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Y2 BRS (Haroop) > 6.4 Abdominal Pain > Flashcards

6.4 Abdominal Pain Flashcards

1
Q

What is the level of the transpyloric plane?

A

L1

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2
Q

Which structures pass through the transpyloric plane?

A
  • First lumbar vertebrae (L1)
  • Pylorus of stomach
  • Neck of pancreas
  • Fundus of gallbladder
  • Renal hilum
  • Duodenojejunal flexure
  • End of spinal cord
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3
Q

What is the interspinous plane?

A

Horizontal plane through the anterior superior iliac spines, marking the boundary of the umbilical region superiorly and the hypogastric region.

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4
Q

At what vertebral level is the supracristal plane?

A

L4

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5
Q

At what level does the abdominal aorta bifurcate?

A

L4

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6
Q

What happens at the supracristal plane?

A

Supracristal plane: Horizontal plane through the iliac crest at the L4 vertebral level.
• Passes through the umbilical and left/right lumbar regions.
• Used to divide the lower and upper abdominal quadrants.
• Level at which the abdominal aorta bifurcates into the left and right common iliac artery.

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7
Q

At what level does the subcostal plane exist?

A

L3

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8
Q

What is the subcostal plane?

A

Subcostal plane: Transverse plane which bisects the body at the level of the 10th costal margin, and the vertebra body L3.

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9
Q

What vertebral level is the origin of the inferior mesenteric artery?

A

L3

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10
Q

What are the 9 abdominal regions?

A 
Right and left hypochondriac
Epigastric
Right and left lumbar
Umbilical 
Right and left iliac region 
Hypogastric
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11
Q

In which abdominal region does the gallbladder reside in?

A

Right hypochondriac region

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12
Q

What structures are associated with the epigastric region?

A

Stomach, duodenum and pancreas

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13
Q

Which structure is associated with the left hypochondriac region?

A

Pancreas

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14
Q

The kidneys are associated with which two abdominal regions?

A

Right and left lumbar regions

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15
Q

Which structures are associated with the umbilical region of the abdomen?

A

Small bowel
Caecum
Retroperitoneal structures

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16
Q

Which structure is associated with the right iliac region?

A

Appendix and caecum

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17
Q

Which structures are associated with the hypogastric region?

A

Transverse colon
Bladder
Uterus and adenxa

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18
Q

The sigmoid colon is associated with which abdominal region?

A

Left iliac region

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19
Q

What forms the foregut?

A

The distal oesophagus till the proximal half of the 2nd part of the duodenum

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20
Q

What supplies the foregut?

A

Coeliac trunk

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21
Q

What are the three main branches of the coeliac trunk?

A

Left gastric, common hepatic and splenic artery

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22
Q

What forms the midgut

A

Distal half of 2nd part of duodenum Proximal 2/3 of transverse colon.

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23
Q

What supplies the midgut?

A

The superior mesenteric artery

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24
Q

What forms the hindgut?

A

Distal 1/3 of transverse colon till the rectum

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25
Q

What supplies the hindgut?

A

The inferior mesenteric artery

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26
Q

What lines the abdominal and pelvic cavities?

A

Parietal peritoneum

27
Q

What lines the external surfaces of the abdominal organs?

A

Visceral peritoneum

28
Q

Which nerves arise from the coeliac plexus?

A

The greater and lesser splanchnic nerves

29
Q

What is the innervation of the midgut?

A

Superior mesenteric plexus

30
Q

What is the innervation of the hindgut?

A

Inferior mesenteric plexus

31
Q

What are the nerve roots for the parasympathetic innervation of the bladder?

A

Pelvic nerves (S2-S4)

32
Q

Which nerve innervates the gastrointestinal tract?

A

Vagus nerve

33
Q

Which nerve innervates the diaphragm?

A

The phrenic nerve

34
Q

What are the nerve roots of the phrenic nerve?

A

C3-5

35
Q

Where does referred pain from the phrenic nerve go to?

A

Radiates to the shoulder

36
Q

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

A

Visceral is autonomic whereas parietal is somatic

37
Q

What are sympathetic nerve roots of the visceral peritoneum?

A

T1-T12

L1-2

38
Q

What is the parasympathetic roots of the visceral peritoneum,?

A

IX, X, III, VII and S2-4

39
Q

What is the character of pain regarding the visceral peritoneum?

A

Dull, crampy and burning

40
Q

What is the site of pain with the visceral peritoneum?

A

Embryological in origin

41
Q

What is the site of pain for parietal peritoneum?

A

Well-localised

42
Q

What is the character of pain for parietal peritoneum?

A

Sharpe, ache

43
Q

What is the innervation for sensation of the foregut?

A

T5-T9

44
Q

What is the innervation for sensation of the midgut?

A

T10-T11

45
Q

What is the innervation for sensation of the hindgut?

A

L1-L2

46
Q

What is the site of pain for the foregut?

A

Epigastrium

47
Q

What is the site of pain for the midgut?

A

Umbilical

48
Q

What is the site of pain for the Hindgut?

A

Hypogastrium

49
Q

How is pain by inflammation characterised?

A
  • Constant pain (aching)
  • Made worse by movement
  • Persists until inflammation subsides + associated with somatic sensation.
50
Q

How is pain characterised by obstruction?

A
  • Colicky pain (gripping)
  • Fluctuates in severity
  • Move to try and get comfortable
51
Q

What is the consequence of prolonged obstruction of a hollow viscus?

A

Can cause distention- constant stretching pain, that is different from inflammation and not colicky

There is a risk of ischaemia

52
Q

What is the definition of colicky pain?

A

Colicky pain describes an intermittent form of pain that begins and stops abruptly due to muscular contractions of a hollow tube in an attempt to relieve the obstruction

53
Q

Which structures are associated with colicky pain?

A
  • Colon
  • Gall bladder
  • Ureter
54
Q

What is colicky pain associated with?

A

Accompanied by sweating and vomiting + visceral sensation (referred centre)

55
Q

How is ureteric colic pain characterised?

A

Associated with intense and fluctuating pain

56
Q

How is biliary colic pain characterised?

A

Refers to constant intense pain for a prolonged period of time until relaxing

57
Q

How is intestinal colic pain characterised?

A

• Intestinal colic refers to frequent contractions of pain, although the intensity of pain is comparatively less.

58
Q

Where does gallbladder related pain radiate to?

A

Through to the back and the right

59
Q

Where does epigastric related pain radiate to?

A

Straight through to the back

60
Q

Where does pancreas related pain radiate to?

A

Through to the back and the left

61
Q

Where does kidney related back radiate to?

A

Loin radiates to the groin

62
Q

Where does umbilical related pain typically radiate to?

A

No radiation

63
Q

Describe the radiation pattern of pain for lower abdominal pain?

A

Pain originating from structure deep within the pelvis is referred to the lower back/perineum.

N/B: Minimal radiation

Y2 BRS (Haroop) (62 decks)

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