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!!!!! BRS YR2 !!!!! > Gastro - Abdominal Pain > Flashcards

Gastro - Abdominal Pain Flashcards

1
Q

What does SOCRATES stand for?

A 
S = site 
O = net 
C = character 
R = radiation 
A = associations 
T = time course, duration 
E = exacerbating / relieving factors 
S = severity
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2
Q

What is region 1 of the 9 quadrants?

A

right hypochondriac region

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3
Q

What is region 2 of the 9 quadrants?

A

epigastric region

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4
Q

What is region 3 of the 9 quadrants?

A

left hypochondriac region

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5
Q

What is region 4 of the 9 quadrants?

A

right lumbar (flank) region

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6
Q

What is region 5 of the 9 quadrants?

A

umbilical region

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7
Q

What is region 6 of the 9 quadrants?

A

left lumbar (flank) region

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8
Q

What is region 7 of the 9 quadrants?

A

righth iliac region

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9
Q

What is region 9 of the 9 quadrants?

A

left iliac region

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10
Q

What is region 8 of the 9 quadrants?

A

suprapubic / hypogastric region

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11
Q

What is the blood supply for the foregut?

A

celiac trunk

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12
Q

What planes are used to divide the abdomen into 9 regions?

A
  • subcostal plane (horizontal)
    (corresponds to a line drawn joining the lower most bony point of the rib cage, usually 10th costal cartilage)
  • transtubercular plane (horiz)
    (corresponds to a line uniting the two tubercles of the iliac crests)
  • mid-clavicular lines (vertical)
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13
Q

What vertebra does the transpyloric plane pass through?

A

L1

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14
Q

What organs of the abdomen are present at the transpyloric plane?

A
  • Pylorus of Stomach
  • Neck of Pancreas
  • Fundus of Gallbladder
  • Renal Hilum
  • Duodenojejunal Flexure
  • End of Spinal Cord (adult)
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15
Q

What vertebra does the subcostal plane pass through?

A

L3

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16
Q

What parts of the abdomen are present at the subcostal plane?

A

origin of inferior mesenteric artery

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17
Q

What vertebra does the supracristal plane pass through?

A

L4

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18
Q

What parts of the abdomen are present at the supracristal plane?

A

bifurcation of aorta

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19
Q

What organs are present in the right hypochondriac region?

A

gall bladder

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20
Q

What organs are present in the epigastric region?

A

stomach, duodenum + pancreas

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21
Q

What organs are present in the left hypochondriac region?

A

pancreas
spleen

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22
Q

What organs are present in the right lumbar / flank region?

A

kidney

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23
Q

What organs are present in the umbilical region?

A

small bowel
caecum
retroperitoneal structures

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24
Q

What organs are present in the left lumbar / flank region?

A

kidney

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25
Q

What organs are present in the right iliac region?

A

appendix
caecum

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26
Q

What organs are present in the suprapubic (hypogastric) region?

A

transverse colon
bladder
uterus
adnexae

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27
Q

What organs are present in the left iliac region?

A

sigmoid colon

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28
Q

What is a part of the foregut?

A

distal oesaphagus
stomach
liver
gall bladder spleen
proximal half of the 2nd part of duodenum

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29
Q

What is the blood supply for the hindgut?

A

inferior mesenteric trunk

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30
Q

What is a part of the midgut?

A

distal half of 2nd part of duodenum –> proximal 2/3 of transverse colon

31
Q

What is the blood supply for the midgut?

A

superior mesenteric artery

32
Q

What is included in the hindgut?

A

distal 1/3 of transverse colon –> rectum

33
Q

What is the parietal peritoneum?

A

membranous sheet that lines abdominal cavity, attached to to the visceral peritoneum to form peritoneal cavity

34
Q

What is visceral peritoneum?

A

membranous sheet that lines the organs within the peritoneal cavity

35
Q

Which organs are intraperitoneal?

A

stomach
spleen
liver
first and fourth parts of the duodenum
jejunum
ileum
transverse colon
sigmoid colon

36
Q

Which organs are retroperitoneal?

A

rest of the duodenum
ascending colon
descending colon
middle third of rectum
pancreas

37
Q

What is the innervation of the parietal?

A

somatic
phrenic nerves
T6-L3

38
Q

What is the innervation of the visceral?

A

autonomic
Sympathetic – T1 to T12, L1, L2
Parasympathetic – CN III, VII, IX, X, S2 to S4

39
Q

What is the site of pain like for parietal?

A

well-localised

40
Q

What is the site of pain like for visceral?

A

embryological origin

41
Q

What is the character of pain like for parietal?

A

sharp, ache

42
Q

What is the character of pain like for visceral?

A

dull, crampy, burning

43
Q

What is the innervation for the foregut?

A

T5-T9

44
Q

What is the innervation of the midgut?

A

T10-T11

45
Q

What is the innervation of the hindgut?

A

L1-L2

46
Q

Where is the site of pain for the foregut?

A

epigastrium

47
Q

Where is the site of pain for the midgut?

A

umbilical

48
Q

Where is the site of pain for the hindgut?

A

hypogastric

49
Q

What are the 2 categories of pain usually?

A

inflammation - based
obstruction of a muscular tube

50
Q

What kind of pain does inflammation present with?

A

Constant pain (‘aching’)
Made worse by movement
Persists until inflammation subsides

51
Q

What kind of pain does obstruction present with?

A 
Colicky pain (‘gripping’) 
Fluctuates in severity 
Move to try and get comfortable
52
Q

What does prolonged obstruction cause?

A

causes distension:
Constant stretching pain
Different from ache of inflammation & not colicky
ischaemia

53
Q

What organs + problems present with constant pain?

A

liver + gall bladder
kidney issues
spleen

54
Q

What organs + problems present with colicky pain?

A

kidney stones, etc.
cholelithiasis
hepatolithiasis
choledocholithiasi
biliary colic
small bowel + large bowel issues

55
Q

What is the character of pain like for ureteric, biliary + intestinal colic?

A
56
Q

How does pain radiate when in the right hypochondriac region? Target Organ?

A

through the back + to the right

(gall bladder)

57
Q

How does pain radiate when in the epigastric region? Target Organ?

A

straight through the back

(stomach, duodenum, pancreas)

58
Q

How does pain radiate when in the left hypochondriac region? Target Organ?

A

through to the back + to the left

(pancreas)

59
Q

How does pain radiate when in the right and left lumbar regions? Target Organs?

A

in the loin and radiates to the groin

(kidneys)

60
Q

How does pain radiate in the umbilical region? target organs?

A

doesn’t normally radiate unless small bowel is consistently inflamed

(small bowel, caecum, retroperitoneal structures)

61
Q

How does pain radiate in the iliac and hypogastric regions?

A

Lower abdominal pain rarely radiates
Pain from structures deep in the pelvis referred to lower back/perineum

62
Q

What region of the abdomen does colicky abdominal pain refer to?

A

visceral sensation

63
Q

Where do you usually feel pain from an inflamed area? Why?

A

felt over the inflamed area, due to somatic sensation

64
Q

What does radiation of pain to other regions usually signify?

A

other structure are getting involved

65
Q

Why might small bowel pain move?

A

pain doesn’t radiate but may move when somatic as well as visceral nerves become irritated

66
Q

What disorders could pain in the RUQ represent?

A

Gallstones
Cholangitis
Hepatitis
Liver abscess

67
Q

What disorders could pain in the epigastric region represent?

A

Oesophagitis
Peptic ulcer
Perforated ulcer
Pancreatitis
Biliary tract disease

68
Q

What disorders could pain in the LUQ represent?

A

Splenic abscess
Acute splenomegaly
Splenic rupture

69
Q

What disorders could pain in the right + left flanks represent?

A

Renal colic
Pyelonephritis
Ovarian cyst Ovarian mass
Ovarian torsion

70
Q

What disorders could pain in the umbilical region represent?

A

Appendicitis (early)
Mesenteric adenitis
Meckel’s diverticulitis

71
Q

What disorders could pain in the RLQ represent?

A

Appendicitis (late)
Crohn’s Disease
Ovarian cyst/torsion
Ectopic pregnancy
Hernias
Renal colic

72
Q

What disorders could pain in the LLQ represent?

A

Diverticulitis
Ulcerative colitis
Constipation
Ovarian cyst/torsion
PID
Ectopic pregnancy
Hernias
Renal colic

73
Q

What disorders could pain in the hypogastric region represent?

A

Urinary retention
Cystitis
Uterine fibroid
Endometriosis

!!!!! BRS YR2 !!!!! (72 decks)

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