Autonomics and Pain Clinical Stuff Flashcards
What are causes of right hypochondriac pain?
gallstones, cholangitis, hepatitis, liver abscess
What are causes of epigastric pain?
esophagitis, peptic ulcer, perforated ulcer, pancreatitis
What are causes of left hypochondriac pain?
spleen abscess, acute splenomegaly, spleen rupture
What are causes of right flank/lumbar pain?
ureteric colic, pyelonephritis
What are causes of umbilical pain?
appendicitis (early), mesenteric adenitis, Meckel’s diverticulitis, lymphomas
What are causes of left flank/lumbar pain?
ureteric colic, pyelonephritis
What are causes of right inguinal pain?
appendicitis (late), Chron’s, cecum obstruction, ovarian cyst, ectopic pregnancy, hernias
What are causes of hypogastric or pubic pain?
testicular torsion, urinary retention, cystitis, placental abruption
What are causes of left inguinal pain?
diverticulitis, ulcerative colitis, constipation, ovarian cyst, hernias
What structures case retroperitoneal pain? Where does the pain go to?
Pancreas, kidney, and aorta
Back
What is colicky pain? What can cause it?
intermittent cramp like caused by obstruction of hollow muscular viscus
bowel obstructions from adhesions, stone in ureter, stone in neck of gall bladder
How would a patient present with a gastric ulcer?
foregut visceral pain, worse on eating, pt tend to avoid meals
How would a patient present with a perforated gastric ulcer?
foregut chronic visceral pain, sudden severe pain spreading all over abdomen, peritonitis
How would a patient present with acute cholecystitis?
foregut visceral pain, somatic pain in RUQ, referred pain to right shoulder, nausea and vomiting, fever, tender RUQ, positive murphy
How would a patient present with acute appendicitis?
midgut visceral pain, somatic pain in RLQ, nausea and vomiting, fever, tender RLQ, if appendix ruptured then signs of localized peritonitis in RLQ
How would a patient present with adhesive small bowel obstruction?
history of previous abdominal surgery, midgut visceral colicky pain, vomiting, not flatus or bowel action, possible dehydration, distended soft abdomen non-tender, increased bowel sounds
How would a patient present with passage of a kidney stone?
sudden onset of very severe colicky pain from loin to groin, patient writhing with pain and pacing, possible hematuria, afebrile, soft abdomen, tender renal angle
How would a patient present with obstructing cancer of descending colon?
older age, weight loss, hindgut visceral colicky pain, no flatus or feces, distended abdomen, possible mass to feel in LLQ, increased bowel sounds
How would a patient present with ruptured ectopic pregnancy?
woman of childbearing age, missed last period, sudden onset of severe pain in hypogastrium radiating to sacral area, afebrile, localized peritonitis in suprapubic, tenderness in rectouterine pouch on DRE or vag exam
How would a patient present with leaking aortic aneurysm?
elderly male w/ history of atherosclerotic disease such as hypertension or cardiac disease
sudden onset of severe back pain
pale and shocked
hypotensive, tender epigastrium, palpable impulse from aneurysm in epigastrium
