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Bioregulatory Systems: Upper GI Tract > Abdominal Pain (Complete) > Flashcards

Abdominal Pain (Complete) Flashcards

1
Q

Most abdominal diseases present usually with which symptom alone?

A

Pain

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2
Q

Most abdominal diseases present with pain alone. However there is likelihood of making a correct diagnosis based on focusing on which 2 things in the history?

A

Site of pain

Character of pain

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3
Q

What acronym is useful in determing cause of abdominal pain in history taking?

A

SOCRATES

Site

Onset

Character

Radiation

Associating

Time course

Exacerbating or relieving factors

Severity

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4
Q

Label the abdominopelvic regions

A
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5
Q

Label the 4 abdominopelvic quadrants

A
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6
Q

Label the horizontal planes of surface anatomy

A
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7
Q

The transpyloric plane is at which vertebral level?

A

L1

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8
Q

List 6 anatomical structures that lie within the transpyloric plane (L1)

A

Pylorus of stomach

Neck of pancreas

Fundus if gallblader

Dueodenojejunal flexure

Hillum of kidney

End of spinal cord (Adult)

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9
Q

What vertebral level is subcostal plane located?

A

L3

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10
Q

What important anatomical structure lies within the subcostal plane (L3)?

A

Origin of inferior mesenteric artery

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11
Q

What vertebral level does the supracristal plane lie on?

A

L4

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12
Q

What important anatomical structure lies at the level of the supracristal plane (L4)?

A

Bifurcation of aorta (Common iliac arteries)

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13
Q

Pain in the right hypochondriac region is mostly a result of which anatomical structure?

A

Gallbladder

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14
Q

Pain in the left hypochondriac region is mostly a result of which anatomical structure?

A

Pancreas

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15
Q

Pain in the epigastrum is mostly a result of which 3 anatomical structure?

A

Stomach

Duodenum

Pancreas

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16
Q

Pain in the right and left lumbar region is mostly a result of which anatomical structure?

A

Kidneys

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17
Q

Pain in the right iliac region is mostly a result of which 2 anatomical structures?

A

Appenidx

Cecum

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18
Q

Pain in the left iliac region is mostly a result of which anatomical structure?

A

Sigmoid colon

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19
Q

Pain in the hypogastric region is mostly a result of which anatomical structure?

A

Colon (Transverse)

Bladder

Uterus

Adnexae (Skin)

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20
Q

Useful pain site diagram

A
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21
Q

What are the 3 main divisions of the gut?

A

Foregut

Midgut

Hindgut

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22
Q

What 3 GI structures are a part of the foregut?

A

Distal oesophagus

Stomach

Proximal half of 2nd part (desecending) duodenum

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23
Q

Which important vessel of the abdominal aorta supplies the foregut?

A

Celiac trunk

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24
Q

What 3 GI structures form the midgut?

A

Distal half of 2nd part of duodenum

Small intestine

Proximal 2/3rds of transverse colon

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25
Q

What GI structures form the hingut?

A

Distal 1/3rd of transverse colon all the way to rectum

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26
Q

What major vessel branching from the abdominal aorta supplies the midgut?

A

Superior mesenteric artery

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27
Q

What major vessel branching from the abdominal aorta supplies the hindgut?

A

Inferior mesenteric artery

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28
Q

What is the main difference between visceral and parietal peritoneum innervation?

A

Visceral innervation is mainly autonomic (sympathetc and parasympathetic)

Parietal innervation is mainly somatic

29
Q

Parietal peritoneal has somatic innervation. What implication does this have on the type of pain experienced?

A

Pain would be sharp/ache

30
Q

How does parietal and visceral peritoneal pain differ between eachother in terms of character?

A

Parietal: Sharp/Ache

Visceral: Crampy, dull, ache

31
Q

How does parietal and visceral peritoneal pain differ between eachother in terms of site of pain?

A

Parietal: Well-localised

Visceral: Embryological origin (not-well localised)

32
Q

Visceral peritoneum is innervated by sympathetic fibres from which vertebral levels?

A

T1-L2

33
Q

Visceral peritoneum is innervated by parasympathetic fibres from which vertebral levels?

A

CN 3, 7, 9, 10, 11

S2-S4

34
Q

The foregut is innervated by autonomic fibres from which vertebral levels?

A

T5-T9

35
Q

The midgut is innervated by autonomic fibres from which vertebral levels?

A

T10-T11

36
Q

The hindgut is innervated by autonomic fibres from which vertebral levels?

A

L1-L2

37
Q

Which abdominopelvic regions do foregut, midgut and hindgut pain displau themselves in mostly?

A

Foregut: Epigastric pain

Midgut: Umbilical pain

Hindgut: Hypogastric pain

38
Q

Most painful conditions of the abdomen fall into which 2 categories?

A

Inflammation

Obstruction of muscular tube

39
Q

What is the 3 main signs that abdominal pain may have a inflammatory cause?

A

Pain is constant

Pain worsened by movement

Pain continues until the inflammation has subsided

40
Q

What is the 3 main signs that abdominal pain maybe due to muscular tube obstruction?

A

Pain is collicky (‘gripping’)

Fluctuates in severetiy

Move to try and get comfortable

41
Q

Prolonged obstruction of a hollow viscus (refers to any large GI organ) can result in distention which has a different characteristic of pain. What are the 2 main signs and what should always be suspected for this type of presentation?

A

Consttant stretching pain

Different from ache of inflammation and not colicky in nature

Always suspect potential ischaemia

42
Q

What 3 abdominal organs present with constant pain in terms of character?

A

Liver

Spleen

Kidney

43
Q

What 3 abdominal organs present with colicky pain in terms of character?

A

Kidneys, Bladder, Ureters (If obstructionl like stone)

Small and large intestine

Gallbladder (Duct obstructions)

44
Q

Memorise diagram

A
45
Q

Diagram showing differences in colic pain intensity between abdominal organs

A
46
Q

How does gallbladder pain tend to radiate?

A

Radiates through the back and to the right

47
Q

How do epigastric pain tend to radiate?

A

Straight through the back

48
Q

How does pancreas (left hypochondriac) pain tend to radiate?

A

Through back and to the left

49
Q

How does right and left lumbar (kidney) pain tend to radiate?

A

Through loin and to the groin

50
Q

How does umbilical pain tend to radiate?

A

Doesnt tend to radiate

51
Q

How does the left and right iliac and hypogastric region pain tend to radiate?

A

Rarely radiates and if pain is from deep pelvic structures, pain tends to be referred to lower back/perineum

52
Q

For abdominal pain, if there is radiation of pain, what does it indicated?

A

Signifies involvement of other structures

53
Q

Colicky abdominal pain is referred to which region usualy?

A

Centre (Visceral sensation)

54
Q

Small bowel pain doesn’t radiate but may move when?

A

Somatic as well as visceral nerves become irritated

55
Q

What is a typical presentation of bowel obstruction based on SOCRATES findings?

A

Site: Central (Umbilical)

O: Gradual

C: Colicky

R: No radiation

Association: Vomitting, Bowels not open

E: Passing flatus relieves pain

Severity: Moderate

56
Q

What is a typical presentation of ureteric colic based on SOCRATES findings?

A

S: Loin (Lumbar)

O: Sudden onset

C: Colicky

R: To groin

A: Vomitting

T: Previous colicky pain

E: Cannot find comfortable positions

S: 10/10

57
Q

What is a typical presentation of billiary colic based on SOCRATES findings?

A

S: RUQ

O: Sudden onset

C: Colicky

R: Right shoulder

A: Nausea, Indigestion

T: After eating

E: Fatty foods

S: 10/10

58
Q

Give 3 examples of causes of biliary colic

A

Cholilethiasis (gallstones)

Hepatolithiasis

Choledocholithiasis

59
Q

What is a typical presentation of appendicitis based on SOCRATES findings?

A

S: Central then shifts to right iliac region

O: Gradual onset

C: Constant

R: No radiation

A: Nausea, Fever, Anorexia

T: No previous pain

E: Movement

S: Dull ache

60
Q

List 4 examples of potential causes of right hypochondriac pain

A

Gallstones

Cholangitis (bile dut inflammation)

Hepatitis

Liver abscess (mass of pus and blood in liver)

61
Q

List 3 examples of potential serious causes of left hypochondriac pain

A

Splenic abscess

Splenic rupture

Acute splenomegaly

62
Q

List 5 examples of potential serious causes of epigastric pain

A

Oesophagitis

Pancreatitis

Peptic ulcer

Perforated ulcer

Biliary tract disease

63
Q

List 5 examples of potential serious causes of right lumbar pain

A

Renal colic

Pyelonephritis (Kidney infection)

Ovarian mass

Ovarian torsion

Ovarian cysts

64
Q

List 4 examples of potential serious causes of left lumbar pain

A

Renal colic

Pyelonephritis

Ovarian cyst Ovarian mass

Ovarian torsion

65
Q

List 3 examples of potential serious causes umbilical pain

A

Appendicitis (early)

Mesenteric adenitis (Inflammed mesenteric lymph nodes)

Meckel’s diverticulitis (Congenital bulge of part of small intestine)

66
Q

List 6 examples of potential serious causes right iliac pain

A

Appendicitis (late)

Crohn’s Disease

Ovarian cyst/torsion

Ectopic pregnancy

Hernias

Renal colic

67
Q

List 6 examples of potential serious causes of hypogastric pain

A

Urinary retention

Cystitis (Inflammed bladder)

Uterine fibroid

Endometriosis

68
Q
A

Bioregulatory Systems: Upper GI Tract (13 decks)

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