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Gastro 2 > Abdominal pain > Flashcards

Abdominal pain Flashcards

1
Q

What organ is in the right hypochondriac region?

A

Gallbladder

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2
Q

What organs are in the epigastric region?

A

-Stomach
-Duodenum
-Pancreas

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3
Q

What organ is in the left hypochondriac region?

A

Pancreas

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4
Q

What organ is in the right lumbar region?

A

Kidney

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5
Q

What organs are in the umbilicus region?

A

-Small bowel
-Caecum
-Retroperitoneal structures

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6
Q

What organ is in the left lumbar region?

A

Kidney

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7
Q

What organs are in the right iliac region?

A

-Appendix
-Caecum

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8
Q

What are the organs in the suprapubic region?

A

-Transverse colon
-Bladder
-Uterus
-Adnexae

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9
Q

What organ is in the left iliac region?

A

Sigmoid colon

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10
Q

What level is the transpyloric plane?

A

L1

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11
Q

What organ structures are found in the transpyloric plane?

A

-Pylorus of stomach
-Neck of pancreas
-Fundus of gallbladder
-Renal hilum of left kidney
-Duodenojejunal flexure
-End of spinal cord in adult

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12
Q

Why is the right kidney renal hilum not at L1 too?

A

The right kidney is pushed down a bit by the liver

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13
Q

What level is the subcostal plane?

A

L3

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14
Q

What structure is found in the subcostal plane?

A

Origin of inferior mesenteric artery

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15
Q

What level is the supracristal plane?

A

L4

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16
Q

What structure is found in the supracristal plane?

A

Bifurcation of aorta

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17
Q

What does the foregut consist of?

A

Distal oesophagus to the proximal half of second part of duodenum

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18
Q

What innervates pain in the foregut?

A

T5-T9

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19
Q

Where is the site of pain for the foregut?

A

Epigastrium

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20
Q

What does the midgut consist of?

A

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

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21
Q

What innervates pain in the midgut?

A

T10 and T11

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22
Q

Where is the site of pain for the midgut?

A

Umbilicus

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23
Q

What does the hindgut consist of?

A

Distal 1/3 of transverse colon to the rectum

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24
Q

What innervates pain in the hindgut?

A

L1 and L2

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25
Q

Where is the site of pain for the hindgut?

A

Suprapubic region

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26
Q

What is the parietal peritoneum?

A

-Covering abdominal wall anteriorly
-Covering abdominal cavity posteriorly

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27
Q

What is the visceral peritoneum?

A

-Peritoneum covering organs
-Liver peritoneum, colon peritoneum

28
Q

What are 2 examples of retroperitoneal structures?

A

-Pancreas
-Duodenum

29
Q

What nerve supplies the parietal peritoneum?

A

Phrenic nerves supply sensation from central tendon to diaphragm (C3, C4, C5)

30
Q

What does C3 and C5 also innervate?

A

Right shoulder so patients can present with right shoulder pain if something is happening with their diaphragm

31
Q

What is the parasympathetic nervous supply to the visceral peritoneum?

A

-Vagus nerve
-S2-S4

32
Q

What is the sympathetic nervous supply to the visceral peritoneum?

A

-Sympathetic chain form T1-T12
-Sympathetic chain from L1-L2

33
Q

What is the character of the pain from visceral peritoneum?

A

Dull, crampy and burning pain

34
Q

What is the character of the pain from the parietal peritoneum?

A

Sharp, ache

35
Q

What are the 2 main categories of pain?

A

-Inflammation
-Obstruction of a muscular tube

36
Q

What kind of pain does inflammation cause?

A

-Constant aching pain
-Worse on movement
-Persists until inflammation subsides

37
Q

What kind of pain does obstruction of muscular tube cause?

A

-Colicky gripping pain
-Fluctuates in severity
-Patient moves to try and get comfortable

38
Q

What does a constant stretching pain mean?

A

-Prolonged obstruction of a hollow organ in the body that has caused distension
-May be impending ischaemia

39
Q

What is the character of pain for the ureter?

A

Colicky

40
Q

What is the character of pain for the liver?

A

Constant
(liver hepatitis/ liver abscess)

41
Q

What is the character of pain for a biliary colic?

A

Colicky

42
Q

What is the character of pain for the spleen?

A

Constant
(splenic abscess/ splenic rupture)

43
Q

What is the character of pain for the kidney?

A

Constant
(pyelonephritis/ abscess)

44
Q

What is the character of pain for the small/large bowel?

A

Colicky

45
Q

Where does gallbladder pain radiate?

A

To the back and right (50% of cases)

46
Q

Where does pancreatic and duodenal pain radiate?

A

Straight through to the back as these structures are retroperitoneal

47
Q

How do people present with a pancreatic cancer?

A

Back pain because tumour infiltrates posteriorly

48
Q

What position do pancreatic cancer patients feel better in?

A

-Sitting up and leaning forward
-Abdominal viscera isn’t pushing against pancreas

49
Q

Where does the tail of pancreas pain radiate?

A

Through to back and left

50
Q

Where does kidney pain radiate?

A

Loin to groin (following ureter)

51
Q

Where dies small bowel, caecum, retroperitoneal structures pain radiate to?

A

Don’t normally radiate as they are visceral

52
Q

What organ can abdominal aortic aneurysm implicate?

A

Left kidney

53
Q

What can people presenting with AAA present regarding left kidney pain?

A

Describe left ureteric colicky pain

54
Q

What are the lower zone organs?

A

-Appendix
-Caecum
-Bladder
-Transverse colon
-Uterus
-Adnexae
-Sigmoid colon

55
Q

Where does lower zone organ pain radiate?

A

-Rarely radiates

56
Q

Where is pain from deep in the pelvis referred?

A

Lower back/perineum

57
Q

What is an example of visceral sensation in the abdomen?

A

Colicky abdominal pain that is referred to the centre

58
Q

What is an example of somatic sensation in the abdomen?

A

Pain from parietal inflammation is felt over the inflamed area

59
Q

What does radiation of pain signify?

A

Involvement of other structures

60
Q

Does small bowel pain usually radiate?

A

No

61
Q

When can small bowel pain radiate?

A

When somatic and visceral nerves become irritated

62
Q

What is mesenteric adenitis?

A

-Inflammatory process with bowel
-Get reactive lymph nodes that cause pain

63
Q

What can mesenteric adenitis be mistaken for?

A

Acute appendicitis

64
Q

What can cause mesenteric adenitis be caused by?

A

Transient viral infection

65
Q

What is Meckel’s diverticulitis?

A

-Outpouching of small bowel that causes inflammation
-Can contain ectopic pancreatic/gastric tissue
-Very non-specific and rare

66
Q

What is cholelithiasis?

A
  1. Stone gets caught in cystic duct
  2. Bile can’t get in and out
  3. Lining of gallbladder keeps producing mucus
  4. Mucus pools and gets infected
  5. Causes localised pain not radiating= Murphy’s sign
67
Q

What is Murphy’s sign?

A

-Palpation of RUQ while patient takes a deep breath in

  • result: normal breath
    + result: interrupted breath due to pain

Gastro 2 (11 decks)

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