Abdominal pain

Question 1

What structures are in the transpyloric plane L1 (6)

Answer 1

1. Pylorus of Stomach
2. Neck of Pancreas
3. Fundus of Gallbladder
4. Renal Hilum
5. Duodenojejunal Flexure
6. End of Spinal Cord (adult)

Question 2

what structures are in the subcostal plane? L3

Answer 2

origin of IMA (3 letters = L3)

Question 3

what structures are in the supracritsal plane? L4

Answer 3

bifurcation of the aorta (L4 for 4 chambers of the heart)

Question 4

what organ corresponds to pain in the right hypochondriac region?

Answer 4

gallbladder

Question 5

which organs corresponds to pain in the epigastric region?

Answer 5

stomach, duodenum, pancreas

Question 6

what organ corresponds to pain in the left hypochondriac region?

Answer 6

pancreas

Question 7

what organ corresponds to pain in the right lumbar region?

Answer 7

kidney

Question 8

what organ corresponds to pain in the left lumbar region?

Answer 8

kidney

Question 9

which organs corresponds to pain in the umbilical region?

Answer 9

• small bowel
  caecum
• retroperitoneal structures

Question 10

which organs corresponds to pain in the right iliac region?

Answer 10

appendix and caecum

Question 11

which organs corresponds to the hypogastric region of the abdomen?

Answer 11

• Tx colon
• Bladder
• Uterus and adnexae

Question 12

which organs corresponds to pain in the left iliac region?

Answer 12

sigmoid colon

Question 13

does small bowel pain usually radiate?

Answer 13

no

-> moves when somatic and when visceral nerves are irritated

Question 14

innervation to visceral peritoneum from ?

Answer 14

T6 -> L3
Vagus nerve
S2-S4

Question 15

innervation to parietal peritoneum from ?

Answer 15

T6-> L3

phrenic nerves

Question 16

character of visceral pain?

Answer 16

dull, crampy, burning

Question 17

character of parietal pain?

Answer 17

sharp, ache

Question 18

innervation of sensation to foregut from?

Answer 18

T5 -> T9

Question 19

innervation of sensation to midgut from?

Answer 19

t10->t11

Question 20

innervation of sensation to HINDgut from?

Answer 20

L1-L2

Question 21

where is the site of foregut pain?

Answer 21

epigastrium

Question 22

where is the site of midgut pain?

Answer 22

umbilical

Question 23

where is the site of hindgutpain?

Answer 23

hypogastrium

Question 24

the two most painful abdomen conditions

Answer 24

1. inflammation

2. obstruction of a muscular tube

Question 25

features of inflammation pain

Answer 25

- constant pain - worse by movement - persists until inflammation subsides

Question 26

features of obstruction of a muscular tube

Answer 26

- colicky pain - fluctuates in severity - move to try and get comfy

Question 27

pain caused by prolonged obstruction of a hollow viscus causing distension:

Answer 27

- constant stretching pain | - different rom ache of inflammation and not colicky

Question 28

organs which present with colicky pain

Answer 28

1. kidneys - stones 2. gall bladder- stones 3. intestines (obstruction)

Question 29

organs which present with constant pain

Answer 29

1. liver 2. spleen 3. kidney

Question 30

how does gall bladder pain radiate (upper zone)

Answer 30

through to the back and right

Question 31

how does pancreas pain radiate (upper zone)

Answer 31

through to the back and left

Question 32

how does stomach, duodenum and pancreas pain radiate (upper zone)

Answer 32

straight through to the back

Question 33

how does kidney pain radiate (central zone)

Answer 33

in loin and radiates to groin

Question 34

how does small bowel, caecum and retroperitoneal structure pain radiate (central zone)

Answer 34

doesn't normally

Question 35

how does lower zone pain radiate?

Answer 35

- rarely radiates | inc structures like sigmoid colon, transverse colon, bladder, uterus, adnexae, appendix and caecum

Question 36

What can pain in the right hypochondriac indicate?

Answer 36

Gallstones Cholangitis Hepatitis Liver abscess

Question 37

What can pain in the epigastric region indicate?

Answer 37

``` Oesophagitis Peptic ulcer Perforated ulcer Pancreatitis Biliary tract disease ```

Question 38

What can pain in the left hypochondriac indicate?

Answer 38

Splenic abscess Acute splenomegaly Splenic rupture

Question 39

What can pain in the left lumbar indicate?

Answer 39

``` Renal colic Pyelonephritis Ovarian cyst Ovarian mass Ovarian torsion ```

Question 40

What can pain in the umbilical region indicate?

Answer 40

Appendicitis (early) Mesenteric adenitis (often affects lymph nodes) Meckel's diverticulitis

Question 41

What can pain in the right lumbar indicate?

Answer 41

``` Renal colic Pyelonephritis Ovarian cyst Ovarian mass Ovarian torsion ```

Question 42

What can pain in the right iliac indicate?

Answer 42

``` Appendicitis (late) Crohn's disease Ovarian cyst/torsion Ectopic pregnancy Hernias Renal colic ```

Question 43

What can pain in the hypogastrium indicate?

Answer 43

Urinary retention Cystitis Uterine fibroid Endometriosis

Question 44

What can pain in the left iliac indicate?

Answer 44

``` Diverticulitis Ulcerative colitis Constipation Ovarian cyst/ torsion PID Ectopic pregnancy Hernias Renal colic ```