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Y2 GASTRO > Abdominal Pain > Flashcards

Abdominal Pain Flashcards

1
Q

When taking a history from a patient presenting with abdominal pain, what 8 salient points about the pain will help you make the correct diagnosis?

A

SOCRATES
Site, onset, character, radiation, associated pain, time, exacerbating factors, severity

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2
Q

Name the 9 quadrants of the abdomen from left (patients right) to right and top to bottom

A

Right hypochondriac region, epigastric region, left hypochondriac region, right lumbar region, umbilical region, left lumbar region, right Iliac region, hypogastric region, left iliac region

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3
Q

What intra-abdominal organs produce pain in the right hypochondriac region?

A

Gallbladder and liver

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4
Q

What intra-abdominal organs produce pain in the epigastric region?

A

Stomach, duodenum and pancreas

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5
Q

What intra-abdominal organs produce pain in the left hypochondriac region?

A

Pancreas

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6
Q

What intra-abdominal organs produce pain in the right lumbar region?

A

Kidney

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7
Q

What intra-abdominal organs produce pain in the umbilical region?

A

Small bowel

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8
Q

What intra-abdominal organs produce pain in the left lumbar region?

A

Kidney

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9
Q

What intra-abdominal organs produce pain in the right iliac region?

A

Appendix and caecum

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10
Q

What intra-abdominal organs produce pain in the hypogastric region?

A

Bladder, uterus and adnexae (ovaries, fallopian tubes, and ligaments that hold the reproductive organs in place)

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11
Q

What intra-abdominal organs produce pain in the left iliac region?

A

Sigmoid colon

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12
Q

What are the three parts of the GI tract?

A

Foregut, midgut, hindgut

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13
Q

Which artery supplies the foregut

A

Celiac trunk

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14
Q

Which artery supplies the midgut?

A

Superior mesenteric artery

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15
Q

which artery supplies the hindgut?

A

Inferior mesenteric artery

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16
Q

The coeliac trunk, superior mesenteric artery and inferior mesenteric artery are all supplied by which blood vessel?

A

Abdominal aorta

17
Q

What type of main would you expect in kidney stones?

A

Colicky

18
Q

What type of pain is often produced by the liver?

A

Constant

19
Q

The spleen often causes colicky or constant pain?

A

Constant

20
Q

The kidney often produces which type of pain?

A

Constant

21
Q

What radiation of pain would you expect the gallbladder to produce?

A

Through to the back and to the right

22
Q

What radiation of pain would you expect the pancreas to produce?

A

Through to the back

23
Q

What radiation of pain would you expect the kidneys to produce?

A

In the loin and radiates to the right groin

24
Q

What radiation of pain would you expect from the small bowel?

A

Doesn’t normally radiate

25
Q

Left loin to groin pain can be indicative of what?

A

A ruptured aortic aneurysm

26
Q

What is the most likely diagnosis with the history of abdominal pain:

S Central then shifts to right iliac region
O Gradual onset
C Constant
R No radiation
A Nausea, anorexia, fever
T No previous pain
E Worse on movement
S Dull ache

A

Appendicitis

27
Q

What is the most likely diagnosis with the history of abdominal pain:

§ Central
O Gradual onset
C Colicky
R None
A Vomiting, bowels not open
IT Previous colicky pain
E Passing flatus relieves pain
S Moderate

A

Bowel obstruction

28
Q

What is the most likely diagnosis with the history of abdominal pain :

S Loin
O Sudden onset
C Colicky
R To groin
A Vomiting
Previous colicky pain
E Cannot find a comfortable position
S Severe - 10/10

A

Urteric colic

29
Q

What is the most likely diagnosis with the history of abdominal pain:

S Right upper quadrant
O Sudden onset
C Colicky
R Right shoulder
A Nausea, indigestion
T After eating
E Fatty foods
S Can be 10/10

A

Biliary colic / cholecystitis

30
Q

What GI structures make up the foregut?

A

Distal oesophagus -> proximal half of 2nd part of duodenum

31
Q

What GI structures make up the midgut?

A

Distal half of 2nd part of duodenum -> proximal 2/3 of transverse colon

32
Q

What GI structures make up the hindgut?

A

Distal 1/3 of transverse colon -> superior portion of rectum

33
Q

What is the visceral sensory innervation in the foregut?

A

T5-T9 - epigastrium

34
Q

What is the visceral sensory innervation in the midgut?

A

T10-T11 - umbilical

35
Q

What visceral sensory innervation is in the hindgut?

A

L1-L2 - hypogastrium

36
Q

Which nerve is responsible for sensory supply of the diaphragm? What other body part does it cover and what affect does this have?

A

Phrenic nerve (C3,4,5)
Covers the right shoulder so right shoulder can often be a site of refered pain

37
Q

Diaphragm and right shoulder pain are indicative of what?

A

Cholecystitis

38
Q

When does colicky pain from the bowel become constant?

A

When the bowel becomes ischaemic

39
Q

What is the difference in colicky pain in: Urteric colic, intestinal colic, biliary colic?

A

• ureteric colic - relatively frequent andvery intensepain
• intestinal colic - more frequent andless intensepain
• biliary ‘colic’ - patients describe as being constant as pain lasts a long time before it relaxes

Y2 GASTRO (10 decks)

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