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BRS - Year 2 > 🍔Gastro🍔 - Abdominal Pain > Flashcards

🍔Gastro🍔 - Abdominal Pain Flashcards

1
Q

What are the most significant properties of (abdominal)

A

Site and character

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2
Q

What are the abdominopelvic regions?

A
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3
Q

What are the abdominopelvic quadrants?

A
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4
Q

What are the 5 main planes of the abdomen?

A
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5
Q

What is the level of the transpyloric plane?

A

L1

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6
Q

What lies on the transpyloric plane?

A

Pylorus of the stomach
Neck of the pancreas
Fundus of the gallbladder
Renal hilum
Duodenojejunal flexure
End of spinal cord (adult)

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7
Q

What is the level of the subcostal plane?

A

L3

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8
Q

What lies on the subcostal plane?

A

Origin of the inferior mesenteric artery

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9
Q

What is the level of the supracristal plane?

A

L4

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10
Q

What occurs on the supracristal plane?

A

Bifurcation of the aorta

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11
Q

What common sites of abdominal pain are located in the right hypochondriac region?

A

Gallbladder

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12
Q

What common sites of abdominal pain are located in the epigastric region?

A

Stomach
Duodenum
Pancreas

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13
Q

What common sites of abdominal pain are located in the left hypochondriac region?

A

Pancreas

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14
Q

What common sites of abdominal pain are located in the right lumbar region?

A

Kidney

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15
Q

What common sites of abdominal pain are located in the umbilical region?

A

Small bowel
Caecum
Retroperitoneal structures

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16
Q

What common sites of abdominal pain are located in the left lumbar region?

A

Kidney

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17
Q

What common sites of abdominal pain are located in the right iliac region?

A

Appendix
Caecum

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18
Q

What common sites of abdominal pain are located in the hypogastric region?

A

Terminal colon
Bladder
Uterus
Andexae - the ovaries, fallopian tubes and ligaments that secure the female reproductive organs

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19
Q

What common sites of abdominal pain are located in the left iliac region?

A

Sigmoid colon

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20
Q

What are the 3 anatomical regions of the GI tract?

A

Foregut
Midgut
Hindgut

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21
Q

What section of the GI tract is labelled as the foregut?

A

Distal oesophagus to the proximal half of the 2nd part of the duodenum

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22
Q

What section of the GI tract is labelled as the midgut?

A

Distal half of the 2nd part of the duodenum to the proximal 2/3 of the transverse colon

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23
Q

What section of the GI tract is labelled as the hindgut?

A

Distal 1/3 of the transverse colon to the rectum

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24
Q

What are the visceral and parietal peritoneum?

A
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25
Q

What are innervations of the visceral vs parietal peritoneum?

A
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26
Q

What are the sites of pain in the visceral vs parietal peritoneum?

A

Visceral has pain of embryological origin
Parietal has well-localised site of pain

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27
Q

What is the difference in the character of pain experience by the visceral and parietal peritoneum?

A

Visceral has a dull, crampy, burning pain
Parietal has sharp pain, or an ache

28
Q

What is the innervation for sensation in the foregut?

A

T5-T9

29
Q

What is the innervation for sensation in the midgut?

A

T10-T11

30
Q

What is the innervation for sensation in the hindgut?

A

L1-L2

31
Q

What are the sites of pain in each of the areas of the gut?

A

Foregut - epigastrium
Midgut - Umbilical
Hindgut - Hypogastrium

32
Q

What categories do the most painful abdominal conditions fall into?

A

Inflammation
Obstruction of a muscular tube

33
Q

What is experienced with inflammation in the abdomen?

A

Constant pain (“aching”)
Made worse by movement
Persists until inflammation subsides

34
Q

What is experience with obstruction of a muscular tube in the abdomen?

A

Colicky pain (“gripping”)
Fluctuates in severity
Move to try and get comfortable

35
Q

What can prolonged obstruction of a hollow viscus lead to?

A

Constant stretching pain
Distention

36
Q

What should be queried if there is an abdominal pain that is different from the ache of inflammation and is not colicky?

A

Ischaemia

37
Q

What character of pain is experienced by the urinary tract?

A

Colicky

38
Q

What character of pain is experience by the liver?

A

Constant

39
Q

What character of pain is experienced by the biliary tree?

A

Colicky

40
Q

What character of pain is experienced by the spleen?

A

Constant

41
Q

What character of pain is experienced by the kidney?

A

Constant

42
Q

What character of pain is experienced by the intestinal tract?

A

Colicky

43
Q

Compare the pains of ureteric, intestinal and biliary colic

A
44
Q

What could a transition from colicky to constant pain indicate?

A

Ischaemia

45
Q

Where does gallbladder pain radiate to?

A

Through to the back and right

46
Q

Where does stomach, duodenal or pancreatic (in the epigastric region) pain radiate to?

A

Straight through to the back

47
Q

Where does pancreatic pain in the left hypochondriac region radiate to?

A

Through to the back and left

48
Q

Where does kidney pain radiate to?

A

The loin and radiates to the groin (on the respective side)

49
Q

Where does small bowel, caecum or retroperitoneal structure pain radiate to?

A

Doesn’t normally radiate

50
Q

Where does lower abdominal pain radiate to?

A

Rarely radiates
Pain from structures deep in the pelvis referred to lower back/perineum

51
Q

Where does colicky abdominal pain generally radiate to?

A

Referred to the centre (visceral sensation)

52
Q

Where does pain from parietal inflammation generally radiate to?

A

Felt over the inflamed area (somatic sensation)

53
Q

What are the causes of pain in the right upper quadrant?

A

Gallstones
Cholangitis
Hepatitis
Liver abscess

54
Q

What are the causes of pain the the epigastric region?

A

Oesophagitis
Peptic ulcer
Perforated ulcer
Pancreatitis
Biliary tract disease

55
Q

What are the causes of pain in the left upper quadrant?

A

Splenic abscess
Acute splenomegaly
Splenic rupture

56
Q

What are the causes of pain in the lumbar regions?

A

Renal colic
Pyelonephritis
Ovarian cyst
Ovarian mass
Ovarian torsion

57
Q

What are the causes of pain in the right lower quadrant?

A

Appendicitis
Crohn’s
Ovarian cyst/torsion
Ectopic pregnancy
Hernias
Renal colic

58
Q

What are the causes of pain in the left lower quadrant?

A

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

59
Q

What are the causes of pain in the pelvic/lower abdominal region?

A

Urinary retention
Cystitis
Uterine fibroid
Endometriosis

60
Q

What is the typical SOCRATES of appendicitis?

A
61
Q

How will someone with appendicitis present?

A

Central pain, visceral stimulation
As progresses, starts to irritate the parietal peritoneum
Gradual onset
Recoiling from the idea of food
Non-classical presentation possible (as appendix can be in a number of places)

62
Q

What is the typical SOCRATES of bowel obstruction?

A
63
Q

How does someone with bowel obstruction present?

A

Can be small or large bowel
Farting relieves pain
Most common cause is adhesions (scar tissue) e.g. post op
Called adhesions because they ‘adhere’ to the bowel

64
Q

What is a typical SOCRATES for ureteric colic?

A
65
Q

How does someone with ureteric colic present?

A

Very painful - stones through the ureter
Usually a fairly easy diagnosis

66
Q

What is a typical SOCRATES for biliary colic?

A

BRS - Year 2 (54 decks)

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