involvement of other structures
53
Colicky abdominal pain is referred to which region usualy?
Centre (Visceral sensation)
54
Small bowel pain doesn’t radiate but may move when?
Somatic as well as visceral nerves become irritated
55
What is a typical presentation of bowel obstruction based on SOCRATES findings?
Site: Central (Umbilical) O: Gradual C: Colicky R: No radiation Association: Vomitting, Bowels not open E: Passing flatus relieves pain Severity: Moderate
56
What is a typical presentation of ureteric colic based on SOCRATES findings?
S: Loin (Lumbar) O: Sudden onset C: Colicky R: To groin A: Vomitting T: Previous colicky pain E: Cannot find comfortable positions S: 10/10
57
What is a typical presentation of billiary colic based on SOCRATES findings?
S: RUQ O: Sudden onset C: Colicky R: Right shoulder A: Nausea, Indigestion T: After eating E: Fatty foods S: 10/10
58
Give 3 examples of causes of biliary colic
Cholilethiasis (gallstones) Hepatolithiasis Choledocholithiasis
59
What is a typical presentation of appendicitis based on SOCRATES findings?
S: Central then shifts to right iliac region O: Gradual onset C: Constant R: No radiation A: Nausea, Fever, Anorexia T: No previous pain E: Movement S: Dull ache
60
List 4 examples of potential causes of right hypochondriac pain
Gallstones Cholangitis (bile dut inflammation) Hepatitis Liver abscess (mass of pus and blood in liver)
61
List 3 examples of potential serious causes of left hypochondriac pain
Splenic abscess Splenic rupture **Acute** splenomegaly
62
List 5 examples of potential serious causes of epigastric pain
Oesophagitis Pancreatitis Peptic ulcer Perforated ulcer Biliary tract disease
63
List 5 examples of potential serious causes of right lumbar pain
Renal colic Pyelonephritis (Kidney infection) Ovarian mass Ovarian torsion Ovarian cysts
64
List 4 examples of potential serious causes of left lumbar pain
Renal colic Pyelonephritis Ovarian cyst Ovarian mass Ovarian torsion
65
List 3 examples of potential serious causes umbilical pain
Appendicitis (early) Mesenteric adenitis (Inflammed mesenteric lymph nodes) Meckel’s diverticulitis (Congenital bulge of part of small intestine)
66
List 6 examples of potential serious causes right iliac pain
Appendicitis (late) Crohn’s Disease Ovarian cyst/torsion Ectopic pregnancy Hernias Renal colic
67
List 6 examples of potential serious causes of hypogastric pain
Urinary retention Cystitis (Inflammed bladder) Uterine fibroid Endometriosis
68

Bioregulatory Systems: Upper GI Tract (13 decks)

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