Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GIR Test 1 > B5.015 Abdominal Pain The Big Case > Flashcards

B5.015 Abdominal Pain The Big Case Flashcards

1
Q

types of pain

A

visceral
somatic-parietal
referred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

transmission of visceral pain

A

transmitted by C fibers that are found in muscle, peritoneum, mesentery, periosteum and viscera

  • most painful stimuli from abdominal viscera are conveyed by these types of fiber
  • highly sensitive to distention, inflammation, and ischemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

characteristics of visceral pain

A

dull, cramping, burning, gnawing, squeezing, deep, sickening
poorly localized and more gradual in onset
often can be referred to a more distant superficial structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

why is visceral pain usually perceived in the midline

A

abdominal organs transmit sensory afferents to both sides of the spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

3 regions of abdominal visceral pain

A 
foregut = epigastric
midgut = periumbilical
hindgut = suprapubic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

secondary autonomic effects of visceral pain

A

sweating, restlessness, nausea, vomiting, perspiration, and pallor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

why may visceral pain have secondary autonomic effects?

A

pathways of visceral afferent fibers that mediate pain travel with autonomic nerves to communicate with the CNS
vagal and pelvic parasympathetic nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

somatic parietal pain transmission

A

mediated by alpha gamma fibers that are distributed principally to the skin muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

characteristics of somatic-parietal pain

A

sharp, stabbing, well localized

usually aggravated by movement or vibration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

why is there lateralization of somatic parietal pain

A

only one side of the nervous system innervates the given part of the parietal peritoneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

referred pain

A

pain felt in areas removed from the diseased organ and results when visceral afferent neurons and somatic afferent neurons from a different anatomic region converge on second order neurons in the spinal cord at the same spinal segment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

example of referred pain

A

gallbladder inflammation can irritate the diaphragm which is innervated by C3,4,5
dermatomes of these spinal cord segments supply the shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Kehr’s sign

A

diaphragmatic irritation from a subphrenic hematoma or splenic rupture being perceives as shoulder pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

chronological patterns of pain

A
  1. subside spontaneously with time
  2. colicky- pain progresses and remits
  3. progressive
  4. catastrophic onset
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

appendicitis pain

A 
gradual
periumbilical early, RLQ late
diffuse early, localized late
ache
no radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

cholecystitis pain

A 
acute 
RUQ
localized
constricting
radiation to scapula
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

pancreatitis pain

A

acute
epigastrium, back
localized
midback radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

diverticulitis pain

A 
gradual
LLQ
localized
ache
no radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

perforated peptic ulcer pain

A 
sudden
epigastric
localized early, diffuse later
burning
no radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

small bowel obstruction pain

A 
gradual
periumbilical
diffuse
cramping
no radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

mesenteric ischemic pain

A 
sudden
periumbilical
diffuse
agonizing
no radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

ruptured AAA

A 
sudden
abdomen, back, flank
diffuse
tearing
no radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

gastroenteritis pain

A 
gradual
periumbilical
diffuse
spasmodic
no radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

pelvic inflammatory disease pain

A 
gradual
either LQ, pelvis
localized
ache
radiation to upper thigh
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

ruptured ectopic pregnancy pain

A 
sudden
either LQ, pelvis
localized
sharp
no radiation
26
Q

examples of aggravating and alleviating factors

A

peritonitis patients lie motionless
renal colic may writhe in pain
fatty foods cause biliary pain
duodenal ulcer relieved by food
gastric ulcer or mesenteric ischemia worsened by food
pancreatitis relieved by sitting up or leaning forward

27
Q

symptoms that may be associated with abdominal pain

A

constitutional symptoms (fevers, chills, night sweats, weight loss, myalgias)
digestive function (nausea, vomiting, diarrhea)
jaundice
change in menses
dysuria
cardiopulmonary symptoms

28
Q

why is history of surgeries important in cases of abdominal pain

A

scar tissue increases risk of obstruction
complication for surgery
abscess

29
Q

cardiovascular disease history

A

raise suspicion for mesenteric ischemia (atherosclerosis)

30
Q

NSAIDs

A

risk for ischemia and peptic ulcer disease

31
Q

narcotics

A

constipation

32
Q

chronic steroids

A

adrenal insufficiency
immunosuppression
atypical abdominal pain presentations

33
Q

ethanol

A

liver disease or pancreatitis

34
Q

family history

A

IBD

cancer

35
Q

travel history

A

gastroenteritis

36
Q

glistening, taut appearance

A

ascites

37
Q

bluish periumbilical discoloration

A

intra-abdominal bleeding

38
Q

straie

A

pregnancy or weight gain
recent origin are pink, but turn silvery white over time
cushings are purplish

39
Q

writhing in pain and changing positions frequently

A

visceral pain (obstruction of gastroenteritis)

40
Q

Cullen’s sign / Grey Turner’s sign

A

ecchymosis
bleeding from retroperitoneal areas
medical emergency

41
Q

increased bowel sounds

A

hunger
gastroenteritis
bowel obstruction

42
Q

high pitched tinkling

A

intestinal fluid and air under pressure, suggests early bowel obstruction

43
Q

decreased bowel sounds

A

peritonitis

paralytic ileus

44
Q

friction rub

A

high pitched, associated with inspiration

inflammation of peritoneal surface from tumor, infection or infarct

45
Q

bruits

A

abdominal aneurysm

46
Q

predominant percussion sound in abdomen

A

tympany- air present in stomach and intestines

47
Q

Carnett sign

A

MSK pain
localized
lift legs or do crunches to contract abs
makes pain worse

48
Q

what’s included in a CMP

A 
electrolytes
BUN
creatinine
glucose
aminotransferases
alk phos 
bilirubin
49
Q

aortic aneurysm on imaging

A

dark central vessel

secondary lumen = aneurysm

50
Q

hepatobiliary scan

A

uses a tracer that is injected into your vein that helps capture imaged of the liver, gallbladder, bile ducts and small intestine

51
Q

acute diverticulitis

A

inflammation/ infection of diverticula

52
Q

acute diverticulitis pain

A

abdominal pain mainly in the LLQ due to involvement of the sigmoid

53
Q

site of acute diverticulitis

A

most commonly occur in the mesenteric side of 2 bands of tenia coli due to perforating nutrient arteries

54
Q

acute diverticulitis presentation

A

affect middle age men
pain constant and usually present for days prior to presentation
20% can palpate tender mass due pericolonic inflammation or peridiverticular abscess
change in bowel habits
leukocytosis (maybe)
serum amylase and lipase may be elevated if there is peritonitis or perforation

55
Q

acute diverticulitis ultrasound findings

A

peridiverticular inflammation, abscess with or without gas bubbles, bowel wall thickening, diverticula

56
Q

acute diverticulitis CT findings

A

localized bowel wall thickening
increase in soft tissue density
pericolonic fat stranding and the presence of diverticula

57
Q

acute diverticulitis MRI findings

A

colonic wall thickening, diverticula, pericolonic exudates, edema, narrowing of the colon, ascites, abcess

58
Q

what % of diverticulosis is symptomatic

A

5-15% bleeds

4% diverticulitis

59
Q

nutritional management of diverticulitis

A

high fiber

low fat

60
Q

medical management of diverticulitis

A

antibiotics (Cipro)
laxatives
stool softeners
hospitalization for refractory disease or immunocompromised with IV antibiotics
colonoscopy is contraindicated in acute setting

GIR Test 1 (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions