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Year 2 Gastro > Abdominal pain > Flashcards

Abdominal pain Flashcards

(61 cards)

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1
Q

What do most intra-abdominal diseases present with?

A

Pain alon

Careful Hx never waster

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2
Q

What are the two most significant properties of pain?

A

Site and Character

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3
Q

What is SOCRATES?

A 
Site
Onset
Character
Radiation
Associations
Time
Exacerabating/Relieving factors
Severity
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4
Q

What are the different natures of pain?

A 
Burning
Throbbing
Stabbing
Constricting
Colicky
Aching
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5
Q

What are the abdomino-pelvic regions?

A 
R + L Hypochondriac
R+L Lumbar
R+L Illiac
Epigastric
Umbilical 
Suprapubic/Hypogastric
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6
Q

What are the 4 abdomino pelvic quadrants?

A

RUQ
LUQ
RLQ
LLQ

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7
Q

What are the different planes in the abdomen?

A 
Transpyloric
Subcostal
Supracristal
Intertubercular
Interspinous
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8
Q

At what level is the Transpyloric plane?

A

L1

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9
Q

What does the Transpyloric plane cut across?

A 
Pylorus of Stomach
Neck of Pancreas
Fundus of Gallbladder
Renal Hilum
Duodenojejunal Flexure
End of Spinal Cord (adult)
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10
Q

At what level is the subcostal plane?

A

L3

Over origin of the IMA

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11
Q

At what level is the supracristal plane?

A

L4

Over bifurcation of the Aorta

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12
Q

What comprises the foregut?

A

Distal oesophagus → proximal half of 2nd part of duodenum

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13
Q

What comprises the midgut?

A

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

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14
Q

What comprises the hindgut?

A

Distal 1/3 of transverse colon → rectum

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15
Q

What are the two causes of the most painful abdominal pain?

A

Inflammation

Obstruction of muscular tube

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16
Q

What are the features of pain caused by inflammation?

A

Constant pain (‘aching’)
Made worse by movement
Persists until inflammation subsides

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17
Q

What are the features of pain caused by tube obstruction?

A 
Colicky pain (‘gripping’)
Fluctuates in severity
Move to try and get comfortable
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18
Q

What does prolonged obstruction of a hollow viscus cause?

A

Distension
Constant stretching pain
Different from ache of inflammation & not colicky

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19
Q

Where does pain associated with the gallbladder radiate?

A

Through to the back & the right

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20
Q

Where does pain associated with the stomach, duodenum and pancreas radiate?

A

Straight through to the back

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21
Q

Where does pain associated with the tail of the pancreas radiate?

A

Through to the back & the left

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22
Q

What is found in the right hypochondriac region?

A

Gallbladder

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23
Q

What is found in the epigastric region?

A

Stomach, duodenum and pancreas

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24
Q

What is found in the left hypochondriac region?

A

Tail of the pancreas

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25
What is found in the right lumbar region?
Kidney
26
What is found in the umbilical region?
Small bowel Caecum Retroperitoneal structures
27
What is found in the left lumbar region?
Kidney
28
What is found in the right illiac region?
Appendix & caecum
29
What is found in the leftt illiac region?
Sigmoid colon
30
What is found in the suprapubic area?
Tx colon Bladder Uterus & adnexae
31
What is the parietal peritoneum?
Lining of the abdominal wall
32
What is the visceral peritoneum?
Covers organs and hollow structures
33
What is the sensory nerves to the visceral peritoneum?
Coelic plexus - foregut Superior mesenteric plexus - midgut Inferior mesenteric plexus - hindgut Vagus - non-specific
34
What is the sensory innervation to the parietal peritoneum?
Segmental via spinal nerves
35
What is pain in the gut and right shoulder associated with?
Phrenic
36
What is visceral innervation?
Autonomic Sympathetic – T1 – T12, L1,L2 Parasympathetic – CN III, VII, IX, X, S2 - 4
37
What is the character if visceral pain?
Dull, crampy, burning
38
What is the character of parietal pain?
Sharp, ache
39
What organs are associated with colicky pain?
Ureter - kidney stones Gallbladder - biliary system Small Bowel
40
What organs are associated with constant pain?
Kidney Spleen Liver
41
Where would kidney pain radiate?
In loin & radiates to groin
42
What is typical of uretic colic pain?
Severe pain intensity that slowly fluctuates
43
What is typical of biliary 'colic'?
Comes and goes quickly | But lasts persistently
44
What is typical of intestinal colic?
Less severe Moderate-mild More frequent
45
Where does lower abdominal pain radiate?
Lower abdominal pain rarely radiates | Pain from structures deep in the pelvis referred to lower back/perineum
46
What are general features of pain radiation?
Colicky abdominal pain is referred to the centre (Visceral sensation) Pain from parietal inflammation felt over inflamed area (Somatic sensation) When pain radiates it signifies other structures are becoming involved Small bowel pain doesn’t radiate but may move when somatic as well as visceral nerves become irritated
47
What causes RUQ pain?
Gallstones Cholangitis Hepatitis Liver abscess
48
What causes LUQ pain?
Splenic abscess Acute splenomegaly Splenic rupture
49
What causes RLQ pain?
``` Appendicitis Crohn’s Disease Ovarian cyst/torsion Ectopic pregnancy Hernias Renal colic ```
50
What causes LLQ pain?
``` Diverticulitis Ulcerative colitis Constipation Ovarian cyst/torsion PID Ectopic pregnancy Hernias Renal colic ```
51
What causes umbilical pain?
Appendicitis (early) Mesenteric adenitis Meckel’s diverticulitis
52
What causes epigastric pain?
``` Oesophagitis Peptic ulcer Perforated ulcer Pancreatitis Biliary tract disease ```
53
What causes suprapubic pain?
Urinary retention Cystitis Uterine fibroid Endometriosis
54
What causes right lumbar pain?
Renal colic Pyelonephritis Ovarian cyst Ovarian mass Ovarian torsion
55
What causes left lumbar pain?
Renal colic Pyelonephritis Ovarian cyst Ovarian mass Ovarian torsion
56
How might a patient with appendicitis present?
``` Central then shifts iliac Gradual Constant pain No radiation Nausea, anorexia, fever Furry tongue and ketotic smell No previous pain Worse on movement Dull ache ```
57
How might a patient with a bowel obstruction present?
``` Central pain Gradual onset Colicky No radiation Vomiting, bowels not open Previous colicky pain Passing flatus relieves pain Moderate severity ```
58
How might a patient with uteric colic present?
``` Loin pain Sudden onset Colicky Radiating to groin Vomiting Previous colicky pain Cannot find comfortable position 10 severity ```
59
How might a patient biliary with present?
``` Right upper quadrant Sudden onset Colicky Right shoulder radiation Nausea, indigestion After eating Fatty foods Can be 10/10 severity ```
60
What is the most common form of bowel obstruction?
Adhesions post-surgery or congenital Fibrotic tissue in abdomen Scar tissue If forms closed loop has a great chance of becoming ischameic
61
Why is biliary colic pain worse after eating?
Particularly fatty foods | CCK signals for bile to be released

Year 2 Gastro (10 decks)

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