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1. GI > Abdominal Pain > Flashcards

Abdominal Pain Flashcards

1
Q

What makes up the small intestine?

A

Duodenum (short)
Jejunum (long)
Ileum (long)

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2
Q

What makes up the large intestine (proximal to distal)?

A 
Colon
 - Caecum
 - Appendix
 - Ascending colon
 - Transverse colon
 - Descending colon
  - Sigmoid colon
Rectum
Anal canal
Anus
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3
Q

What are the abdominal organs of the foregut?

A

Oesophagus to mid-duodenum
Liver + gall bladder
Spleen
½ of pancreas

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4
Q

What are the abdominal organs of the midgut?

A

Mid-duodenum to proximal 2/3rds of Transverse colon

½ of pancreas

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5
Q

What are the abdomincal organs of the hindgut?

A

Distal 1/3rd of Transverse colon to Proximal ½ of Anal canal

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6
Q

What are the four quadrants?

A

Right Upper
Right Lower
Left Upper
Left Lower

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7
Q

What are the nine REGIONS?

A

Right Hypochondrium Epigastric Left Hypochondrium
Right Lumbar Umbilical Left Lumbar
Right Inguinal Pubic Left Inguinal

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8
Q

What is the role of the abdominal muscles?

A

contract to guard the abdominal organs when injury threatens

This guarding also occurs in peritonitis

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9
Q

What does the peritoneum line?

A

walls of the abdominopelvic cavity and organs

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10
Q

What does the parietal peritoneum line?

A

the body wall

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11
Q

What does the visceral peritoneum line?

A

the organs

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12
Q

What is the peritoneal cavity?

A

between the parietal and visceral peritoneum

contains a small amount of lubricating fluid

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13
Q

What will blood, pus, or faeces in the peritoneal cavity cause?

A

severe and painful inflammation of the peritoneum (peritonitis)

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14
Q

What are the three ways that organs are classed in the peritoneum?

A
  • intraperitoneal
  • retroperitoneal
  • with a mesentery
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15
Q

Describe intraperitoneal organs?

A

Almost completely covered in visceral peritoneum

Minimally mobile

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16
Q

Describe retroperitoneal organs?

A

Only has visceral peritoneum on its anterior surface

Located in the retroperitoneum

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17
Q

Describe organs with a mesentery?

A

Covered in visceral peritoneum
Visceral peritoneum wraps behind the organ to form a double layer – mesentery
Mesentery suspends the organ from the posterior abdominal wall – very mobile

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18
Q

What is a mesentery?

A

two layers of visceral peritoneum that wraps around and organ and meets at the end

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19
Q

Name the 5 intraperitoneal organs?

A 
Liver + gall bladder
Stomach
Spleen (not GI Tract- Lymphatic)
Parts of small intestine
Transverse colon
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20
Q

Name the 5 retroperitoneal organs?

A 
Kidneys (not GI Tract - Renal)
Adrenal gland (not GI Tract – Endocrine)
Pancreas
Ascending colon
Descending colon
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21
Q

What 3 formations occur during peritoneal formation?

A

Mesentery - Usually connects organ to posterior body wall

Omentum (Greater and Lesser) - Double layer of peritoneum that passes from stomach to adjacent organs

Peritoneal ligaments - Double layer of peritoneum connect organs to one another or body wall

22
Q

What is the role of the greater omentum?

A

moves to cover any pathology to try to stop it from spreading

23
Q

What is the role of the lesser omentum?

A

splits the visceral pleura into two sacs

24
Q

Describe the greater omentum?

A

Four-layered
Hangs like apron
Attaches the greater curvature of stomach to transverse colon

25
Q

Describe the lesser omentum?

A

Double-layered
Runs between lesser curvature of stomach and duodenum to liver
Has a free edge

26
Q

Name the 3 parts of the portal triad? Where does it lie?

A

hepatic artery
bile duct
portal venule

  • free edge of the lesser omentum
27
Q

What two ligaments does the lesser sac make up?

A

Hepatogastric ligament

Hepatoduodenal ligament

28
Q

What are the names of the two pouches that the peritoneum creates in a female?

A

Vesico-uterine pouch

Recto-uterine pouch (pouch of Douglas)

29
Q

What is the name of the pouch that the peritoneum creates in a male?

A

Rectovesical pouch

30
Q

What is the importance of the pouches made by the peritoneum?

A

can allow the drainage of excess fluid

31
Q

What is Ascites? and how can it be treated?

A

Fluid in the peritoneal cavity

paracentesis/Abdominocentesis

32
Q

What is Ascites commonly caused by?

A

liver disease

  • Cirrosis
  • Portal hypertension
33
Q

Where must the needle be placed in paracentesis? what does this avoid?

A

lateral to the rectus sheath

  • avoids the inferior epigastric artery
34
Q

Describe visceral pain?

A

from an organ

tends to be dull, achy and nauseating

35
Q

Describe somatic pain?

A

from the body wall

tends to be sharp and stabbing

36
Q

What is colicky pain?

A

pain comes and goes

37
Q

What nerves are in contact with the visceral peritoneum?

A

Visceral afferents (sensory nerves)

The enteric nervous system

The autonomic motor nerves

38
Q

What nerves are in contact with the parietal peritoneum?

A

(same nerves as the body wall that it is in contact with)

Somatic sensory nerves

Somatic motor nerves

Sympathetic nerve fibres

39
Q

Where do the sympathetic nerves NORMALLY come from? Where do they come from for the abdomen?

A

T1-L2

for the abdomen T5-L2

40
Q

How do sympathetic nerve fibres get from the CNS to the abdominal organs?

A

Leave the spinal cord between levels T5 and L2

Enter the sympathetic chains (bilaterally) but do not synapse

Leave the sympathetic chains within abdominopelvic splanchnic nerves

Synapse at prevertebral ganglia which are located anterior to the aorta at the exit points of the major branches of the abdominal aorta

Postsynaptic sympathetic nerve fibres pass from the prevertebral ganglia onto the surface of the arterial branches leaving the abdominal aorta

They take part in “periarterial plexuses” with other nerve fibres

41
Q

What is unique about the adrenal glands sympathetic nerve supply?

A

DO NOT synapse at prevertebral ganglia

42
Q

How does the parasympathetic nerve CNX (vagus nerve) reach the abdominal organs?

A

presynaptic parasympathetic nerve fibres enter abdominal cavity on surface of the oesophagus (“vagal trunks”)

travel into the periarterial plexuses around the abdominal aorta

carried to the walls of the organs where they synapse in ganglia

supply parasympathetic nerve fibres to the GI tract + abdominal organs up to the distal end of the transverse colon

43
Q

How does the parasympathetic nerve Pelvic Splanchnic Nerves (S2,3,4) reach the abdominal organs?

A

Presynaptic parasympathetic nerve fibres

smooth muscle/glands of the descending colon to anal canal

44
Q

What region does foregut pain present?

A

epigastric

45
Q

What region does midgut pain present?

A

umbilical

46
Q

What region does hind gut pain present?

A

pubic region

47
Q

At what vertebral level do visceral afferents corresponding to the foregut structures leave?

A

T6-T9

48
Q

At what vertebral level do visceral afferents corresponding to the midgut structures leave?

A

T8-T12

49
Q

At what vertebral level do visceral afferents corresponding to the hindgut structures leave?

A

T10-L2

50
Q

What is referred pain?

A

pain from organs tends to be perceived by the patient in the dermatomes of the levels at which the visceral afferents for that organ enter the spinal cord
- ie pain of an organ is translated to body wall pain

1. GI (61 decks)

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