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!!!!! BRS YR2 !!!!! > Gastro - Abdominal Pain > Flashcards

Gastro - Abdominal Pain Flashcards

(73 cards)

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1
Q

What does SOCRATES stand for?

A 
S = site 
O = net 
C = character 
R = radiation 
A = associations 
T = time course, duration 
E = exacerbating / relieving factors 
S = severity
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2
Q

What is region 1 of the 9 quadrants?

A

right hypochondriac region

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3
Q

What is region 2 of the 9 quadrants?

A

epigastric region

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4
Q

What is region 3 of the 9 quadrants?

A

left hypochondriac region

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5
Q

What is region 4 of the 9 quadrants?

A

right lumbar (flank) region

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6
Q

What is region 5 of the 9 quadrants?

A

umbilical region

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7
Q

What is region 6 of the 9 quadrants?

A

left lumbar (flank) region

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8
Q

What is region 7 of the 9 quadrants?

A

righth iliac region

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9
Q

What is region 9 of the 9 quadrants?

A

left iliac region

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10
Q

What is region 8 of the 9 quadrants?

A

suprapubic / hypogastric region

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11
Q

What is the blood supply for the foregut?

A

celiac trunk

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12
Q

What planes are used to divide the abdomen into 9 regions?

A
  • subcostal plane (horizontal)
    (corresponds to a line drawn joining the lower most bony point of the rib cage, usually 10th costal cartilage)
  • transtubercular plane (horiz)
    (corresponds to a line uniting the two tubercles of the iliac crests)
  • mid-clavicular lines (vertical)
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13
Q

What vertebra does the transpyloric plane pass through?

A

L1

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14
Q

What organs of the abdomen are present at the transpyloric plane?

A
  • Pylorus of Stomach
  • Neck of Pancreas
  • Fundus of Gallbladder
  • Renal Hilum
  • Duodenojejunal Flexure
  • End of Spinal Cord (adult)
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15
Q

What vertebra does the subcostal plane pass through?

A

L3

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16
Q

What parts of the abdomen are present at the subcostal plane?

A

origin of inferior mesenteric artery

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17
Q

What vertebra does the supracristal plane pass through?

A

L4

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18
Q

What parts of the abdomen are present at the supracristal plane?

A

bifurcation of aorta

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19
Q

What organs are present in the right hypochondriac region?

A

gall bladder

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20
Q

What organs are present in the epigastric region?

A

stomach, duodenum + pancreas

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21
Q

What organs are present in the left hypochondriac region?

A

pancreas
spleen

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22
Q

What organs are present in the right lumbar / flank region?

A

kidney

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23
Q

What organs are present in the umbilical region?

A

small bowel
caecum
retroperitoneal structures

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24
Q

What organs are present in the left lumbar / flank region?

A

kidney

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25
What organs are present in the right iliac region?
appendix caecum
26
What organs are present in the suprapubic (hypogastric) region?
transverse colon bladder uterus adnexae
27
What organs are present in the left iliac region?
sigmoid colon
28
What is a part of the foregut?
distal oesaphagus stomach liver gall bladder spleen proximal half of the 2nd part of duodenum
29
What is the blood supply for the hindgut?
inferior mesenteric trunk
30
What is a part of the midgut?
distal half of 2nd part of duodenum --\> proximal 2/3 of transverse colon
31
What is the blood supply for the midgut?
superior mesenteric artery
32
What is included in the hindgut?
distal 1/3 of transverse colon --\> rectum
33
What is the parietal peritoneum?
membranous sheet that lines abdominal cavity, attached to to the visceral peritoneum to form peritoneal cavity
34
What is visceral peritoneum?
membranous sheet that lines the organs within the peritoneal cavity
35
Which organs are intraperitoneal?
stomach spleen liver first and fourth parts of the duodenum jejunum ileum transverse colon sigmoid colon
36
Which organs are retroperitoneal?
rest of the duodenum ascending colon descending colon middle third of rectum pancreas
37
What is the innervation of the parietal?
somatic phrenic nerves T6-L3
38
What is the innervation of the visceral?
autonomic Sympathetic – T1 to T12, L1, L2 Parasympathetic – CN III, VII, IX, X, S2 to S4
39
What is the site of pain like for parietal?
well-localised
40
What is the site of pain like for visceral?
embryological origin
41
What is the character of pain like for parietal?
sharp, ache
42
What is the character of pain like for visceral?
dull, crampy, burning
43
What is the innervation for the foregut?
T5-T9
44
What is the innervation of the midgut?
T10-T11
45
What is the innervation of the hindgut?
L1-L2
46
Where is the site of pain for the foregut?
epigastrium
47
Where is the site of pain for the midgut?
umbilical
48
Where is the site of pain for the hindgut?
hypogastric
49
What are the 2 categories of pain usually?
inflammation - based obstruction of a muscular tube
50
What kind of pain does inflammation present with?
Constant pain (‘aching’) Made worse by movement Persists until inflammation subsides
51
What kind of pain does obstruction present with?
``` Colicky pain (‘gripping’) Fluctuates in severity Move to try and get comfortable ```
52
What does prolonged obstruction cause?
causes distension: Constant stretching pain Different from ache of inflammation & not colicky ischaemia
53
What organs + problems present with constant pain?
liver + gall bladder kidney issues spleen
54
What organs + problems present with colicky pain?
kidney stones, etc. cholelithiasis hepatolithiasis choledocholithiasi biliary colic small bowel + large bowel issues
55
What is the character of pain like for ureteric, biliary + intestinal colic?
56
How does pain radiate when in the right hypochondriac region? Target Organ?
through the back + to the right | (gall bladder)
57
How does pain radiate when in the epigastric region? Target Organ?
straight through the back | (stomach, duodenum, pancreas)
58
How does pain radiate when in the left hypochondriac region? Target Organ?
through to the back + to the left | (pancreas)
59
How does pain radiate when in the right and left lumbar regions? Target Organs?
in the loin and radiates to the groin | (kidneys)
60
How does pain radiate in the umbilical region? target organs?
doesn't normally radiate unless small bowel is consistently inflamed | (small bowel, caecum, retroperitoneal structures)
61
How does pain radiate in the iliac and hypogastric regions?
Lower abdominal pain rarely radiates Pain from structures deep in the pelvis referred to lower back/perineum
62
What region of the abdomen does colicky abdominal pain refer to?
visceral sensation
63
Where do you usually feel pain from an inflamed area? Why?
felt over the inflamed area, due to somatic sensation
64
What does radiation of pain to other regions usually signify?
other structure are getting involved
65
Why might small bowel pain move?
pain doesn’t radiate but may move when somatic as well as visceral nerves become irritated
66
What disorders could pain in the RUQ represent?
Gallstones Cholangitis Hepatitis Liver abscess
67
What disorders could pain in the epigastric region represent?
Oesophagitis Peptic ulcer Perforated ulcer Pancreatitis Biliary tract disease
68
What disorders could pain in the LUQ represent?
Splenic abscess Acute splenomegaly Splenic rupture
69
What disorders could pain in the right + left flanks represent?
Renal colic Pyelonephritis Ovarian cyst Ovarian mass Ovarian torsion
70
What disorders could pain in the umbilical region represent?
Appendicitis (early) Mesenteric adenitis Meckel’s diverticulitis
71
What disorders could pain in the RLQ represent?
Appendicitis (late) Crohn’s Disease Ovarian cyst/torsion Ectopic pregnancy Hernias Renal colic
72
What disorders could pain in the LLQ represent?
Diverticulitis Ulcerative colitis Constipation Ovarian cyst/torsion PID Ectopic pregnancy Hernias Renal colic
73
What disorders could pain in the hypogastric region represent?
Urinary retention Cystitis Uterine fibroid Endometriosis

!!!!! BRS YR2 !!!!! (72 decks)

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