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Block 15 Ellen > L2: Understanding abdominal pain: > Flashcards

L2: Understanding abdominal pain: Flashcards

1
Q

3 types of abdominal pain

A

visceral
parietal
referred

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2
Q

what is visceral pain

A

sensory fibres from the bowel/ organs/ mesentery conveying pain to the brain with mechanical/ chemical or thermal stimuli

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3
Q

what pattern does visceral pain follow

A

embryological distribution of organs

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4
Q

description of visceral pain (5)

A
  • non specific
  • poorly localised
  • ache or dull pain
  • gradual onset
  • usually midline
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5
Q

foregut=

A

oesophagus to second part of duodenum

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6
Q

midgut=

A

second part of duodenum to splenic flexure

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7
Q

hindgut=

A

splenic flexture to rectum

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8
Q

parietal pain=

A

sensory nerve fibres in the parietal peritoneum

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9
Q

what does parietal pain localise

A

the organ underneath

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10
Q

what pattern does parietal pain follow

A

dermatological

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11
Q

describe parietal pain

A
  • localising pain
  • sharp pain
  • peritonitic
  • worse by movement
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12
Q

what pattern does radiation of pain take

A

from visceral innervation to parietal innervation

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13
Q

epigastrium–>

A

foregut

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14
Q

periumbilical –>

A

midgut

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15
Q

hypogastrium–>

A

hindgut

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16
Q

foregut -> RUQ=

A

cholecystitis

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17
Q

foregut ->back=

A

pancreatitis

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18
Q

midgut -> RIF =

A

appendicitis

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19
Q

midgut -> lower=

A

meckels diverticulitis

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20
Q

forgut -> lower right

A

perforated duodenal ulcer

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21
Q

what is referred pain

A

pain originated from one source felt at another site

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22
Q

where is irritation to the diaphragm (e.g by gallbladder) felt

A

scapular/ shoulder tip area (C3,C4,C5 keeps the diaphragm alive)

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23
Q

acute of sudden causes of pain (5)

A 
torsion 
perforation 
ruptured AAA
ischaemia 
obstruction
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24
Q

few days onset of pain (2)

A
  • inflammation (cholecystitis, appendicitis, diverticulitis)
  • obstruction
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25
Q

2 causes of chronic relapses of pain

A
  • exacerbation of Crohn’s disease

- recurrent small bowel obstruction

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26
Q

colicky pain=

A

obstruction

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27
Q

description of colicky pain

A

comes and goes in waves, gripping pain and then eases and come again

28
Q

what structure causes the colicky pain

A

hollow muscular structure trying to unblock itself with exaggerated contractions

29
Q

bowel colic time=

A

every 15 mins

30
Q

biliary colic time=

A

2-6 hours

31
Q

which obstruction may not have colicky pain

A

late bowel obstruction

32
Q

non-colicky pain/ persistent =

A

inflammation/ itis

33
Q

description of persistent pain

A

pain for few days which doesn’t go away unless with pain killers

34
Q

causes of inflammation persistent pain= (6)

A
  • acute cholecystitis
  • appendicitis
  • gastritis
  • pancreatitis
  • diverticulitis
  • colitis
35
Q

gastro tract pathology symptoms=

A 
vomiting 
bleeding 
bowel changes 
weight loss 
fever
36
Q

gynae pathology symptoms

A

PV bleeding

dysmenorrhoea

37
Q

urology pathology symptoms

A

fever
frequency
UTI
bleeding

38
Q

vascular pathology symptoms

A

dizziness
sweaty
palpitations

39
Q

what can a hiatus hernia present as

A

chest pain

40
Q

liver signs in inspection (4)

A

ascities
spider naevi
clubbing
jaundice

41
Q

murphy’s sign=

A

tenderness in gallbladder

42
Q

rebound tenderness=

A

peritoneum is so painful patient jumps

43
Q

tympanic percussion=

A

gaseous

44
Q

dull percussion=

A

solid/ fluid

45
Q

2 reasons for increased bowel movement

A

gastroenteritis

bowel obstruction

46
Q

5 common pathology’s of acute abdomen

A 
obstruction 
inflammation 
perforation 
biliary 
vascular
47
Q

4 symptoms of obstruction=

A
  • colicky abdo pain
  • vomiting
  • absolute constipation
  • abdominal distension
48
Q

4 signs of obstruction

A

abdo distension
tympanic
visible peristalsis
increased bowel sounds

49
Q

2 types of obstruction

A

closed loop

open loop

50
Q

symptoms of inflammation (4)

A
  • persistent abdo pain
  • feels unwell
  • maybe fever
  • localised pain
51
Q

sign of inflammation

A

abdominal tenderness

52
Q

symptoms of perforation/ peritonitis

A

persistent colicky pain initially later localising pain progressing to generalised abdo pain

53
Q

signs of perforation/ peritonitis (4)

A
  • tender abdomen
  • unable to tolerate deep palpation
  • rigid abdomen
  • rebound tenderness
54
Q

cholecystitis signs

A
  • tender URQ
  • murphy’s sign positive
  • pyrexia and tachycardia
55
Q

biliary colic signs

A

no localising pain

jaundice

56
Q

what is acute cholecystitis

A

gallstones inflaming gallbladder wall

57
Q

what is biliary stones

A

gallstones impacted in neck of the gallbladder obstructing gallbladder

58
Q

symptoms of appendicitis

A
  • periumbilical pain radiating to RIF
  • anorexia
  • nausea
59
Q

signs of appendicitis

A

tender at Mcburney’s
+ve rovsing sign
+ve Psoas sign

60
Q

where is Mcburney’s point

A

1/3 between Anterior superior iliac spine to umbilicus

61
Q

symptoms of vascular emergencies

A

sudden onset of acute pain
light headed
dizzy
loss of concentration

62
Q

signs of vascular emergencies (7)

A
  • tender abdomen (no specific distribution)
  • peritonitis
  • pale
  • tachycardia
  • sweaty
  • hypotension
  • collapsing
63
Q

differential diagnosis for vascular emergencies

A

ruptured abdominal aneurysm
ruptured spleen
other aneurysm

64
Q

symptoms of an embolic event

A
  • sudden acute abdominal pain

- restless with severe pain

65
Q

signs of embolic event

A
  • too painful to examine
  • bowel sounds absent
  • AF

Block 15 Ellen (11 decks)

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